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Dr. Andrew Kaufman on Psychiatry, Good and Bad Research, Treating Severe Mental Health, and More!
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This week, we are honoured to have Dr. Andrew Kaufman on! We discussed Dr. Kaufman's experiences and observations as a psychiatrist. We talk about the problems in diagnoses and how they can act as a pseudo-understanding for individuals.
We discuss the flaws of looking at mental health conditions as brain pathology and emphasize the important note that mental health and physical health are not separate. We also highlight the problems with labeling individuals as abnormal.
We briefly discuss good and bad experiments in psychology. This leads into a discussion of some possible ways to treat severe mental health conditions. We also hear Dr. Kaufman's advice for people working in the mental health field.
I thoroughly enjoyed recording this episode! I hope you enjoy it!
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Transcript
Introduction to Beyond Train and Guest Introduction
00:00:02
Speaker
Welcome everybody to another episode of the Beyond Train podcast. I'm your host, Liam Dalton. I could give a very long winded introduction today. Um, you know, I could talk about this man's work. You can talk about the influence he's had on me, uh, my path. I can talk about how he's influenced so many people in this world. Uh, the impact that he's had, I could talk about how I think he's likely going to go down as one of the best scientists in history, uh, truthfully. Um,
00:00:31
Speaker
definitely one of the most, one of the most important. But I'll save my lung with an intro and that's all you'll get. And all I can offer is thanks for everything that you've done. And of course, thanks for coming on today. Dr. Andrew Coffin, thank you. Well, that was a very generous introduction of you, Liev. It's nice to be here with you and hopefully I'll be able to answer your questions. Yeah, certainly. Well, I've been
00:00:59
Speaker
Looking forward to the answer to our introductory question.
Defining Health and Psychological Insights
00:01:02
Speaker
I ask all my guests to define health. I like to know how you look at health, what it means, how it manifests, and it gives us a good baseline to work off of. Well, to me, it's mainly about function. So how well do you function in life? Can you do all the things you want to do? Can you meet your goals? Or are you held back by bodily problems, psychological problems?
00:01:29
Speaker
uh, existential crises, uh, and the like. And, uh, that's the balance, uh, where health lies in the degree of functionality. Yeah. Amazing. Nice and concise. Um, you know, I have similar thoughts on it actually as well. You know, it's anything for me, it's anything that really inhibits your,
00:01:54
Speaker
development as a person, anything that's getting in the way of your goals and dreams and rights. I really, really appreciate that definition. That's amazing. Yeah. And so today, you know, the topic I really want to discuss with you was sort of along the lines of the more psychological realms. You've certainly done your due diligence in the, in this field, of course, and the train. So I'm really curious to hear sort of your thoughts on the psychological realm of things, because of course,
00:02:23
Speaker
your trained psychiatrist. And so I think that you'll have some extremely valuable insights on the development of mental health conditions, whether they be severe or acute. So maybe I could just open up the floor and allow you to take it from there. Yeah. I mean, I can certainly get this kind of a discussion going. I was trained in the current model of
Critique of Psychiatry and Mental Health Labels
00:02:52
Speaker
medical psychiatry with the DSM, the Diagnostic and Statistical Manual of Diagnoses, which is in the fifth version right now. And of course, each version that comes out expands the number of what they call mental health diagnoses or
00:03:15
Speaker
mental illnesses, but it's not based on any science or any clear findings from nature. It's really just a bunch of people get together in a room and sort of say, okay, let's put these elements together, which are often very arbitrary. I always love hearing Tom Cowan talk about
00:03:40
Speaker
attention deficit disorders, for example, where there's something in there like excessive tapping as one of the criteria. And then, well, what's excessive? Obviously, these things are all extremely subjective and arbitrary. And one time I was at a professional conference with a bunch of very
00:04:05
Speaker
highly accomplished colleagues who were mostly faculty members of medical schools or had a successful private practice and had published research papers and such. And we were sitting around drinking one night during the conference. And this discussion went into, oh, what diagnosis do you have? And all these people with all these achievements and families and success,
00:04:35
Speaker
because they're like automatons when it comes to this information that they just give themself a diagnosis and say, oh, I'm mentally ill too.
