Thank you, Fred for commenting so quickly on this article. As soon as I read it, I was hoping you would have a response as always I look for your views on this topic and un education again thanks.
Here’s what’s strange: if you look at the Readers’ Picks for comments on that article, nearly all of them criticize it. Here are just a few examples:
- "This is so incredibly irresponsible that I don’t even know where to begin."
- "The hubris displayed by Ms. Delano and her spouse is infuriating. The treatment approach that worked for this Harvard-educated individual—who likely has strong financial and social support—does not work for many people with severe mental illness."
- "Any time someone is glorified online for 'their' reason (read: cure), they seek more validation by having others follow suit. This is a very disturbing trend."
So, rather than catering to its audience, is the NYT just engaging in clickbait journalism?
I remember that piece. Psychiatry finally housed him AFTER it tortured him for years, moving him from one curb to the next, one cage to the next. People like you never ask what may have happened to him, if he had been permanently housed in a TIMELY manner.
I find sorting comments by Readers Picks to be reassuring nearly every time the Times runs some insane, utterly out of touch article like this one. The readers—often hundreds of them—never agree with these extreme pieces.
I honestly think this might be it. The lure of the clickbait is strong
Highbrow publications often also profile “society” couples who are financially irresponsible, and the editors and journalists must know how much it angers their readership who have to work hard to pay the bills every month. But it gets clicks and shares!
Worth bearing in mind that people with actual skin in the game - patients, their loved ones, psychiatrists - are probably more likely to click on an article about mental health. And also to know what the fuck they're talking about.
The affluent lib version of the anti-psychiatry movement makes a lot more sense when you consider that their reference point for mental illness is ADHD, or mild anxiety, or some other neurosis that minimally impacts people's lives.
I agree with them that children with ADHD should not be medicated as a first line of treatment, but it's insane to extrapolate this argument to disorders like bipolar, or schizophrenia.
Partly diagnosis and self identity have gotten so sloppy that a bunch of people think they know what bipolar disorder is based off friends that never would've been diagnosed by a responsible psychiatrist. See Freddie's article from a couple months back about "rapid cycling" bipolar, or all the "my bipolar friend isn't antisemitic, so obviously Kanye is choosing to be a horrible person" tweets.
I’m flabbergasted that someone could think ADHD/ADD minimally impacts someone’s life. I was diagnosed with ADD (no hyperactivity) in 7th grade (1989). I immediately started medication and it absolutely changed the course of my life for the better. I still use medication to this day.
I've run into this in my personal life when discussing mental illness as both a patient with and a family member of bipolar 1. There's a lot of people with various mental health problems in their teens that are not really responsive to medication and that they grow out of by their mid 20s. A lot of these people were over medicated and the meds really weren't going to be an answer to their troubles. They then often claim that all people with mental illness would be better off off meds, without realizing that there's a serious difference between their "rapid cycling" teenage "bipolar" mood swings and my brother staying up for a week straight and being hospitalized while ranting about how he's a deity.
Sometimes I don’t understand the NY Times in particular. They are getting slammed for sanewashing Trump and for platforming the Curtis Yarvin figures in MAGAworld, but at the same time it sometimes feels there are certain elements of 1965-1975 and 2012-2022 Social Justice that they just can’t let go of. De-institutionalization being the best example.
They’ll publish this but will they seriously consider a pro-carceral-institution viewpoint like Freddie’s? It’s not like nobody else in New York does; NYMag Intelligencer published Freddie forcefully making the case for institutionalization in June 2024.
Like so many other things, deinstitutionalization could have worked if the community care that was supposed to be the alternative was funded to the level required. But the advocates massively overestimated society’s willingness to pay for that level of care. People instead segregate themselves away from the consequences, by moving to suburbs. (I’m in Toronto and this is true here too. We closed our infamous institution at 999 Queen St around the same time as the US wave of closing the institutions, also didn’t fund the supposed replacement community care to the lavish level required, and are also reaping the consequences.)
