Monthly Archives: January 2021

Three New Book Titles on Schizophrenia for 2021

By Marvin Ross

Since 2008, I’ve been publishing books mostly on schizophrenia via my company Bridgeross Communications. The current titles can be found on the books page on this blog and I’m pleased to say that they have been well received by readers and reviewers and are still selling. I had no intention of publishing anymore but circumstances changed and I’m pleased to announce that three new books are coming this Spring. Allow me to introduce them to you:

What’s So Funny? The Autobiography of a Professional Schizophrenian, Artist, Public Speaker and Singer

Jude Mersereau, the author, I have known for a number of years as we live in the same city where she is an amazing artist. She was one of three artists with schizophrenia that were the subjects of a documentary film that Dr Dawson and I did of the art program she was involved with. This is the trailer for that film which does feature Jude who is also the singer along with her husband, George on guitar.

The book features a lot of her art in colour. Those who have read the draft are very impressed. Sandra Yuen Mackay who wrote My Schizophrenic Life which I published said:

“Schizophrenian Judy Mersereau writes with humour, poetic cleverness and lively originality. The book is beautifully illustrated with her art. The telling of her story winds and weaves with elements of joy in her memories. An entertaining read, written with honesty and insight, demonstrates Judy’s example of a full life despite diagnosis. She found ways to cope and give through her music, art and writing.”

Sandra is the recipient of the Courage to Come Back Award given by Vancouver’s Coastal Health and was named one of the five faces of mental illness in Canada to promote understanding of mental illness.

Kathy Mochnacki, chair of the board of Home on the Hill Supportive Housing commented that:

“Jude is a master at using literary tools. Her play on words can cause involuntary outbursts of laughter. But most striking is her use of juxtaposition which jars us into thinking from her perception of the world. Her artwork is original and enigmatic and is showcased throughout.”

Jude has spoken at Home on the Hill and she and her husband have performed for them.

When Neurons Tell Stories: A Layman’s Guide to the Neuroscience of Mental Illness and Health

By Erin Emiru (nee Hawkes) who is the author of When Quietness Came: A Neuroscientist’s Personal Journey with Schizophrenia. As the title of her first book states, Erin has schizophrenia and is a neuroscientist. She became ill while an undergraduate but managed to go on to complete a masters in neuroscience at the University of British Columbia and enrol in their PhD program while sick.

She managed to be the recipient of numerous prestigious awards and scholarships, including two Natural Science and Engineering Research Council’s (NSERC) grants and a Michael Smith award. Her papers were published in a variety of academic peer-reviewed journals in conjunction with her supervisors, colleagues, and fellow students. For several years, she attended and presented research at the massive (35,000+ attendees) Society for Neuroscience conferences.

It took years for Erin to find a medication that helped and, until then, had numerous forced hospitalizations where she was transported to hospital restrained by police. She has written a number of articles on how forced treatment saved her life. Unfortunately, Erin was not able to continue with her doctorate or to continue working in a neuroscience lab so became a peer support worker in addition to her many lectures to nurses, doctors and others on schizophrenia.

Her book takes you on a tour of the neuroscience of schizophrenia and other related topics. The subjects who will bring this neuroscience to life are her clients who experience mental health and addiction challenges. Their stories form the backbone of this book. She also describes her role as a peer support and how peer support should be done as part of a treatment team.

Her book will be an antidote to all the anti-psychiatry types who deny the existence of serious mental illness. Her definition of what recovery should be will be very enlightening. As a companion to that book is

Anti-psychiatry and the UN Assault on the Mentally Ill

This is my own foray back into book writing since my Schizophrenia Medicine’s Mystery Society’s Shame in 2008.

The book is an evidence based refutation of all the dribble spouted by the anti-psychiatry crowd which is becoming more entrenched. In my blog after the US election, I mentioned that I put anti-psychiatry in there with the anti-mask, anti-vax, alternative medicine proponents who are becoming more and more prevalent. Thanks to my friend Dr John Gray in Victoria, one of Canada’s leading experts in mental health legislation, I learned of their role with the UN.

