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Psychiatry’s greatest challenge is grappling with the fact that mental health—like diabetes and hypertension—is shaped by our choices. Yet decades of pharmaceutical programming have convinced us we’re helpless against these brain disorders and that saying otherwise is ‘stigma.’

“Your mental illness is a brain condition.” Has there ever been a more disempowering, life-denying, dehumanizing message? Life and vitality stem from belief in agency, power, capacity. Robbing someone of that belief is the closest I come to grasping the meaning of sin.

We literally teach kids the value of a growth mindset and ‘self-efficacy’. But as soon as a kid spirals into crisis, we tell them their brain is against them and they need our pills in order to function—and then congratulate ourselves for ‘fighting stigma.’ It’s a cruel system.

Finally, my true expertise is being acknowledged…🤔

A formative event: 20 years ago, a man told me his doctors diagnosed him with schizophrenia, but they misunderstood it—it wasn’t a disease, but a heightened mode of perception. As a product of the mental health system, I’d never heard anything so subversive.

“Justin, I used to have romantic ideas about mental illness too, until I worked in an asylum.” Why do people always say this? They know I spent my formative years in and out of these places, first visiting my dad and then being locked up myself. It’s what fuels my work.

This is not difficult to understand: to act effectively in the world, I must trust that I perceive reality correctly, and I can reason about it well. Any person or institution that seeks to convince me otherwise, as psychiatry does, is inflicting unspeakable harm.

Had a fantastic conversation with Jack Weinstein on Why? Radio—diving into the reappropriation of ‘madness,’ insanity and responsibility, madness as divine guidance, and (somehow) LSD vs. speed. Always a pleasure to engage with a fellow philosopher! wp.me/p8pYQY-lhy

The worst thing you can do to a person is convince them their mind or personality is a symptom of a disorder. It’s morally hideous.

“Reality is on our side”: has any statement more succinctly captured the essence of psychiatry, the breathtaking arrogance of the field? “We are plugged into reality; our opponents are swimming in a sea of delusion; they cannot win.”

What’s so gut-wrenching is there *are* positive and empowering ways of thinking about depression, psychosis, ADHD…but the disease model is too lucrative. So instead we get: “you have a brain disease, but we can conquer it with drugs.”

I believe that those we call “mad” are, for the most part, more attuned to reality than the rest of us, and this heightened attunement can sometimes be overwhelming and scary. “Therapy” should consist in honoring this attunement while protecting from its dangers.

Happy father’s day to my dad, who left us just over 20 years ago. Just found this picture of him - he was on his way from Harvard to the White House and was interviewed by Maclean’s. 35 and on top of the world.

Entertaining to watch psychiatrists now climbing over one another to boast about their “deprescribing” skills, as if they weren’t mocking and belittling the practice a year ago. “Nobody deprescribes better than me” “lol we’ve always been deprescribing”