Is there a name for phenomenon where a person will make currently-used option A illegal or unavailable, saying how much better B is? But then people kicked off of A naturally fall into the much worse option C, and the person will simply state it's not their fault, they did their job by getting rid of option A?
I think it’s a common failing of leftist policies we saw in the two great Social Justice waves (1965-1975, and 2012-2022) that a policy is enacted with an insufficient level of cynicism about human nature.
The imperfect (“unjust”) old solution (option A) is cancelled; a new policy is put in place assuming perfect human nature. However, the real-world effect is then the bad outcome (your option C). People then bemoan that outcome by saying things like “we could have had option B if only citizens cared more” / “men were better and not so sexist” / “people weren’t racist” etc.
It goes beyond leftism though: the famous Chesterton saying “The Christian ideal has not been tried and found wanting. It has been found difficult; and left untried.” is a very similar sentiment.
Our host Freddie here is a paradox to me, because he and I are very aligned on our curmudgeonly middle-aged-dad cynicism and realism about things like institutionalization. But he persists in calling himself a Marxist when that requires just as much utopian thinking about how humans behave in response to incentives. It feels like he’s a moderate centrist on half of everything and a hard leftist on the other half.
That's a good description. I think Freddie falls into marrying himself young to the mysticism of Marxism. For the great masses, one may lean politically left or right, and meander one many issues. But when you declare yourself a Marxist you wear that label for life.
The thought has crossed my mind that Marxism as an identity is hard to renounce quietly.
Fatherhood tends to make men more conservative. I think it’s notable that Yglesias (who was never a Marxist, indeed an enthusiastic Obama neoliberal) has emerged as an intellectual leader of the movement to push the Democrats back towards 1990s Clinton Democrats after he became a dad.
I sometimes wonder if we’ll see an article like this from Freddie in a few years.
“ Like so many other things, deinstitutionalization could have worked if the community care that was supposed to be the alternative was funded to the level required.”
I don’t believe that’s true. For those on the street the issues include but are not limited to:
1. Anosognosia - one of the hallmarks of their disease is the belief they aren’t sick. It’s impossible in many cases to convince them to take medication with a lot of terrible side effects when they don’t think they are sick.
2. Treatment non-response - like with almost any health problem sometimes treatment just isn’t effective.
I wish funding was the entire problem, but after years of working with people living on the street, in tents, and in permanent supportive housing, I am certain it is a fraction of the problem. Schizophrenia in particular causes many of its sufferers to actively fear or hate people and institutions that exist to help them. One man I served believed he was actively monitored and recorded anytime he was indoors, making housing him a non-starter and causing mistrust in anyone who approached the subject. Another believed the medication he was given each time he was ITAd (involuntarily committed on a 72-hour hold) was turning him into a different race, leading to a fresh trauma each time that would have him scratching away his skin following every release. One woman wanted help getting a protection order against unknown people who were tasing her wherever she went. Community mental health funding does not and cannot reach people in those shoes.
No one can convince me that people whose illnesses trap them in their own minds and cause them to live unhoused in abject filth and despair have more dignity than hospitalization affords. Out in the world, they are pitied, hated, feared, viewed with disgust, or all of these by most humans with whom they come in contact, which sends them further inside themselves and more likely to use illicit substances to survive. There are very few legal, non-degrading things people on the street can do to put enough money together to self-medicate. They are often beat up, sexually exploited, arrested, incarcerated, and cycled repeatedly through courts that keep jailing them for failure to pay the fines and fees associated with their survival behavior. Sometimes they are victims of homicide on the subway.
I know we can’t make good public policy based on worst-case situations. But we can’t make good public policy without considering them, either.
Not many people publicly do the mental health math like Freddie. I am grateful for it. It’s something to hold onto while these boots are on the ground.