This volume exposes the danger of the anti-psychiatry beliefs and their infiltration into the UN and that body’s Convention on the Rights of Disabled Persons. Many countries have signed on although a few like Canada and Australia refused to ratify the odious terms for psychiatry. The US has not signed but there is every indication that the Biden Presidency will sign it all.

This book and Erin’s book will provide the ammunition you need to counter anti-psychiatry’s arguments.

I will let everyone know when the books will become available and they will be available internationally in print and in e-book formats.

Schizophrenia Research Lost a Giant

By Marvin Ross

Dr Philip Seeman, the scientist who discovered the dopamine D2 receptor in 1974 and the basis for the dopamine hypothesis of schizophrenia, passed away at the age of 87 in Toronto. In 1999 he discovered that the atypical antipsychotics clozapine and quetiapine rapidly dissociate from D2, explaining why these antipsychotics are preferred by patients. This discovery led to the synthesis of new fast-off-D2 antipsychotics.

In 1963, he was a Canadian doctor, trained at McGill in Montreal, and doing research for a PhD at the Rockefeller University in New York City. His wife, Mary, was a psychiatrist and she took Philip with her to the Manhattan State Hospital. Dr. Philip stated in an essay he wrote in 2001 that the sight of 2000 patients with schizophrenia or psychosis was unforgettable. His wife said “why don’t you do something useful? Why don’t you find the cause of schizophrenia?”

That challenge set him on a lengthy journey to discover how the antipsychotic drugs worked which he did during his tenure in the departments of pharmacology, chair of neuroscience, and a member of the faculty of psychiatry at the University of Toronto. Quoting from my 2008 book on Schizophrenia (Schizophrenia Medicine’s Mystery, Society’s Shame), I had this to say of his work:

What Philip Seeman discovered was that antipsychotic drugs blocked a dopamine receptor that he called the D2 receptor. It was then discovered that people with schizophrenia have more of these receptors than normal. Psychotic symptoms are relieved when the drug blocks the receptor and prevents dopamine from binding. The longer an antipsychotic drug blocks these receptors, the more potent it is in reducing psychotic symptoms.

More recently, it has been discovered that in people with schizophrenia, there is a supersensitivity to dopamine. It was also discovered that the older antipychotic medications (the typical antipsychotics) blocked the dopamine receptors more extensively and for longer periods of time than the newer drugs called atypical antipsychotics.

The therapeutic action of the drugs occurs when 65% to 85% of brain D2 receptors are occupied. When more than 78% or 80% of the D2 receptors are occupied then the side effects associated with the atypical drugs occur. The atypical drugs occupy less of the receptors. The length of time that the drug occupies the receptor is also important. The older drugs stay on the receptor much longer than the newer ones thus these newer drugs have fewer parkinsonism side effects.

Haldol stays on the D2 receptor for 38 minutes, chlorpromazine for 30 minutes but clozapine for only 15 seconds and quetiapine for 16 seconds. This short time period is still long enough to interrupt dopamine but to then allow enough to get through to avoid the side effects. It is believed that only a few hours a day of 60-70% D2 occupancy is sufficient to relieve psychotic symptoms. Of course, these newer drugs do have other side effects. They can cause extreme weight gain, type 2 diabetes, elevated cholesterol levels and sexual side effects such as impotence and disrupted menstruation.

One of the criticisms of antipsychotics mentioned by Robert Whitaker was based on one of Philip Seeman’s animal studies on hypersensitivity to dopamine. These drugs induced an increase in dopamine receptors which then led to the antipsychotic effect becoming less potent. Whitaker referred to this as withdrawal psychosis. Both Drs Alan Francis and Fuller Torrey dispute this in their critiques of Whitaker and Dr Torrey suggests that the dopamine hypothesis is far more complex than Whitaker admits. I can’t find where I wrote this but at the time, I contacted Dr. Mary Seeman (as I had heard that Philip was not well) and asked her about Whitaker’s ideas. She e-mailed me back to say that Whitaker had misunderstood what the paper was about.

