Michael O’Loughlin - Exploring Narrative Approaches to Psychological Distress
09/30/17 • 28 min
This week, Mad in America’s news editor Justin Karter interviews Professor Michael O’Loughlin.
Professor O’Loughlin is a college professor and researcher at Adelphi University on Long Island. He is a licensed psychologist and a psychoanalyst in private practice in New Hyde Park, New York. Dr O’Loughlin writes critically about the biomedical model of psychiatry and psychology and also has a deep interest in psychiatric rights and social justice issues.
In 2015 as an editor he launched a book series entitled Psychoanalytic Studies: Clinical, Social, and Cultural Contexts, with Lexington Books.
In August 2017, with colleagues Dr. Awad Ibrahim (University of Ottawa), Dr, Gabrielle Ivinson (Manchester Metropolitan University), and Dr. Marek Tesar (University of Auckland), as series co-editors, he launched a book series, Critical Childhood & Youth Studies: Clinical, educational, social and cultural inquiry, to be published by Lexington Books.
Professor O'Loughlin talks about his childhood experiences and how they influenced his narrative and conversational approach to psychological distress.
In this episode we discuss
How Dr O’Loughlin’s early experiences growing up in Ireland led to a deep interest in social justice issues, particularly poverty and inequality.
That as a young man in college he engaged in charity work and activism.
How, more recently, he became interested in psychiatry when he was appointed as a lecturer in clinical psychology, but realised that there weren’t required courses on trauma or psychosis.
That this led to teaching courses in intergenerational trauma and the way that our history shapes us as people.
That Michael has engaged in autobiographical writing to understand the way that deprivations and injustices that he experienced had a formative impact on his own thinking and writing.
That another course on madness and psychosis was perceived by clinical psychology students as radical, leading to a realisation that mainstream psychology is a very conservative discipline.
How he became interested in interviewing psychiatric patients and telling stories that represented a diverse group of people and experiences of psychiatric services.
That this led to a project at Fountain House in New York City to see if narratives could be reinforced and shared.
That Michael does not himself use the terms mental illness or disorder because he feels that we need to be flexible and that even this terminology can be traumatising.
How he has recently focused on creating spaces where participants can share their experiences and stories and it shouldn’t be a classification or categorization exercise.
That he has found many that have experienced the psychiatric system have felt that the system impeded their recovery.
That a collaborative team of Adelphi academics, Fountain House staff and Fountain House members will together publish research.
That Professor O’Loughlin feels that psychology and psychiatry are traditional and reactive disciplines and that psychiatry has been driven by pharmacological concerns.
How Michael’s work with children is grounded in his own childhood experiences and a sense that human beings need nurturing spaces and validation.
That Michael is extremely disturbed about the medicating young children with drugs that are not known to be safe for them such as antipsychotic drugs.
The unwillingness to understand that a child's distress has an origin and that we have a responsibility to engage with the child and create a space for them to communicate.
How we define normality within such a narrow range that children find it very difficult to conform to society’s expectations.
That there seems to be little room for a child in school, only room for a student.
That psychoanalysis has tools to understand our emotions and experiences but also has tools to help understand societal drivers that may underlie psychological distress.
The worry that talking therapies are being replaced by tick lists and categories and that we need to bring stories back into psychology.
Relevant links:
Psychoanalytic Studies: Clinical, Social, and Cultural Contexts
To get in touch with us email: [email protected]
© Mad in America 2017
This week, Mad in America’s news editor Justin Karter interviews Professor Michael O’Loughlin.
Professor O’Loughlin is a college professor and researcher at Adelphi University on Long Island. He is a licensed psychologist and a psychoanalyst in private practice in New Hyde Park, New York. Dr O’Loughlin writes critically about the biomedical model of psychiatry and psychology and also has a deep interest in psychiatric rights and social justice issues.
In 2015 as an editor he launched a book series entitled Psychoanalytic Studies: Clinical, Social, and Cultural Contexts, with Lexington Books.
In August 2017, with colleagues Dr. Awad Ibrahim (University of Ottawa), Dr, Gabrielle Ivinson (Manchester Metropolitan University), and Dr. Marek Tesar (University of Auckland), as series co-editors, he launched a book series, Critical Childhood & Youth Studies: Clinical, educational, social and cultural inquiry, to be published by Lexington Books.
Professor O'Loughlin talks about his childhood experiences and how they influenced his narrative and conversational approach to psychological distress.
In this episode we discuss
How Dr O’Loughlin’s early experiences growing up in Ireland led to a deep interest in social justice issues, particularly poverty and inequality.