Good post. If this is true, then deinstitutionalization was doomed to fail from the beginning, at least for those hardest of hard cases. Did nobody consider this in the 1960s when it was first being pursued? I’d love to go back to the primary literature from that time and see how they thought about what to do with cases like this.
Or maybe it was all just emotions and reacting to “One Flew Over the Cuckoo’s Nest” and everyone put their head in the sand about the really serious cases. That wouldn’t surprise me given the period 1965-1975 was as crazy as 2012-2022 was.
Many people have acted as if "One Flew Over The Cuckoo's Nest" was a documentary, when it was a novel, a novel written by someone who had never been an inpatient in a psych hospital.
"One Flew Over the Cuckoo's Nest " was a great book as far as literature goes, but it's ghost still lingers in the community mind regarding psychiatric disease and treatment. I'm occasionally involved in ECT treatment as a health professional (and have a close relative with bipolar with many of the issues described so eloquently by FdB), and it amazes me that there are 20 year old nursing students who come to learn about ECT who are flabbergasted that it is "nothing like that movie", and that it still exists as a treatment (obviously only for people in whom it is a reasonable option), and that it works.
"It’s impossible that they don’t know how this all reads, and yet the piece does nothing to address the immense privilege here."
I'd say it is 50/50 they didn't even think that this might read as anything other than useful background info. After all, most of the people who would have been in a position to spot the problem (journalist, editors) probably live in that world themselves. It's like the famous Pauline Kael (sp?) quote about how she didn't see how Nixon won when she didn't know anyone who voted for him. Never underestimate the power of a bubble! That's why I subscribe - to get non-bubbled views! Keep them coming!
Though let me footnote that the actual Kael quote is
"I live in a rather special world. I only know one person who voted for Nixon. Where they are I don't know. They're outside my ken. But sometimes when I'm in a theater I can feel them."
-- Pauline Kael, speech delivered at the Modern Language Association Dec. 28, 1972
Kael, at least, was self-aware about the bubble she was in.
I’m curious Freddie, what did you make of Aviv’s treatment of Delano?
I think she captured some nuance in her book. The first chapter highlights a man who clearly needed meds, while her chapter on Delano showed someone who had to walk away from meds to regain control of her life.
I am a new therapist at a community mental health center and I legit gasped when I read this part of the article.
Ms. Delano said the issue of suicide comes up regularly in withdrawal communities. “I know so many people who have killed themselves over the years, in withdrawal or even beyond” she said. In 2023, a young woman who joined Inner Compass died by suicide, she said. Afterward, Ms. Delano and Mr. Davis consoled distraught community members, who worried that they should have taken some action to intervene. Ms. Delano said she would call 911 if a member overdosed on pills, but, short of that, she doesn’t weigh in on treatment choices. She noted that many members come to withdrawal groups precisely because they feel they have been harmed by the medical system. “We have given psychiatry and licensed mental health professionals this godlike power to keep people alive,” she said. “Speaking for myself — this is not an organizational belief, but for me personally — I don’t think anyone should have that power over another human being.”
There are a few circumstances when a therapist is legally required to break confidentiality and tell someone about something the client said in session; when a vulnerable person is being abused or neglected, or when the client is a) at high risk of seriously harming themselves, b) at high risk of seriously harming someone else, or c) at high risk of being harmed by someone else. The idea isn't that you have the "godlike power of life and death," but that maybe you should do something *right now*, so that cooler heads can prevail and people don't end up making horrible, life ruining choices for themselves and others (let alone that you shouldn't let disabled adults or children be starved, beaten or raped.)
I think there is a real possibility that someone in this group said something that otherwise would have driven a therapist to act ( to be fair, we don't KNOW that the person who committed suicide said anything in session), but because they said it in this group, that person is dead. This kind of coaching is the worst of both worlds--enabling the clients' worst impulses and telling them what you think based on YOUR OWN value system while denying any and all responsibility for bad outcomes. If a therapist messes up, they can lose their license. If Ms. Delano doesn't act when someone wants to hurt themselves or others, well, hey, who am I to play god? You're not supposed to call 911 when someone is overdosing, you're supposed to do so before they get to that point. What a crock of fucking shit.
