My latest input – 200 words by which psychiatry needs reforming – oh yesssss..
HOW MENTAL HEALTH SHOULD BE REFORMED [200 WORDS]
(1)DIGNITY NOT stigma, (2)friendliness NOT fear, (3)emotional support NOT alienation, (4)”what’s happened to you?” NOT “what’s wrong with you?”, (5)”a good hard listening to” NOT fobbed off with pills. Unachievable? Not at all – this is precisely what I was taught in my first full time psychiatric post, back in 1963, the so-called Therapeutic Community – ‘therapy’ by the ‘community’. Please bring it back, urgently. I was black-listed in 1967 for refusing to give ECT (shock treatment) so spent 22 years in General Practice, learning what real psychiatry is all about – children frighten easily, and need help in adulthood to kick those fears out. The 5 points listed above, do just that, even with psychotic symptoms.
There’ll be no psychiatric reform until ‘DSM-psychiatry’ goes. No other medical text book could get away with ignoring ‘stress’, or ‘causative factors’, to say nothing of will power, which the current psychiatric ‘bible’ tells doctors to. Who can doubt children are impressionable or that adults can be encouraged to shout back at yesterday’s abuser – tricky, but doable and successful. Nowadays, medical journal editors don’t even reply to my letters. Reform? Can’t come soon enough.
I’m doubly qualified [MRCPsych, MRCGP, PhD, MA(psychol)], with a peer reviewed approach to trauma [Br J Forensic Practice, 2006, 8:3;4-15]; a consultant psychiatrist since 1991. My resignation in disgust from my 5 successful years in Parkhurst Prison featured in The Guardian in 1996. David Brindle chaired our public debates, and agreed to chair my latest public ‘workshop’ – “Grounds for Optimism with Psychoses”. Having found a way through today’s psychiatric labyrinth, those already mired in it, cry ‘foul’. I had stepped out of the goldfish bowl, but when I re-entered, no one wanted to know. I cite five places where this approach already succeeds [Soteria, Open Dialogue, Geel, TCs, The Early York Retreat (1796-1850s)]. Legally, the Human Rights Act should take precedence over all – and the 5 points listed do no more than insist that Human Rights are therapeutic – what’s not to like?
25 January 2016 www.DrBobJohnson.org
LATEST -chapter 7 of my book
The science of ‘intent’, Chapter 7: The One Self-Enforcing Law In Our Biosphere
chapter 7 biosphere law
Earlier – I attached an audio recording – on psychosis – 5 minute CLIP 24MAR15
the following text applies.
ARE PSYCHOSES CURABLE? – does this 5 minute clip prove anything?
PSYCHOSIS mystifies – except that everyone, INCLUDING YOU, can agree two simple facts. FIRSTLY, there’s no psychosis without ‘thought disorder’, broken sentences, blocked phrases. If you don’t know this, then you fail your medical exams, and rightly so. SECONDLY, childhoods matter. OK so far? Problems thinking and problematic childhoods – can you suspend disbelief for a moment and blend these two long established facts, despite what you’ve been taught all your life?
Sam, a pseudonym, is now 45. Even so, this 5 minute audio clip (transcribed below) shows that he believes he is still “being hit” today, because, apparently, his father hit him so hard at age 2. He doesn’t want to believe this, any more than you do. So listen carefully to how he stumbles over the word ‘hit’, how he argues against the idea that he is currently stronger than his dad, even though the latter is now 74, and that even thinking he is stronger is ‘prohibited’ to him, by him. Whether he was actually hit or not, I don’t know, and I’m not interested – what matters is that he still thinks he is being hit today – and he isn’t, that is something I do know. The key is that he begins to feel ‘relief’ once today’s reality percolates through the cognitive mire. You don’t have to believe me, but if you want solid clinical evidence, have a listen. Osler told you to listen to the patient, because s/he is telling you the diagnosis. Here I invite you to listen to the dialogue, because Sam and Freda are telling you the pathology.