00:04:48
Speaker
more of a high functioning mental illness, but nevertheless, and I it was almost laughable and I had to, you know, put my foot down and, you know, they were trying to say that I was being, you know, cocky about it or something because I didn't consider myself mentally ill. But, you know, the key thing is that whatever these things are just common experiences that are described and labeled as pathologic. But
00:05:17
Speaker
there is a caveat that there has to be serious functional impairment.
Pharmaceutical Influence and Treatment Approaches
00:05:22
Speaker
It's just everyone ignores that part of it and just goes right there for the symptom criteria. And of course, the whole overall goal of this scheme is really a business model. And it came about when the field of psychiatry was losing market share because primarily psychiatrists were
00:05:46
Speaker
psychotherapists. And following in the, you know, paradigm of Sigmund Freud of psychoanalysis, you know, the stereotypic lay down on a couch, free associate like that was actually the main model of psychiatric treatment aside even in institutions with psychotic folks, they did that as the primary therapy. But
00:06:10
Speaker
Other professionals like psychologists and social workers began training themselves in doing psychotherapy. And of course, since they didn't have as much school or the expectation of making as much money as a doctor, they were undercutting the psychiatrists and the psychiatrists were losing business. And essentially their professional guild, the American Psychiatric Association got together with the pharmaceutical industry.
00:06:40
Speaker
And they came up with a model to medicalize psychiatry. And that's when psychiatrists were encouraged to start wearing white coats, which is what I was taught to do at Duke, where I did my training. And they started using pharmaceuticals. And it's so interesting because one of the first drugs that was used was Thorazine. And it was actually being developed as an allergy medicine.
00:07:08
Speaker
And they just noticed that the subjects they tested on were quite docile. And then this became then marketed as a psychiatric drug and all it is is essentially a tranquilizer. It's like, you know, shooting a dart at an animal, like that's the drug that would be inside of it. And this has really continued that they've been able to develop pharmaceuticals that kind of mask some of the more noticeable
00:07:37
Speaker
manifestations of people in a lot of mental distress and pass that off as a treatment and it's become a huge market. In fact, some of the top 10 best-selling drugs are psychiatric drugs and they're often marketed for off-label uses like for example as sleeping aids, which I think there are more prescriptions for that purpose with antipsychotics than actually using them.
00:08:03
Speaker
as an antipsychotic and then all of the data of which there is a lot showing the lethality and toxicity of these drugs is suppressed. For example, a couple of Canadian studies showing increased mortality even short term from antidepressant drugs. We have data from the Pennsylvania Health System which encompasses quite a large number of patients.
00:08:31
Speaker
showing that virtually any class of drug used as a sleeping pill increases your mortality at five years. We've got a study out of Tennessee looking at children and adolescents finding a substantial number of just sudden death occurrences from them taking antipsychotics.
00:08:52
Speaker
And also we have other data, longer term data on the modern antipsychotics showing short lifespans and a lot of cardiovascular death. So all of this is out there. It's published in the peer review journals and it is almost completely ignored in the way psychiatry is practiced. And of course, when I was in the trenches, I observed, you know, one after another patient not get better
00:09:20
Speaker
and not even really have any psychiatrist or other health professional understand the nature of their problem. And they just go on and unchanged in their life and all these strategies, adding more drugs, switching from one to the next, to the next, to the next.
Natural Healing and System Critique
00:09:39
Speaker
It was a fruitless exercise. And at the same time, ignoring the things that actually could help like eating a proper diet,
00:09:49
Speaker
taking care of yourself. Of course, getting off the psychiatric drugs, doing, you know, perhaps detoxification protocols, those things are, you know, just unheard of. But the first time I ever tried a natural healing protocol with another individual, it was someone with terrible anxiety issues. And just from
00:10:17
Speaker
a elimination diet. It was practically cured. Yeah, I really think that the environment plays a large role. And here we say that all disease, mental, physical, spiritual, whatever it is, is caused by three things, one of three things, or a combination, toxicities, deficiencies, or traumas. It's no different when it comes to
00:10:45
Speaker
mental health conditions, right? So it's really addressing the terrain no matter what it is. And you could take many different approaches to that too. Well, Liev, I wouldn't really distinguish between a mental illness or a physical illness.