That as a young man in college he engaged in charity work and activism.
How, more recently, he became interested in psychiatry when he was appointed as a lecturer in clinical psychology, but realised that there weren’t required courses on trauma or psychosis.
That this led to teaching courses in intergenerational trauma and the way that our history shapes us as people.
That Michael has engaged in autobiographical writing to understand the way that deprivations and injustices that he experienced had a formative impact on his own thinking and writing.
That another course on madness and psychosis was perceived by clinical psychology students as radical, leading to a realisation that mainstream psychology is a very conservative discipline.
How he became interested in interviewing psychiatric patients and telling stories that represented a diverse group of people and experiences of psychiatric services.
That this led to a project at Fountain House in New York City to see if narratives could be reinforced and shared.
That Michael does not himself use the terms mental illness or disorder because he feels that we need to be flexible and that even this terminology can be traumatising.
How he has recently focused on creating spaces where participants can share their experiences and stories and it shouldn’t be a classification or categorization exercise.
That he has found many that have experienced the psychiatric system have felt that the system impeded their recovery.
That a collaborative team of Adelphi academics, Fountain House staff and Fountain House members will together publish research.
That Professor O’Loughlin feels that psychology and psychiatry are traditional and reactive disciplines and that psychiatry has been driven by pharmacological concerns.
How Michael’s work with children is grounded in his own childhood experiences and a sense that human beings need nurturing spaces and validation.
That Michael is extremely disturbed about the medicating young children with drugs that are not known to be safe for them such as antipsychotic drugs.
The unwillingness to understand that a child's distress has an origin and that we have a responsibility to engage with the child and create a space for them to communicate.
How we define normality within such a narrow range that children find it very difficult to conform to society’s expectations.
That there seems to be little room for a child in school, only room for a student.
That psychoanalysis has tools to understand our emotions and experiences but also has tools to help understand societal drivers that may underlie psychological distress.
The worry that talking therapies are being replaced by tick lists and categories and that we need to bring stories back into psychology.
Relevant links:
Psychoanalytic Studies: Clinical, Social, and Cultural Contexts
To get in touch with us email: [email protected]
© Mad in America 2017
Previous Episode
Irving Kirsch - The Placebo Effect and What It Tells Us About Antidepressant Efficacy
This week I have had the honour of interviewing Dr Irving Kirsch.
Dr Kirsch is Associate Director of the Program in Placebo Studies and lecturer in medicine at the Harvard Medical School and Beth Israel Deaconess Medical Center. He is also Professor Emeritus of Psychology at the University of Plymouth and the University of Hull in the UK and University of Connecticut in the US. He has published 10 books and more than 250 scientific journal articles and book chapters on placebo effects, antidepressant medication, hypnosis, and suggestion. He originated the concept of response expectancy. His meta-analyses on the efficacy of antidepressants were covered extensively in the international media and influenced official guidelines for the treatment of depression in the United Kingdom. His 2009 book, The Emperor’s New Drugs: Exploding the Antidepressant Myth, was shortlisted for the prestigious Mind Book of the Year award and was the topic of 60 Minutes segment on CBS and a 5-page cover story in Newsweek.
In this interview, we discuss Dr Kirsch’s research into the placebo effect and the efficacy of drugs used for depression.