"Yes, I understand - this bizarre elite-media fixation on the Jackie and JFK of anti-psychiatry is less about ideology and more about the fact that the two of them have a good agent, or they’re Sulzberger cousins, or they have blackmail on David Remnick, or something; certainly, the paper can’t stop publishing this sort of thing in general because it so perfectly flatters the biases of tony Brooklyn Heights creative-class millionaires who wax poetic about urban diversity before sending their kids to Miss Porter’s. If you’re the kind of cosseted wealthy coastal meritocrat who has utterly pruned your daily existence of exposure to the homeless and the criminal, then of course Laura Delano makes sense to you as some sort of avatar about what mental illness really is"
"but the bottom line is that the taking-three-Baggu-bags-to-the-farmer’s-market contingent is the only thing keeping paid media alive right now"
These observations apply to everything the NYT publishes. FdB says that it is "less about ideology than. . .", but a few words later attributes the piece to. . . .ideology. Oh, one can quibble over whether "ideology" or "worldview" is the appropriate term. But the salient point is that FdB is accurately describing a class whose reality is entirely a product of their imaginations and bears little or no resemblance to actual reality. And yes, the NYT, Atlantic, WaPo, etc. cater to this class and their make-believe reality, reinforcing their faith in their own fantasizing.
Why anyone concedes any authority to anything the NYT and its ilk publish is beyond me. It is tempting to give the NYT the Mary McCarthy treatment and say that every word it prints is a lie, including "and" and "the."
Their cultural/social articles have been "strange" in my opinion, especially anything to do with parenting. But, even now with a veil of censorship covering them, they do have some interesting political/business/foreign articles. You have to make sure to read the more obscure headings down from the top. They were the ones who first broke the story that Trump is serious about taking over Canada.
Let me give one one tiny cheer for Ms. Delano. Maybe she's doing a valuable thing by getting people like her -- that is to say, people who don't actually have real mental illnesses -- a chance to get off the medications that they do not in fact actually need.
But you're right that we shouldn't be confusing the excessively-medicated-but-basically-normal class with actual mentally ill people, and supposing that the easy solutions for them apply to the really messed up people.
I work in a field in which we encounter people with serious behavioral problems regularly. In the past few days, we have had two physical encounters between our security and persons exhibiting dangerous threatening behavior. We fortunately have very good, responsible security officers who kept everyone safe and responsibly restrained the people involved without injury.
But it's reminded me of how suddenly dangerous things can get. You can't always give people the benefit of the doubt or treat them gently. Sometimes you have to stop them from hurting other people, or themselves, by whatever means necessary.
Well-said. That she's advertising her business may seem questionable, but I think it would be more charitable to place her on the side of those who (and DeBoer is one if understand aright) argue that if everyone is urged to consider themselves ill, then the ones who are really ill or crazy, will not get priority. And society needs them to have priority. And the truth of their conditions recognized.
Thank you, Fred for commenting so quickly on this article. As soon as I read it, I was hoping you would have a response as always I look for your views on this topic and un education again thanks.
Here’s what’s strange: if you look at the Readers’ Picks for comments on that article, nearly all of them criticize it. Here are just a few examples:
- "This is so incredibly irresponsible that I don’t even know where to begin."
- "The hubris displayed by Ms. Delano and her spouse is infuriating. The treatment approach that worked for this Harvard-educated individual—who likely has strong financial and social support—does not work for many people with severe mental illness."
- "Any time someone is glorified online for 'their' reason (read: cure), they seek more validation by having others follow suit. This is a very disturbing trend."
So, rather than catering to its audience, is the NYT just engaging in clickbait journalism?
I saw similar reader comments on a piece they did about a psychotic man who was rotting in permissive "supportive housing."