00:11:03
Speaker
Right and I try not to use categories, you know like that because I try to instead refer to the cause right so the causes could be trauma. Right and let's say that it's psychological trauma is the cause well.
00:11:18
Speaker
that can manifest as physical symptoms, it can manifest as psychological and spiritual symptoms, and it can manifest really as all three. And I think even when something seems to have a primarily physical cause, like let's say, you know, an acute poisoning, for example,
00:11:39
Speaker
there still is going to be psychological and spiritual components because there are spiritual aspects of what's going to happen to me if I do die. What's the meaning? What about my loved ones? All those things come up when you have a life-threatening experience. And then what about how you're going to interact with the treatment? What if to get better you have to fast but you have a food addiction?
00:12:05
Speaker
then you have to confront that as part of the healing process. So the current allopathic mainstream system, it really ignores the interaction between these aspects of the self, the so-called body, mind, and spirit. I mean, if you ask any doctor, they'll kind of acknowledge that, but they won't know how to approach it medically whatsoever.
00:12:33
Speaker
And this is one of the major deficiencies that we have. And this why, depending on what doctor you go to, you get a different answer because they only see things through a certain lens, even if there's published research that shows otherwise. Well, I appreciate that very much. That's very valuable. We have this sort of need to categorize everything, too.
00:12:58
Speaker
Dr. Mark Bailey brought that up when we had him on. We have this need to place things in categories and that's largely what we've done with these diagnoses. I have a real issue with the diagnoses in general because I find that it puts people in boxes. For a lot of people, they get so attached to it because it's
00:13:21
Speaker
a sort of understanding for them, you know, like, even if it may not be correct, you know, say somebody who may display symptoms of a certain diagnosis, like ADHD, well, then they identify, well, I have ADHD, and this is how I act. And then they're in this box and they can, you know, adapt, right? So I think there's a huge problem with diagnosis in general.
00:13:43
Speaker
Yeah, you make a good point because on the one hand, it does like when you have a name to call your experience, it makes it such that it's recognizable, it may be it's predictable, it affects other people. So you feel less isolated and there's less unknowns or fewer unknowns perhaps. Although you have to question, well, what's the accuracy of this information?
00:14:09
Speaker
as you pointed out. But the real negative aspect is, and this really comes from how the establishment describes these diagnoses, is that it takes away all of your responsibility, both as being part of the cause of the problem and also as part of the solution. You just defer your authority to a substituted figure, entity, which is the doctor.
00:14:39
Speaker
And whatever they say to do, you just do, which usually just involves popping a pill one or more times a day. Although it could mean subjecting yourself to humiliation in the forms of stripping down naked, exposing your vulnerable bodily areas. It could involve trauma, being stabbed, poked, prodded, impaled, et cetera. Well, and they describe it as a brain pathology.
00:15:08
Speaker
And I think that's a really terrible way to look at it. And it stems from that neurochemical imbalance theory, which we know is flawed and we know is completely inaccurate. And many psychiatrists, even the modern ones, will admit that the serotonin deficiency theory of depression is incorrect, but they'll still say, well, the drugs work. That's always a classic. I've been hearing a lot of psychiatrists argue that
00:15:38
Speaker
But anyways, this idea of brain pathology really has nothing to stand on. They look at neuroimaging and they look at these different experiments that are done, but they don't realize that these things are a result and not a cause. We're always taken away from the cause. Well, that's a very important and salient point that often associations are attributed as
00:16:08
Speaker
causative relationship, which is completely incorrect. But when you mentioned functional imaging studies, so I want to point out another flaw, which is using simulations or models to gather data about the natural world. So functional imaging is a essentially computational model. It's not like it gives you a real time image of what your brain is doing.
00:16:37
Speaker
It only gives data that goes through a lot of computer processing and modeling to then be interpreted as meaning that your brain is doing something, something functional or important.
