Thank you so much for this! Their agenda is far clearer when you look at what they are trying to do in addiction, which is get rid of the only two treatments proven to cut the death rate from opioid addiction by 50% or more and replace them with their "spiritual" 12-step wellness farms —despite the fact that abstinence-only treatment is actually linked to HIGHER death rates than no treatment at all. As I wrote recently in the Times, SAMHSA now wants doctors and patients to re-evaluate the use of these medications annually, which sounds like a nice worry about overprescribing, but in reality, most people come off of the meds way too soon rather than staying on too long. They also say they will no longer fund "medication only" use of these treatments, despite the fact that they just spent the last few years implementing new regulations to *encourage* medication only / low threshold care because there's no evidence that forced counseling or daily pick up requirements do anything other than increase treatment dropout and overdose deaths.
“The binary of disease-based reductive psychiatry on one side and “critical psychiatry” on the other nudges us to assume there is nothing in between. In fact, the space between is large and well populated.”
Thank you for recognizing the middle. It’s a space I live in… as a pediatric NP who cares for way too much mental illness (3 of my 15 patients yesterday were for serious mental illness… not just the “garden variety” depression and anxiety I also see so much of). I talk about lifestyle and how this matters AND sometimes I also prescribe meds.
I’m also a patient who recently finished a 26 month taper off Prozac… neither myself nor my own psych NP had any idea how awful this can sometimes me (an attempted 7 week taper at the beginning was a disaster). I found the info and support I needed to successfully do this in the peer community… which is amazing, but, yes, sometimes frustratingly very one sided.
I was unsurprised to learn that Daniel Bergner is a journalist like Robert Whitaker, Ethan Watters, and Michael Pollan who have also delved into neuroscience, psychiatry, and consciousness. The complexities of these topics is why I typically avoid books written by journalists, though I did like We’ve Got Issues by Judith Warner who is also a journalist. Overall, I much prefer the insights you provide on this site. Thank you.
I think it's important to note that they're also against therapy, trauma-informed care, psycho-education, and gentle parenting. From the MAHA report, right after it discusses supposed overdiagnosis of ADHD:
"Dominant mental health approaches, often relying on reductive diagnoses and targeted treatments, face scrutiny for overlooking environmental factors. Some interventions may even cause harm. For example, universal school-based mental health programs can inadvertently increase distress in certain adolescents by encouraging rumination, though evidence is debated.
"Such over-pathologization may lead to interventions that fail to address root causes. Echoing these concerns, Abigail Shrier’s 2024 book, Bad Therapy: Why the Kids aren’t Growing Up, contends that interventions like therapy and Social-Emotional Learning programs may weaken resilience by pathologizing normal emotions. This perspective raises concerns that practices like trauma-informed care and gentle parenting potentially pathologize normal emotions, undermine resilience, and contribute to rising anxiety and depression rates among children and teenagers. Though controversial and disputed by many experts, this perspective remains viable and warrants rigorous scientific investigation to either confirm or refute its validity."
When they say "environmental factors" causing mental health problems, they're not talking about poverty, racism, intimate partner violence, child abuse, harsh work environments, pollution known to adversely affect development that occurs in racist distributions*, suburban social isolation as a deliberate capitalist ploy to increase consumerism and decrease labor organizing**, etc. They're talking about any cultural practice that isn't in line with fascist ideology. There is no common ground between MAHA and people who want a society where people are cared for and there are real solutions for mental distress.
* They will talk about pollution since it lines up with fascist ideology around the purity of the body, but e.g. they mention agricultural chemicals only in terms of the small amounts on foods that children are eating, not the much-larger exposures of children in mostly-Latino farm worker families. And their actual policy exists to further sabotage already-weak environmental regulations.
** They like blaming social isolation on screen time for kids, not a hostile, car-centric built environment and generations of urban development deployed deliberately to destroy thriving cultural communities in urban areas. It is of course easy to loop Christian moralizing into their arguments around social isolation.