Freda, also a pseudonym, is now aged 40. Her mum died 33 years ago, but still paralyses her thinking, even in the supermarket – check it out below. Listen to her struggling to ‘think what we’re thinking about’. Elsewhere, she is coherent. Here she’s ‘blocked’.
SO WHAT’S GOING ON?
You could dismiss these 5 minutes, as being just another bee in my bonnet trying to link thought blocks and childhoods. Or you could listen, say to line 35, where Freda says “I can’t say it” – is this true, and if so why? If she wants her mum ‘to go’ (“I want to think her gone,” line 22), why can’t she think clearly enough so that she does? Is her cognition really clogged? Is this what psychosis is all about – gummed up cognitive processes, because the sufferer ‘thinks’ the trauma is still ‘alive’ in her head? If you provide her with adequate trustworthy emotional support, could you persuade her that, since her mum is dead, it’s over? If you did, would she be cured? We know childhood traumas ceased long ago – a fact both these two simply don’t believe – what would happen if they caught up with reality? They keep desperately pressing me for more, because they think they’d be cured. Do you?
The model is simple, though far from easy. Infants learn to cope with erratic parenting. Dad shouts, mum dies, or vice versa – the actual event is not material, the context is all. Infants have no physical defence, so they devise a mental one – “this isn’t happening to me”. So here’s a message to Sam’s dad, and to all parents – no parent I have ever met wants to give their child a psychosis, and I’m sure Sam’s didn’t – but some infants are caught on the hop, and get stuck. They can be unstuck, but only when they can be persuaded that thinking is safe again – simple, but not easy. Infant survival strategies get prolonged into adulthood, ‘infantism’ – it doesn’t work, it can be shown not to work, and with enough trustworthy emotional support, non-psychotic thinking can be restored. Or can it?
Like any ‘thought-coach’, I use whatever ‘verbal spanners’ come immediately to hand. You may find my responses brusque – but such is the trust between the three of us that they take it on the chin, and profess to be helped by it. Could this be clinical evidence of efficacy? They think it is, do you?
HEALTH WARNING – since the trauma is still going on in the head, though not in reality, expert care is needed in ALL SUCH CASES, not to make matters immeasurably worse – re-traumatisation is a constant, inevitable risk – so TAKE EXTRA CARE. What seems simple, and at one level is, defeats many, inflicting enormous mental pain – don’t make it worse because you don’t know what you’re doing.
This audio clip is available for download at www.DrBobJohnson.org/audio – handle with care. I reproduce it here with permission. © Dr Bob Johnson, 2015, – but please feel free to circulate it, and this transcript, without charge, as widely as you wish.
Dr Bob Johnson, Sunday, 22 March 2015 www.DrBobJohnson.org
5 MINUTE EXCERPT, 2015. [B: is Bob, me; F: is Freda; S: is Sam; ~ is ‘blocking’.]
- B: [to Freda] So how does your experience agree with Sam’s?
- F: um ~~ very much ~ the same
- B: Go on – in what way?
- F: I’m finding it SO difficult to think. . . and not just thn~. . I find it ~ to think about what’s being said, so difficult
- B: [softly] Wow. That’s interesting, isn’t it. Why is it so difficult to think?
- F: In this context . . .
- B: yes
- F: . . we’re talking about thinking about what we’re thinking about . .
- B: yes
- F: how to ~ stop our parents stop us thinking. What I’m doing ~. It happens ~ that I can’t think about it. But I can’t think ~ about the supermarket shopping when my mum’s in my head either. It goes on everywhere. But here, I can’t ~ I tried to get on the point of what Sam’s saying, ‘cos it’s relevant. . .
- B: It is relevant, yes.
- F: . . . and I can’t think [sighs exasperatedly]. I can’t think [sighs again] properly.
- B: [gently] It’s training, right. You’ve trained yourself not to think
- F: mmm
- B: say that
- F: ~~ I’ve trained ~. I have ~ trained, I’ve trained myself not to think.