Mary Seeman has also been involved in significant research into schizophrenia as well and particularly into gender differences in schizophrenia and the impact of parenting with mental illness. She founded the first outpatient clinic for women with psychosis at the Centre for Addiction and Mental Health in Toronto. She has authored 278 articles on schizophrenia while her husband penned compared to 173 for Philip.

The Continuing Puzzle of Human Behaviour

By Dr. David Laing Dawson

Social media and instant mobile communication appear to have unleashed a human potential for hive behaviour. We talk of information silos, but the parallel behaviours of some groups within these silos seem to be simple stimulus response mechanisms rather than cognitive decision making based on information.

So we come to the mob of insurrectionists and onlookers at the U. S. capitol on the sixth of January. Some, it seems, may have had plans for an armed coup complete with executions, though “plans” may be too precise a term. More likely fantasies of palace seizures drawn from God knows what Facebook accounts, television series, and scanty knowledge of history.

But thousands of others were caught up in the moment of mob rule, and followed along. Law enforcement is seeking out those of the thousands who actually breached the capitol building and engaged in illegal acts. But there must have been some (at least a few) in the crowd who noticed the momentum had changed from peaceful protest in front of the building to full on insurrection, and who, at that moment, observed, and thought, and considered, and then turned around to go home. I hope there were, and I would like to see these people interviewed, because then we might learn something. What is it about them that allowed them to see clearly at that moment and turn away from the hive? From the riot? From the mob?

And then we have Conrad Black. Despite his unwelcome elitist/conservative view of the world, he has more knowledge, understanding, education in his little finger than Donald Trump has in his head or his book shelf. Black can also speak English and weave complex thoughts together in a linear, logical fashion. Trump cannot.

So why on earth is Black a Trump supporter even now? Is any of it ideological? Does Black have a truly unhealthy fascination with kings and potentates? Or is it all about the pardon and self-interest and money?

In my waning quest to understand human behaviour I would like to know the answers to these questions.

Let Trump Fade Away

By Dr David Laing Dawson

Do not remove Trump from office or impeach him during these last 9 days of his presidency. Ensure he does leave Washington before the inauguration of Joe Biden and that he is not planning a competing rally. A phalanx of Republican senators marching to the White House (a la Nixon) and telling him to resign might be the best way to achieve this, but do not turn him into a martyr in the eyes of his followers. When he has no power and no platform they will soon move on. But, as we know, a martyr can live for several generations in the minds of acolytes.

With the suspension of Trump’s twitter account my ongoing mental status examination must come to an end as well.

But the natural course of Trump’s disorder of supreme narcissism with more than a touch of sociopathy is increasing isolation and an all encompassing delusion. His remaining days can be spent surrounded by (a thinning number) of friends and sycophants while he rewrites his own history to his liking, nurses grievances, surrounds himself with mementos of his “achievements”, watches film clips of his greatest hits, pampers himself, golfs with his buddies, and complains to all who will listen.

Video clips and sound tracks of the “insurrectionists” from January 6th, show clearly they were mostly people spoiling for a fight, angry, aroused easily by a Donald Trump, dangerous for sure, but totally devoid of plan or purpose, at least not beyond making a big splash, and shouting empty borrowed slogans. “Heads on pikes,” shouted one of them, borrowing the phrase from a Frankenstein movie, I suspect, rather than actual history.

With the exception of the organized right wing extremist groups the rest should fade away along with Trump under the onslaught of a boring but sensible four years of governance in the USA. (optimism is important for mental health)

So, Nancy et al. Focus on COVID and reconciliation, on saving America and the planet. Let Trump fade away. Do not turn him into a martyr. Martyrdom will only give substance to that which actually had none. There are signs of change in America. Let it evolve.