Maybe it is just highbrow ragebait.
I remember that piece. Psychiatry finally housed him AFTER it tortured him for years, moving him from one curb to the next, one cage to the next. People like you never ask what may have happened to him, if he had been permanently housed in a TIMELY manner.
I find sorting comments by Readers Picks to be reassuring nearly every time the Times runs some insane, utterly out of touch article like this one. The readers—often hundreds of them—never agree with these extreme pieces.
I honestly think this might be it. The lure of the clickbait is strong
Highbrow publications often also profile “society” couples who are financially irresponsible, and the editors and journalists must know how much it angers their readership who have to work hard to pay the bills every month. But it gets clicks and shares!
... ahh ... "The Fine Art Of Teasing A Cat"
Careful how loud you say that around here!
Alternatively, the writers and staff are living in a bubble.
Worth bearing in mind that people with actual skin in the game - patients, their loved ones, psychiatrists - are probably more likely to click on an article about mental health. And also to know what the fuck they're talking about.
The affluent lib version of the anti-psychiatry movement makes a lot more sense when you consider that their reference point for mental illness is ADHD, or mild anxiety, or some other neurosis that minimally impacts people's lives.
I agree with them that children with ADHD should not be medicated as a first line of treatment, but it's insane to extrapolate this argument to disorders like bipolar, or schizophrenia.
Partly diagnosis and self identity have gotten so sloppy that a bunch of people think they know what bipolar disorder is based off friends that never would've been diagnosed by a responsible psychiatrist. See Freddie's article from a couple months back about "rapid cycling" bipolar, or all the "my bipolar friend isn't antisemitic, so obviously Kanye is choosing to be a horrible person" tweets.
Yes - as is often the case, the problem lies with people not knowing what the fuck they're talking about.
I partially agree with your point, but they aren't quite so unworldly. In my experience the reference point is often
1) OCD with serious symptoms
2) decently severe major depression or anxiety
3) eating disorder
4) addiction
So, not completely trivial suffering, but incredibly different from psychosis in terms of treatment (often without medication) and prognosis.
I’m flabbergasted that someone could think ADHD/ADD minimally impacts someone’s life. I was diagnosed with ADD (no hyperactivity) in 7th grade (1989). I immediately started medication and it absolutely changed the course of my life for the better. I still use medication to this day.
I've run into this in my personal life when discussing mental illness as both a patient with and a family member of bipolar 1. There's a lot of people with various mental health problems in their teens that are not really responsive to medication and that they grow out of by their mid 20s. A lot of these people were over medicated and the meds really weren't going to be an answer to their troubles. They then often claim that all people with mental illness would be better off off meds, without realizing that there's a serious difference between their "rapid cycling" teenage "bipolar" mood swings and my brother staying up for a week straight and being hospitalized while ranting about how he's a deity.
Yes, I think that's a real dynamic
I agree. Not that many years ago I finished growing out of it.
I agree with this nuance to be sure; but I do think on the whole then mental health care in the us is too quick to turn to meds.
Well said, but the NYT is immune to criticism.
Sometimes I don’t understand the NY Times in particular. They are getting slammed for sanewashing Trump and for platforming the Curtis Yarvin figures in MAGAworld, but at the same time it sometimes feels there are certain elements of 1965-1975 and 2012-2022 Social Justice that they just can’t let go of. De-institutionalization being the best example.
They’ll publish this but will they seriously consider a pro-carceral-institution viewpoint like Freddie’s? It’s not like nobody else in New York does; NYMag Intelligencer published Freddie forcefully making the case for institutionalization in June 2024.
Like so many other things, deinstitutionalization could have worked if the community care that was supposed to be the alternative was funded to the level required. But the advocates massively overestimated society’s willingness to pay for that level of care. People instead segregate themselves away from the consequences, by moving to suburbs. (I’m in Toronto and this is true here too. We closed our infamous institution at 999 Queen St around the same time as the US wave of closing the institutions, also didn’t fund the supposed replacement community care to the lavish level required, and are also reaping the consequences.)