In this episode we discuss:
- How, as an undergraduate student, Dr Kirsch became interested in behavioural therapy but that he doubted the rationale behind these approaches
- That this led to an interest in beliefs that people had and research into the placebo effect
- How, while working at the University of Connecticut, his research into the placebo led to an interest in the efficacy of antidepressant drugs when compared to placebo
- How his work led to the surprising conclusion that, were antidepressant drugs were concerned, the placebo effect was so large that there was very little room for a meaningful drug effect
- How this changed Dr Kirsch’s views on antidepressant drugs entirely, causing him to ask whether the risks were worth the small benefit for depressed patients
- That a belief that a person has can affect their response to a drug either in a positive way (placebo) or in a negative way (nocebo)
- Dr Kirsch found that there are many conditions that can show a profound placebo effect including depression, anxiety, irritable bowel syndrome, pain, Parkinson’s disease and asthma
- That the placebo tends to have a greater effect in conditions that have a large psychological component when compared to functional disorders such as diabetes
- That placebo can have an effect even if the patient knows that they are taking an inactive tablet and that part of this response is down to classical conditioning
- That Dr Kirsch is working on ‘open-label placebo’ which is being able to prescribe placebo to patients without deception
- That Dr Kirsch used to refer depressed patients for antidepressant treatments, but that his research made him a disbeliever when looking at the evidence of efficacy when compared to placebo
- How, when you give someone a new treatment, that often will counter feelings of hopelessness that characterise depressive experiences
- That in looking at this size of this effect, it made clear that the difference between placebo response and antidepressant response was so small that it was not clinically significant
- That even drugs with very different modes of action resulted in virtually identical responses in patients, for example, Tianeptine, which is an SSRE (selective serotonin reuptake enhancer) and decreases serotonin levels between neurons, this drug should make depressed people worse but instead, it showed the same efficacy as SSRI antidepressants
- How, when looking at the clinical trials used to demonstrate antidepressant efficacy, it became clear that the obvious nature of antidepressant adverse effects meant that trial participants would often “break blind” and they would know if they were in the active drug group or the placebo group, this would naturally influence the results of the trial
- That, in a small number of studies, an active placebo was used, which was a substance that mimicked the side effects of the active drug while having no clinical effect itself
- That in these active placebo studies, you were much less likely to get a significant difference between drug and placebo when compared to trials that used an intern placebo
- That the trials conducted by pharmaceutical manufacturers are designed to show their drug in the best possible light and so they do not use active placebo in their studies
- That Dr Kirsch feels that when conducting trials for drugs used for depression, patients should be asked early on in the trial whether they think they are in the active group or the placebo group and that this question would help ensure the trials were reliable
- How, when using the data from unpublished trials, the difference between placebo effect and drug effect was even smaller
Next Episode
Bonnie Burstow and Nick Walker - An Introduction to Cognitive Liberty
This week, Mad in America editor Emily Sheera Cutler presents the first in a series of interviews that examine the many important issues around forced treatment and cognitive liberty. The series will examine philosophical, theological, and sociological perspectives on coercive treatment.
In this first part, Emily interviews two well known and very respected academics and activists Bonnie Burstow and Nick Walker. Central to both Bonnie and Nick’s work is the concept of cognitive liberty or freedom and integrity of the mind. Early proponents of cognitive liberty have defined it as the right to control one’s own consciousness and be free from mind-altering drugs and technologies, as well as the right to use mind-enhancing drugs and technologies without facing legal consequences. Contemporary proponents of cognitive liberty have expanded the definition to include the right to experience and express each and every thought, feeling, state of mind, and belief as long as it does not harm anyone else. Both Bonnie and Nick describe cognitive liberty as the right to express oneself authentically. In this first episode, they get to the core of why so many human rights activists oppose forced treatment – it can interfere with people’s rights to be themselves.
In this episode we discuss:
- How Bonnie became an antipsychiatry activist and scholar, and why she sees the institution of psychiatry as a human rights violation
- How Nick became a neurodiversity scholar through his involvement with the Autistic rights movement
- The difference between the neurodiversity paradigm, which views neurological, mental, and cognitive differences on the natural spectrum of human diversity, and the pathology paradigm, which assumes there is a right way or healthy way of being and to differ from it is unhealthy
- What it means for each person to have cognitive liberty and be able to express their own unique way of being and processing the world without repercussions
- How psychiatry curtails our cognitive liberty and freedom of mind by pathologizing difference to justify forceful and coercive measures
- The social model of disability, which states that people are disabled by lack of access and discrimination, not by medical conditions or internal deficits
- How the social model of disability intersects with neurodiversity and antipsychiatry but also falls short
- That Applied Behavior Analysis (ABA) constitutes a human rights abuse against Autistic children, forcing and coercing them to act more normal and less different
- That other behaviour therapies and even humanistic therapies can be coercive as well
- That the autism industry profits off of the pathology paradigm, convincing parents there is something wrong with their Autistic children and that it is not okay to be Autistic, and their children need to be subjected to ABA and other “treatments”
- How antipsychiatry and neurodiversity intersect with feminism and queer studies
- Why it is necessary for educators to teach students “mad literacy” from an early age
- The importance of writing and publishing literature with accurate, positive representations of neurodivergent and Mad people
- How we can build communities in which people support one another through emotional distress without violating anyone’s autonomy or restricting anyone’s freedom
- Why the conventional notion of “suicide prevention” is problematic and can serve to take away people’s coping skills
- How the ideas of somatic therapy can help us support people in distress
Relevant Links
Bonnie Burstow’s articles for Mad in America
The Bonnie Burstow Scholarship in Antipsychiatry
Throw Away the Master’s Tools: Liberating Ourselves from the Pathology Paradigm by Nick Walker
Neuroqueer: An Introduction by Nick Walker
The social model of disability vs. the medical model of disability
To get in touch with us email: [email protected]
© Mad in America 2017
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