The caveat to all this is the demonstration we have just watched of the extent to which the fictions of our television, film, and social media have eroded our foothold in reality. These were not starving peasants storming the castle for food, or a farmer’s revolt, or a class struggle, or the populace rising up against a brutal dictator. With their selfie sticks and costumes these were mostly people (stupidly and dangerously) playing Game of Thrones.

Lived Experience and Peer Support

By Marvin Ross

I recently received a manuscript from a peer support worker (PSW) who works on an Assertive Community Treatment (ACT) team at a hospital. The manuscript deals with the neuroscience behind the lives of this person’s clients. This PSW has a good knowledge of science, medicine and the underpinnings of mental illness. This person also works on a team with medical doctors, nurses, social workers and other professionals involved with the treatment and support of people with serious mental illness.

That, to me, is a personal support worker – trained in science, supervised and part of a team of professionals. I don’t dismiss the need for PSWs to also fill the role of friend and advisor offering comfort and support along with wisdom learned from having gone through the system and survived. But that alone is not sufficient particularly if the PSW also holds pseudoscientific or alternative health views that are not based in good evidence.

One of the best programs that the Hamilton chapter of the Schizophrenia Society of Ontario had when I was involved with them was a family buddy system. A new family member, if they wished, was paired with an experienced family member to offer support and advice of the system and what to expect and how to react. It was not a substitute for the excellent family education program the hospital ran with professionals but it afforded new families the opportunity to vent, question and get comfort and support..

Unfortunately, peer support often means the loosey goosey anti-psychiatry views of those with lived experience. That lived experience is often focused on the concept of trauma as a main cause of the problem and trauma informed care. Both Dr Dawson and I have dealt with trauma in earlier blogs on this site. His first of a number of blogs on the subject was entitled “As for trauma causing schizophrenia NO! NO! NO!”.

As Susan Inman has written in the past, Peer workers need much better science training than they presently receive. She pointed out that:

the guidelines support the increasingly powerful “alternative'” movement in mental health care. This movement either denies the medical basis for illnesses like schizophrenia or bipolar disorder or minimizes its presence. Instead, people are led to believe that all mental health problems are the result of trauma and neither the people with illnesses nor those who work with them need to know anything about major mental illnesses.

Recently, I was made aware of what seems to be a private for profit company providing peer support and family peer support. Located in Winnipeg Manitoba, the company is run by Robyn Priest who describes herself as a “straight shooting Aussie” transplanted to bitterly cold (in winter), Winnipeg. She has a bachelor of human movement studies and a post graduate diploma in public health. One of her colleagues is a peer support worker with a bachelor of commerce degree, another is only a PSW, one is trained in Neurolinguistic Programming (an unproven pseudoscience), and one has cultural anthropology, art history, and a PhD in women’s Studies. The PhD has (ABD) beside it.

ABD means all but dissertation which is a crucial part of the PhD work. According to an academia website, it means “Some people think it’s ok to call yourself PhD ABD when in the Canadian or US system, you pass the qualifying exams and coursework, but haven’t yet, or fail to ever, deliver the thesis” Another person on the same site said it is “like an espresso that is All But Coffee. It’s hot water with a bit of sugar, thus defeating the entire purpose of the exercise.” The most important part of a PhD is the dissertation which is how the candidate demonstrates their ability to do original research which they must defend in front of a committee of experts. Without that, you don’t have anything so to call yourself a PhD is deceptive.

Their claim to expertise, however, is that they all claim lived experience. They say that they “all have experienced many life challenges e.g. mental health issues, addictions, divorce, death, abuse, etc. and are using those life experiences to share simple, easy ways to have meaningful conversations so you don’t feel like a deer in the headlights.” That’s like telling me that I have lived experience with cancer but no academic qualifications in medicine, oncology or science but I am going to give you training in cancer.

That might be OK if that is all it is but they are training people to become PSW and family support workers and do not appear to have the credentials that I would like to see – knowledge and understanding of the evidence-based causes and treatments for these conditions.