Is there a name for phenomenon where a person will make currently-used option A illegal or unavailable, saying how much better B is? But then people kicked off of A naturally fall into the much worse option C, and the person will simply state it's not their fault, they did their job by getting rid of option A?
I think it’s a common failing of leftist policies we saw in the two great Social Justice waves (1965-1975, and 2012-2022) that a policy is enacted with an insufficient level of cynicism about human nature.
The imperfect (“unjust”) old solution (option A) is cancelled; a new policy is put in place assuming perfect human nature. However, the real-world effect is then the bad outcome (your option C). People then bemoan that outcome by saying things like “we could have had option B if only citizens cared more” / “men were better and not so sexist” / “people weren’t racist” etc.
It goes beyond leftism though: the famous Chesterton saying “The Christian ideal has not been tried and found wanting. It has been found difficult; and left untried.” is a very similar sentiment.
Our host Freddie here is a paradox to me, because he and I are very aligned on our curmudgeonly middle-aged-dad cynicism and realism about things like institutionalization. But he persists in calling himself a Marxist when that requires just as much utopian thinking about how humans behave in response to incentives. It feels like he’s a moderate centrist on half of everything and a hard leftist on the other half.
That's a good description. I think Freddie falls into marrying himself young to the mysticism of Marxism. For the great masses, one may lean politically left or right, and meander one many issues. But when you declare yourself a Marxist you wear that label for life.
... kinda like a Swastika tattoo, you ain't getting out of that.
The thought has crossed my mind that Marxism as an identity is hard to renounce quietly.
Fatherhood tends to make men more conservative. I think it’s notable that Yglesias (who was never a Marxist, indeed an enthusiastic Obama neoliberal) has emerged as an intellectual leader of the movement to push the Democrats back towards 1990s Clinton Democrats after he became a dad.
I sometimes wonder if we’ll see an article like this from Freddie in a few years.
https://www.slowboring.com/p/how-i-went-from-left-to-center-left
Bait-and-Switch?
Probably more likely is what Fredric Bastiat wrote about: "That Which Is Not Seen."
Yes, it's called "Elon Musk and DOGE".
“ Like so many other things, deinstitutionalization could have worked if the community care that was supposed to be the alternative was funded to the level required.”
I don’t believe that’s true. For those on the street the issues include but are not limited to:
1. Anosognosia - one of the hallmarks of their disease is the belief they aren’t sick. It’s impossible in many cases to convince them to take medication with a lot of terrible side effects when they don’t think they are sick.
2. Treatment non-response - like with almost any health problem sometimes treatment just isn’t effective.
I wish funding was the entire problem, but after years of working with people living on the street, in tents, and in permanent supportive housing, I am certain it is a fraction of the problem. Schizophrenia in particular causes many of its sufferers to actively fear or hate people and institutions that exist to help them. One man I served believed he was actively monitored and recorded anytime he was indoors, making housing him a non-starter and causing mistrust in anyone who approached the subject. Another believed the medication he was given each time he was ITAd (involuntarily committed on a 72-hour hold) was turning him into a different race, leading to a fresh trauma each time that would have him scratching away his skin following every release. One woman wanted help getting a protection order against unknown people who were tasing her wherever she went. Community mental health funding does not and cannot reach people in those shoes.
No one can convince me that people whose illnesses trap them in their own minds and cause them to live unhoused in abject filth and despair have more dignity than hospitalization affords. Out in the world, they are pitied, hated, feared, viewed with disgust, or all of these by most humans with whom they come in contact, which sends them further inside themselves and more likely to use illicit substances to survive. There are very few legal, non-degrading things people on the street can do to put enough money together to self-medicate. They are often beat up, sexually exploited, arrested, incarcerated, and cycled repeatedly through courts that keep jailing them for failure to pay the fines and fees associated with their survival behavior. Sometimes they are victims of homicide on the subway.