- B: yes, ‘and now I have to train myself TO think.’
- F: [smoothly] and now I have to train myself to think.
- B: what do you have to think?
- F: I have to ~ think ~ what I want to think, individually
- B: yes? And what with respect to your mum?
- F: ummm. I want ~ if I want. I want her to go. I want to think her gone. I really have to believe that I want to think her gone, so that I can think. I get myself little rhythms, and tongue tied things that I . . .
- B: you also have to look her in the eye, I’m afraid. And beat her. Not in a physical sense, but in a victorious sense. ‘I’m stronger than you mum’ – off you go.
- S: [coughs]
- F: er ~ I ~~~ I’m stronger than ~ you-mum. [rapidly]
- B: well, that wasn’t very convincing was it?
- F: [brightly] I actually believe it.
- B: what do you believe?
- F: that I’m stronger than my mum
- B: well say so then, not with b-b-g, it’s called muttering. Come on. Off the top, come on . . .
- F: I’m stronger than you mum.
- B: it’s a bit feeble still, isn’t it? [2:18]. I mean you know, it wasn’t, you know, 100%. Sit her down there [loudly] ’HELLO MUM’ . . And tell her. Go on.
- F: umm. Hello mum, I’m stronger than you
- B: do you believe that?
- F: I~ um~~. I can’t say it.
- B: [loudly, lots of emphasis] WHY NOT?
- F: [giggles nervously] ~ for thinking and speaking ~ for myself
- B: a very good idea, try again
- F:~~ I’m stronger than you mum
- B: [to Sam] what do you think of that diction? It’s not good, is it?
- S: mmm
- B: what do you think? What’s your comment on that diction? [2:54]
- S: . . . ummm. [softly] Doesn’t quite believe it.
- B: she doesn’t, does she?
- S: no
- B: go on, tell her.
- S: ugh.
- B: [brightly] what about you? Are you stronger than your dad?
- S: . . . . I don’t, I don’t think so, no.
- B: well I want you to say ‘HELLO DAD, I’M STRONGER THAN YOU, you’re 70, heh, heh, heh’.
- S: all right. OK. Hello dad, I’m stronger than you, you’re 74. [3:28]
- B: 74? It’s gone up since I last asked. And what happens to you when you say that?
- S: . . . a little tiny bit of relief
- B: Ha! So if you said it and believed it you’d have lots of relief. Is that correct?
- S: probably, yeah
- B: what do you mean ‘probably’. The whole object of the exercise [laughing] is to get you some relief. ‘Tiny bit of relief !’ Do it again.
- S: hello dad, I’m stronger than you, you’re 74 [chuckles briefly]
- B: Hey ! See the giggle. So what happened then?
- S: . . . . ummm . . . . like he dies or something?
- B: no. It’s just real. If you’re stronger than him, he’s not going to hit you. Say that please.
- S: if I’m stronger than you, you can’t hit me [hurried] . . ~ can’t hit me
- B: what happened to that sentence? Say it again [insistently].
- S: if I’m stronger than you, ~~ you can’t ~ hit me
- B: do you believe that?
- S: partly
- B what do you mean, ‘partly’ [derisive tone]
- S: a bit
- B: what do you mean, ‘a bit’ [argumentative] [4:40] It’s logical. Isn’t it?’
- S: . . . I dare say ~ I don’t want to see him
- B: [insistently] I beg your pardon?
- S: ~ maybe . . . I don’t want to see him
- B: Aah. Aah. ‘I don’t want to see him’. What effect does that have?
- S: it makes me mad.
- B: no it doesn’t, [lightly] it makes you impotent. It paralyses you. ‘I’m not looking at the person who’s hitting me. And he continues to hit me because I don’t look at him.’ [5:08] Hey, how about saying that? I like that. Off you go.
- S: I don’t look at the person that’s hitting me . . .