Psychology's Flaws and Individual Focus
00:16:53
Speaker
But I wouldn't really rely on that at all. And there was a similar phenomenon with a different kind of model that I observed related to this idea about some perturbation in serotonin being a cause of depression. And let me just review for the audience that serotonin is a chemical that's found in the brain and also in the gut and also in the skeletal muscle.
00:17:17
Speaker
that is said to be a neurotransmitter or said to send a signal from one cell to the other. And that's not quite fully proven either. But let's put that aside for the moment. And we're told that because drugs that supposedly affect the serotonin system,
00:17:40
Speaker
supposedly work in depression, although that's been disproven, that the cause of depression must be some abnormality in the serotonin system. Of course, why would there be an abnormality in that? Does that mean that the brain just broke down?
00:17:59
Speaker
That doesn't make a lot of sense, but nevertheless, that's the hypothesis. So I was at Duke and they had this group that was doing this huge data mining project where they were looking at genetic samples of a large number of, I believe it was nursing home residents across the country.
00:18:22
Speaker
And they were doing all kinds of number crunching. And they came up with some finding that showed a certain mutation related to serotonin. And they said, oh my god, we found the link of the cause of depression in serotonin. And they
00:18:40
Speaker
the department was so excited. I mean, they were having champagne, you know, celebrations at the, you know, faculty lounge or whatever, right away. And this went on for several days. And there was like a special grand rounds about it and all this kind of stuff. And then all of a sudden it quieted down. And I was like, you know, a couple months later, I'm like, Hey, whatever happened with that? And it turns out that it was just a mathematical anomaly.
00:19:10
Speaker
that was blown out of proportion. And when they looked for it in other similar data sets, of course they couldn't find and they figured out, oh, this is just the computer making every possibility under the sun, including one that we want, but none of them are real. So we have this same thing happened to predict the tens of millions of deaths during the pandemic that justified the lockdowns.
00:19:38
Speaker
The same kind of modeling that has been proven wrong over and over again, but still guides policies about global warming, climate change. So this is one of the big, big tricks that's used to misguide us all across various scientific disciplines. And we have to be very, very cautious when we encounter such a pseudo scientific report.
00:20:08
Speaker
You do know that psychology is one of the most irreducible parts of the literature that alongside antibody research, but you know, the studies are not reproduced. And so I was actually thinking about this the other day, even those like, think about the Stanford prison experiment. You know, if you did that with a different group of people, the results could be drastically different. Say you took and, you know, say you even manipulated who was in there. If you took everyone, say from the same faith, you know, you'd likely get different results. Say you cherry picked
00:20:38
Speaker
very responsible benevolent people, you'd probably get different results. So even with these studies that are so foundational to how we think that we understand human nature, you have to take it on a case-by-case basis. And I love what Young said about this. He did not care about averages at all. The averages don't have anything to do with an individual. You have to look at the individual.
00:21:05
Speaker
I actually think that there's a case that qualitative research may be much more valuable in psychology or even getting away from empiricism altogether and looking at it from a more rationalism standpoint, but I guess that you could probably get way deep into that too.
00:21:20
Speaker
Well, I think it's important to, first of all, differentiate what is actually science. Because the scientific method is a procedure to understand and confirm a cause and effect relationship in nature. And it requires certain things, like it requires an independent variable, a
00:21:44
Speaker
control, experiment, et cetera. Now, the experiments in psychology that you're describing are not scientific experiments. Now, there are scientific experiments like in cognitive science with animals and with humans that are reproducible and are done with proper controls and such. But they haven't explained all of human behavior or anything like that. They're mostly about learning and memory and things like that.
00:22:12
Speaker
But the Stanford Prison Experiment, which is an observational study, it's like in this certain situation.
Real-World Applications and Mental Health Perception
00:22:21
Speaker
And by the way, so even though that was set up for research purposes, that scenario plays out every single day in the real world. It just not at a university setting, it plays out in actual penal institutions.
00:22:36
Speaker
And I've witnessed this at many, because earlier in my career, since I was in forensic psychiatry, I had both educational rotations that were at penal institutions, and then also I actually worked and taught at a couple of different jails.