I know we can’t make good public policy based on worst-case situations. But we can’t make good public policy without considering them, either.
Not many people publicly do the mental health math like Freddie. I am grateful for it. It’s something to hold onto while these boots are on the ground.
Good post. If this is true, then deinstitutionalization was doomed to fail from the beginning, at least for those hardest of hard cases. Did nobody consider this in the 1960s when it was first being pursued? I’d love to go back to the primary literature from that time and see how they thought about what to do with cases like this.
Or maybe it was all just emotions and reacting to “One Flew Over the Cuckoo’s Nest” and everyone put their head in the sand about the really serious cases. That wouldn’t surprise me given the period 1965-1975 was as crazy as 2012-2022 was.
Many people have acted as if "One Flew Over The Cuckoo's Nest" was a documentary, when it was a novel, a novel written by someone who had never been an inpatient in a psych hospital.
"One Flew Over the Cuckoo's Nest " was a great book as far as literature goes, but it's ghost still lingers in the community mind regarding psychiatric disease and treatment. I'm occasionally involved in ECT treatment as a health professional (and have a close relative with bipolar with many of the issues described so eloquently by FdB), and it amazes me that there are 20 year old nursing students who come to learn about ECT who are flabbergasted that it is "nothing like that movie", and that it still exists as a treatment (obviously only for people in whom it is a reasonable option), and that it works.
"It’s impossible that they don’t know how this all reads, and yet the piece does nothing to address the immense privilege here."
I'd say it is 50/50 they didn't even think that this might read as anything other than useful background info. After all, most of the people who would have been in a position to spot the problem (journalist, editors) probably live in that world themselves. It's like the famous Pauline Kael (sp?) quote about how she didn't see how Nixon won when she didn't know anyone who voted for him. Never underestimate the power of a bubble! That's why I subscribe - to get non-bubbled views! Keep them coming!
Though let me footnote that the actual Kael quote is
"I live in a rather special world. I only know one person who voted for Nixon. Where they are I don't know. They're outside my ken. But sometimes when I'm in a theater I can feel them."
-- Pauline Kael, speech delivered at the Modern Language Association Dec. 28, 1972
Kael, at least, was self-aware about the bubble she was in.
Yup, Freddy was ready. GREAT piece!
I’m curious Freddie, what did you make of Aviv’s treatment of Delano?
I think she captured some nuance in her book. The first chapter highlights a man who clearly needed meds, while her chapter on Delano showed someone who had to walk away from meds to regain control of her life.
As soon as I saw that piece on NYT, I was looking forward to this missive.
I am a new therapist at a community mental health center and I legit gasped when I read this part of the article.
Ms. Delano said the issue of suicide comes up regularly in withdrawal communities. “I know so many people who have killed themselves over the years, in withdrawal or even beyond” she said. In 2023, a young woman who joined Inner Compass died by suicide, she said. Afterward, Ms. Delano and Mr. Davis consoled distraught community members, who worried that they should have taken some action to intervene. Ms. Delano said she would call 911 if a member overdosed on pills, but, short of that, she doesn’t weigh in on treatment choices. She noted that many members come to withdrawal groups precisely because they feel they have been harmed by the medical system. “We have given psychiatry and licensed mental health professionals this godlike power to keep people alive,” she said. “Speaking for myself — this is not an organizational belief, but for me personally — I don’t think anyone should have that power over another human being.”
There are a few circumstances when a therapist is legally required to break confidentiality and tell someone about something the client said in session; when a vulnerable person is being abused or neglected, or when the client is a) at high risk of seriously harming themselves, b) at high risk of seriously harming someone else, or c) at high risk of being harmed by someone else. The idea isn't that you have the "godlike power of life and death," but that maybe you should do something *right now*, so that cooler heads can prevail and people don't end up making horrible, life ruining choices for themselves and others (let alone that you shouldn't let disabled adults or children be starved, beaten or raped.)