- B: yes
- S: . . (because I don’t want to)
- B: right. ‘I’ve trained myself to . . . ’
- S: and umm . . . .
- B: ‘he continues to hit me’
- S: that makes me small and impotent, that’s like keeping me . . .[at 2]
- B: so my advice is to look at him – OK?
- F: I had a little thing to say there which is . . . . a bit . . .
- B: off you go . . . [5:44]
Continues. This is an excerpt from over 3 hours of group work. The above is my rendering of the audio – check it out for yourself on www.DrBobJohnson.org/audio
If you look at this with a calm, non-prejudging eye, it is immediately clear, clinically, that thought block varies from line to line – it is not random, it is meaningful, because it’s strategic, and accordingly is worse with some emotive topics than with others. See especially lines 16 and 18 – the contrast between them is dramatic and so obvious – why? Line 18 is obviously so much healthier – what’s wrong with having as a therapeutic aim that all lines become as unencumbered as this? Alas, to achieve this you need to persuade the sufferer that that is a realistic, safe, strategic goal. It’s hard enough convincing doctors or legislators.
“I can’t think properly” complains Freda at line 12. Here is thought disorder from the inside. She can think clearly enough about a myriad other topics – she immediately has trouble when she begins to focus on how memories of mum derail her cognition.
Over the last 4 years I’ve spent upwards of 200 hours listening intensively to gobbledegook – raw, unadulterated, unbiased. I wonder how many others have had this privilege. The above is my conclusion. It has disturbing implications for all other aetiologies. Faulty brain chemicals, dopamine for example, do not vary within the same micro-second, neither do genomics – in order to claim these as causative factors, you’d have to assume they would impact on all thinking, and all speaking. If there is a significant neurological factor impacting on thinking and speaking – then it should impact right across the vocabulary, as it does in Alzheimer’s or paresis. Variable and strategic thought block, which characterises all psychoses, needs a different model – brain pathology alone won’t suffice. This is why clinical examination of the actual verbatim recording is so crucial – much is sane and non-psychotic, much else is anything but – how would you account for the difference?
The so-called ‘anti-psychotic’ drugs degrade the whole sensorium, not just those parts already blocked, a sledgehammer by any other name. Indeed this is one explanation why they hinder recovery – fears cannot become ‘burnt out’, if thinking about them is obliterated not only emotionally, but also chemically.
Sadly, attempts to promulgate this type of detailed clinical reasoning are uphill – psychosis has for so long been taught to be life-long, intractable, and fundamentally inexplicable. And many of its more bizarre symptoms seem to confirm this – wild apparently random assertions, quite devoid of realism – the reason for which is described here. But clinical evidence presented here shows that there is an underlying pattern, a purpose, which in favourable circumstances as here, can be discerned – but which the average sufferer from psychotic symptoms actively wishes you not to discern – for reasons touched on above. This all goes to show why the future of this approach remains problematic. At all events, I have now closed my clinic, in order to allow me more time to clarify and codify all the clinical evidence I’ve accumulated to date. Thank you for your interest so far.
Dr Bob Johnson
Empowering intent detoxifies psychoses
EARLIER – -
I base my work on a sound view of the fallibility of knowledge – check out chapter 1 of my ebook – it’s free – download by clicking this link.
PLEASE NOTE –
Dr Bob Johnson’s clinic is now closed
Happily, my researches into the emotional roots of psychiatric disorder, especially psychotic symptoms have been fruitful. Unhappily, I have been unable to attract support for this approach either from the NHS or elsewhere. The reality is that I cannot cope with the flood of sufferers who would like to pursue this for themselves or their family. Accordingly I have had to close my clinic, and restrict myself to medico-legal work, which hopefully will bring about some of the necessary reforms. I append below, a link to a recent Dublin case.