One of their courses is a 2 hour workshop on homelessness for $45. In that time they will explain why people become homeless but I can do that in one sentence. The homeless have untreated mental illness, an addiction problem or they are poor and lost their housing. It would be better to send the $45 to an agency that helps. In my community there is an out of the cold program that provides hot meals to the homeless at various religious facilities around the city. That would be a much better use of the money.

The peer support training costs $750.00 and consists of 20 sessions over a 2 week period. The topics covered can be found on their page at https://www.robynpriest.com/product-page/2week-online-peer-supporter-worker-training-becoming-an-exploration-fac I don’t see anything on the basics of mental illness and how mental illness is treated which you would think is crucial. There is a session called “Let’s talk about the “S” word”. I have no idea what that is. At first I thought stigma but there is a session on stigma and discrimination. In discussing this with someone, we came to the conclusion that it must be a discussion of schizophrenia and by calling it the S word, it does not suggest that it is thought of favourably. Your guess is as good as mine.

Now they do say that the course follows the Mental Health Commission of Canada guidelines but Susan was referring to them in her blog about peer support. She said:

However, various ideological agendas have led the internationally powerful peer support movement in questionable directions. These directions are apparent in a close examination of the Mental Health Commission of Canada’s (MHCC) “Guidelines for the Training of Peer Support” a document released last year that focuses on the “skills and knowledge to be included in training programs.” The problematic beliefs informing these Guidelines are apparent in the recently announced program of the group’s National Conference on Peer Support.

Those of you who followed my Huffington Post blogs, know that I have been highly critical of the commission which still exists despite an arms length review suggesting the government stop funding it. My caveat for these courses is “buyer beware”.

Three More Months Till the End of 2020

By Dr. David Laing Dawson

Most of our celebrations are organized to coincide with a natural earthly movement and change of seasons. We may link them to real or imagined historical events but they are really ancient celebrations of a change of season. Easter (Oestrus) and spring. Beginning of summer. End of summer. Harvest time. Winter Solstice.

But not January 1st and the beginning of a New Year. And not this year for sure. The events south of the border are approaching a solstice all their own. A culmination of craziness. On the sixth of this month the Congress and Senate gather to ratify the electoral college vote for president. A ceremonial moment usually.

But Trump’s own Albert Speers have been using social media to create their own version of a Nuremberg light show. The drums are beating and the far right groups are gathering in Washington. Their intent is quite simple: Overturn the election and keep Trump in office, with vastly more power. Many in the Republican party are …. well what the hell are they doing? They are busy demonstrating that which we all fear about politicians. To stay in power, to be re-elected, they are quite willing to speak out of both sides of their mouths, to risk lives and democracy itself, to retain this thing called power, and their current social status. They are willing to prop up a little man with a moustache or a fat man with a comb over, even if they can see the carnage that could follow.

And that fat man with the comb over, I see, as soon as I wrote this piece, was taped telling the Georgia Secretary of State to “find” votes for him, or it would be “very costly”. CNN likened this to a mob boss, but even a mob boss knows to send a lieutenant to deliver this kind of veiled threat in person. Trump is a 14 year old boy pretending to be a mob boss. His blind narcissism may save us in the end.

So, 2020 and the threat to democracy will not be over until the end of January. Perhaps, we hope, with, eventually, a peaceful transition of power to Joe Biden. But a lot rests in the hands and mind of one Mike Pence, in the patience, wisdom, and tolerance and fortitude of most congressmen and women and senators, and in the preparedness of the D. C. police force.

And then we have COVID-19, also not paying attention to this being a new year. Currently setting new records of infections, of deaths, and close to overwhelming our hospital systems. Three more months is my guess, and maybe then, after stringent lock downs and millions of vaccinations delivered, we will be able to walk, and talk, and breathe freely.

And then, maybe, we can take all these lessons learned from 2020, welcome the arrival of 2021, and tackle climate change, the sorry state of our long term care facilities, our universal readiness for the next pandemic, prevention of the next pandemic, and, along the way, homelessness, poverty, and mental health care that works for all with serious mental illness.