I think there is a real possibility that someone in this group said something that otherwise would have driven a therapist to act ( to be fair, we don't KNOW that the person who committed suicide said anything in session), but because they said it in this group, that person is dead. This kind of coaching is the worst of both worlds--enabling the clients' worst impulses and telling them what you think based on YOUR OWN value system while denying any and all responsibility for bad outcomes. If a therapist messes up, they can lose their license. If Ms. Delano doesn't act when someone wants to hurt themselves or others, well, hey, who am I to play god? You're not supposed to call 911 when someone is overdosing, you're supposed to do so before they get to that point. What a crock of fucking shit.
Nice Sedona call-out Freddie. I live near there and it's all true. But it sure is pretty.
Does Sedona need to be ruined for there to be justice in the world?
"Yes, I understand - this bizarre elite-media fixation on the Jackie and JFK of anti-psychiatry is less about ideology and more about the fact that the two of them have a good agent, or they’re Sulzberger cousins, or they have blackmail on David Remnick, or something; certainly, the paper can’t stop publishing this sort of thing in general because it so perfectly flatters the biases of tony Brooklyn Heights creative-class millionaires who wax poetic about urban diversity before sending their kids to Miss Porter’s. If you’re the kind of cosseted wealthy coastal meritocrat who has utterly pruned your daily existence of exposure to the homeless and the criminal, then of course Laura Delano makes sense to you as some sort of avatar about what mental illness really is"
"but the bottom line is that the taking-three-Baggu-bags-to-the-farmer’s-market contingent is the only thing keeping paid media alive right now"
These observations apply to everything the NYT publishes. FdB says that it is "less about ideology than. . .", but a few words later attributes the piece to. . . .ideology. Oh, one can quibble over whether "ideology" or "worldview" is the appropriate term. But the salient point is that FdB is accurately describing a class whose reality is entirely a product of their imaginations and bears little or no resemblance to actual reality. And yes, the NYT, Atlantic, WaPo, etc. cater to this class and their make-believe reality, reinforcing their faith in their own fantasizing.
Why anyone concedes any authority to anything the NYT and its ilk publish is beyond me. It is tempting to give the NYT the Mary McCarthy treatment and say that every word it prints is a lie, including "and" and "the."
Their cultural/social articles have been "strange" in my opinion, especially anything to do with parenting. But, even now with a veil of censorship covering them, they do have some interesting political/business/foreign articles. You have to make sure to read the more obscure headings down from the top. They were the ones who first broke the story that Trump is serious about taking over Canada.
When are we going to stop pretending the shitrag NYT is still 'the paper of record?' We don't have one of those anymore.
Let me give one one tiny cheer for Ms. Delano. Maybe she's doing a valuable thing by getting people like her -- that is to say, people who don't actually have real mental illnesses -- a chance to get off the medications that they do not in fact actually need.
But you're right that we shouldn't be confusing the excessively-medicated-but-basically-normal class with actual mentally ill people, and supposing that the easy solutions for them apply to the really messed up people.
I work in a field in which we encounter people with serious behavioral problems regularly. In the past few days, we have had two physical encounters between our security and persons exhibiting dangerous threatening behavior. We fortunately have very good, responsible security officers who kept everyone safe and responsibly restrained the people involved without injury.
But it's reminded me of how suddenly dangerous things can get. You can't always give people the benefit of the doubt or treat them gently. Sometimes you have to stop them from hurting other people, or themselves, by whatever means necessary.
Well-said. That she's advertising her business may seem questionable, but I think it would be more charitable to place her on the side of those who (and DeBoer is one if understand aright) argue that if everyone is urged to consider themselves ill, then the ones who are really ill or crazy, will not get priority. And society needs them to have priority. And the truth of their conditions recognized.
Amen