My position on psychiatric problems is now clearer and stronger. The central causative factor is fear, leading to ‘frozen terror’ from traumas which have long since ceased in the real world, but which persist solely in the sufferer’s head [a variant form of PTSD]. Trust, which you cannot buy, but must earn, is the sovereign antidote to fear, and given enough resources winkles out even the most challenging of psychotic symptoms, and all the lesser ones too. My view of psychiatric medication is also far clearer – I agree with Dr Joanna MonCrieff in her book “the Myth of the Chemical Cure”, page 244, where she confirms they all work by ‘intoxication’, nothing more. Mental pain killers, yes, curative neurological drugs, no. There are perhaps 100 neurotransmitters, dopamine, serotonin, et al, of which we know 20. Psychiatric disorders are software, not hardware – tampering with brain tissue has lots of longer term disadvantages, and the more clinical evidence we accumulate, the more this will be proven – my psychiatric colleagues are painfully slow in acknowledging this.
I do try to respond to emails coming in, but there’s often a delay. I have had to cut my clinic hours to cope with all the other pressures, including the upkeep of this website which has had to take second place for far too long. My plan is to organise some of the 1000s of hours of videos, into a coherent pattern to assist. I’m also working on a book, “The Science of ‘Intent’ ”, which I intend to circulate as an free eBook, once I can get it completed . I would also like to run a series of public seminars – but again, all this needs time and effort, whence my closing my clinic.
I’m sorry to disappoint many – I see so clearly how they are suffering, not only from the disease, but also from psychiatric misunderstandings and ignorance – my hope is that drawing more publicity to the latter, will, eventually aid the former. I’ve decided this is the best way forward for me at this time, and apologise to those it disappoints.
Bob Johnson Tuesday, 28 October 2014
Dublin case reported at
[THIS WEBSITE IS IN URGENT NEED OF REVISION. When my current spate fades a little I'll get on to it - there's simply been too much going on, leaving no time for it, so far . . . . . .]
the last project was an introductory workshop in Dublin, Ireland.
by cutting its traumatic roots
an introductory half-day workshop
for sufferers, supporters, professionals, families & all
Saturday, 6th July 2013, 1-5pm
The Bewleys Hotel, Leopardstown, Dublin 18
20 minutes by the Luas from St. Stephens Green
Dr Bob Johnson
expert in trauma treatment
Psychosis is terrifying – ignorance of what’s wrong perpetuates the suffering. Video analysis (& chat) shows where the terror comes from, and how to stop it. The healthy parts of the mind are used to remedy the bits which don’t work – optimism, hope and delight are restored, because 100% cure becomes possible.
TO CURE PSYCHOSES –
- 1. look in the right place
- 2. the sufferer works hardest
- 3. help find the sufferer’s software bug
- 4. use only Truth, Trust and Consent = Healing Hand Of Kindness Plus Insight.
- 5. learn and then know 100%, there’s a 100% cure
- 6. never ever, ever, ever give up
‘PSYCHOSIS’ here covers all psychotic symptoms, including all varieties of psychoses, ‘schizophrenias’, all ‘depressions’ manic or otherwise, bipolar, BPD, PD, ADHDs, anorexias, irrationalities, what have you – all are really variants of PTSD.
- 1. look in the right place – not in the brain chemicals, but in the memories – somewhere in there is a ‘false belief’, a toxic factoid, along the lines that “I need Dad/Mum to survive”. I.e. look for infantism – the transfer into adult life of infant survival strategies. It’s a ‘bottled up’ disorder – needs unbottling. Ditch the DSM.
- 2. the sufferer works hardest – what we’re asking for is that the sufferer swap their very foundation stones – their very mental security – hard work, requiring buckets of reliability and trustworthiness.
- 3. find what the sufferer can’t – their software bug – the sufferer has needed these factoids to survive, so cannot evaluate them sufficiently, unsupported, to adapt to adulthood. Persuasion is the only remedy – risk of re-traumatisation is always high.
- use only Truth, Trust and Consent – this is just the Healing Hand Of Kindness Plus Insight. Consent is the key – you cannot change them, they change themselves, only with your benign assistance.