Thank you so much for this! Their agenda is far clearer when you look at what they are trying to do in addiction, which is get rid of the only two treatments proven to cut the death rate from opioid addiction by 50% or more and replace them with their "spiritual" 12-step wellness farms —despite the fact that abstinence-only treatment is actually linked to HIGHER death rates than no treatment at all. As I wrote recently in the Times, SAMHSA now wants doctors and patients to re-evaluate the use of these medications annually, which sounds like a nice worry about overprescribing, but in reality, most people come off of the meds way too soon rather than staying on too long. They also say they will no longer fund "medication only" use of these treatments, despite the fact that they just spent the last few years implementing new regulations to *encourage* medication only / low threshold care because there's no evidence that forced counseling or daily pick up requirements do anything other than increase treatment dropout and overdose deaths.
“The binary of disease-based reductive psychiatry on one side and “critical psychiatry” on the other nudges us to assume there is nothing in between. In fact, the space between is large and well populated.”
Thank you for recognizing the middle. It’s a space I live in… as a pediatric NP who cares for way too much mental illness (3 of my 15 patients yesterday were for serious mental illness… not just the “garden variety” depression and anxiety I also see so much of). I talk about lifestyle and how this matters AND sometimes I also prescribe meds.
I’m also a patient who recently finished a 26 month taper off Prozac… neither myself nor my own psych NP had any idea how awful this can sometimes me (an attempted 7 week taper at the beginning was a disaster). I found the info and support I needed to successfully do this in the peer community… which is amazing, but, yes, sometimes frustratingly very one sided.
I was unsurprised to learn that Daniel Bergner is a journalist like Robert Whitaker, Ethan Watters, and Michael Pollan who have also delved into neuroscience, psychiatry, and consciousness. The complexities of these topics is why I typically avoid books written by journalists, though I did like We’ve Got Issues by Judith Warner who is also a journalist. Overall, I much prefer the insights you provide on this site. Thank you.
I think it's important to note that they're also against therapy, trauma-informed care, psycho-education, and gentle parenting. From the MAHA report, right after it discusses supposed overdiagnosis of ADHD:
"Dominant mental health approaches, often relying on reductive diagnoses and targeted treatments, face scrutiny for overlooking environmental factors. Some interventions may even cause harm. For example, universal school-based mental health programs can inadvertently increase distress in certain adolescents by encouraging rumination, though evidence is debated.
"Such over-pathologization may lead to interventions that fail to address root causes. Echoing these concerns, Abigail Shrier’s 2024 book, Bad Therapy: Why the Kids aren’t Growing Up, contends that interventions like therapy and Social-Emotional Learning programs may weaken resilience by pathologizing normal emotions. This perspective raises concerns that practices like trauma-informed care and gentle parenting potentially pathologize normal emotions, undermine resilience, and contribute to rising anxiety and depression rates among children and teenagers. Though controversial and disputed by many experts, this perspective remains viable and warrants rigorous scientific investigation to either confirm or refute its validity."
When they say "environmental factors" causing mental health problems, they're not talking about poverty, racism, intimate partner violence, child abuse, harsh work environments, pollution known to adversely affect development that occurs in racist distributions*, suburban social isolation as a deliberate capitalist ploy to increase consumerism and decrease labor organizing**, etc. They're talking about any cultural practice that isn't in line with fascist ideology. There is no common ground between MAHA and people who want a society where people are cared for and there are real solutions for mental distress.
* They will talk about pollution since it lines up with fascist ideology around the purity of the body, but e.g. they mention agricultural chemicals only in terms of the small amounts on foods that children are eating, not the much-larger exposures of children in mostly-Latino farm worker families. And their actual policy exists to further sabotage already-weak environmental regulations.
** They like blaming social isolation on screen time for kids, not a hostile, car-centric built environment and generations of urban development deployed deliberately to destroy thriving cultural communities in urban areas. It is of course easy to loop Christian moralizing into their arguments around social isolation.
I’m so glad you wrote this. I listened to the whole conference and recognized it needed a subtle response that I did not feel capable of writing.