- 5. learn and then know 100%, there’s a 100% cure – the conviction you carry on your part is half the battle – don’t do it, if you don’t believe it, but work at it, learn it all, so that you do .
- never ever, ever, ever give up – watching human beings blossom beats anything else on offer in this unfathomable world – so stick with it – we are all born with the right to mental health – never doubt it.
www.DrBobJohnson.org Saturday, 18 May 2013-
This website is being re-constructed – please bear with us for a while.
I’ve recently revived my interest in medical computing.
I participated in a debate at the 2012 Hay-on-Wye festival, as follows.
My response was as follows =
“The Psychiatric Emperor has no clothes, s/he dumped them in 1978, but who dares tell the doctor s/he’s mistaken?”
An Open Manifesto For Reforming Psychiatry
1. A healthy mind is standard issue – we expect every child, first to walk, then to talk – the one needs healthy legs, the other a healthy mind – QED.
2. Intent is vital both for Sanity and for The Law – but intent (and its cousin ‘consent’) have been arbitrarily and indeed intentionally anathematised by psychiatrists since 1978 (DSM-III).
3. Dopamine doesn’t cause psychosis . So ‘anti-psychotic’ drugs are really just ‘anti- dopamines’. Are they being mis-sold? Is re-labelling them required, legally? Detoxification needs careful timing.
4. Brains shrunk by 10% . Giving anti-dopamines is like giving anti-insulin – they cannot avoid damaging all brain tissue, an irresponsible medical practice. (Recoveries happen).
5. Dopamines disable recovery – which a long term 15-year study  (& others) proves. Dismal outlook, unacceptable nerve tissue damage – the medical case against anti-dopamines is irrefutable.
6. All psychiatric drugs work by ‘intoxication’  – none (including Ritalin) is better than alcohol. We all need calming down from time to time – let’s admit it, and handle transparently and responsibly.
7. Doctors are addicted to giving drugs – time to wean them. Ignoring robust and repeatable medical evidence is unethical. I wonder which nation will be the first to haul its doctors back to legality.
8. Trauma festers – a child reacts by ‘not-thinking’, by cognitive fog, by ‘irrationality’, which persists. The remedy is first to say, and then believe: “I had a lousy childhood, but it doesn’t matter now.”
9. Every psychosis is ‘bottled rage from bottled pain’ – unbottle both using the Healing Hand Of Kindness , plus insight. Sanity is sorting out a pain-free pathway for intent.
10. Our one and only evolutionary advantage as bipeds – would be if we were all born ‘Lovable, Sociable and Non-Violent’ – are we? Can ‘Truth, Trust and Consent’ stop us becoming extinct? 
Refs:Moncrieff, Harv Rev Psychiatry 2009,17:214-225; Jackson. ISBN 978-1438972312; Harrow. J Nerv Ment Dis 2007;195: 406–414;Moncrieff ISBN 978-0230574328 p 244;Whitaker ISBN 978-0465020140;Johnson ISBN 978-0955198502
Dr Bob Johnson Consultant Psychiatrist www.DrBobJohnson.org
Wednesday, 9 May 2012
Psychiatry since 1980 has lost its way. For 40 years it has been marching resolutely in the wrong direction, leaving the comforting shores of Therapeutic Communities, in which I was thankfully trained, for the wilder reaches of an imaginary micro-neurological mire.
Sadly, the James Nayler Foundation which was founded in 1997, has run into funding problems – our workload exceeded the capacities of our unpaid staff, so this Charity is currently in the process of closing.
HOWEVER, we still hope to be able to keep the same spirit alive, by running workshops, establishing training programmes, and helping sufferers from emotional distress in the best wasy we can manage. Our aim still is to establish ‘fear free zones’ where emotional distress melts away.
I’m on Twitter => http://twitter.com/BobTrustConsent
VIDEO restored on http://tinyurl.com/PDvid
VIDEO also at http://vimeo.com/4960044