00:22:54
Speaker
So I, over time, observed a lot of how the staff, and I'm not just talking about prison and jail guards, right, because we expect those people are going to have a different kind of personality, work ethic, worldview than people in the healing professionals and then, you know, your average college student.
00:23:20
Speaker
But we had psychologists and social workers, a lot of social workers who were working in the prison system. And there, from the helping professions, many of them began working in that institution because they thought, oh, mentally ill people might be institutionalized there. I want to be able to help them.
00:23:42
Speaker
Some of them may have gone because there's a salary premium to work in a setting like that. But nevertheless, what I observed in almost every place that I practiced in was that over a period of time, these mental health workers or advocates would take on the identity and the role of a guard.
00:24:06
Speaker
And instead of treatment, they would give punishment. And you would hear them say things like, they don't deserve this or that, as when you're talking about putting them on and off suicide precautions. Suicide precautions, I saw over and over again, were used by those folks as a punishment.
00:24:27
Speaker
when someone was accused of a raucous crime that was really nasty or if they misbehaved.
00:24:37
Speaker
They were essentially put on this status as a punishment and they wouldn't take them off even though it was not clinically indicated at all. That's just one example of this type of behavior, but it was essentially the same process that we saw in the Stanford Prison Experiment that I've seen over and over again with mental health workers in prison and jail settings.
00:25:06
Speaker
Yeah. And so I'm thinking back to our discussion with Mr. Robert Whitaker there, you know, we sort of concluded that. Like when you look at someone else as abnormal or, you know, lesser, right. In some sort of way, whether it comes to, like you're talking about right now, or even in, you know, these insane asylums, um, you treat people differently when you label them as abnormal. And I thought that was a really interesting conclusion, right? He brought up like,
00:25:35
Speaker
how if somebody was labeled as a schizophrenic in one of these institutions, the workers, whether they be a psychiatrist, a lunch lady, whatever it could be, they would treat them differently. If they were custodian, they would treat them differently because they were labeled as lesser and abnormal. And that's obviously half the problem. They'd ask, if a schizophrenic person would ask for the time, they wouldn't even acknowledge them as a human being.
00:26:06
Speaker
Right. It's just, you know, and, and I think, I think back to the book, how to become a schizophrenic, right? He laid it out beautifully how he was treated as an insane person. You know, if you're treated as a bad person, well, eventually it's going to be a self-filmed prophecy. Yeah. There, there is definitely a lot.
00:26:26
Speaker
you know, to unpack there. And those things are definitely true, that if you have certain expectations for somebody, they'll meet those expectations, even if it's not, you know, their natural proclivity. But, you know, I also want to say that in the hospital setting, like in the mental hospitals and such,
00:26:50
Speaker
I saw the staff be mostly kind to the patients and not treat them in any way other than someone who needed help. Now, there were a lot of very difficult individuals in that system who would make your life hell, and they were not acting responsibly or maturely or cooperatively in any way, even when you were genuinely trying to help them and not force things on them.
00:27:19
Speaker
And so there is some natural consequences. And I'm not saying it's 100% those people's fault either, but they still take responsibility. And you can't just behave any which way without expecting consequences. But by and large, the times that they really harm people were one with respect to
00:27:47
Speaker
committing them to the hospital against their will, even when it wasn't really justified. And they, they have a power trip in many ways. But only the doctors can do that. And then also like putting them in restraints and force injecting them with medications that can be rather cruel and traumatic. And
00:28:08
Speaker
Part of the problem is that people just don't have the talking skills and the understanding of what the person with raging psychosis is experiencing.
Understanding Psychosis and Treatment Limitations
00:28:20
Speaker
But I know because I tried really hard to develop those skills that you can actually overcome that and you can connect with someone, you can develop understanding.
00:28:30
Speaker
and cooperation even when it seems like it's not possible. It just takes understanding of what they're going through and a lot of listening and patience. Yeah, no, I appreciate you sharing that. That's really valuable. Well, especially in these institutions as well, they're forcefully medicated as well, right? So that plays a role.
00:28:58
Speaker
you know, if you look back at history, a lot of psychiatrists spoke about how when patients will go on antipsychotics, you know, if they were to be, you know, in between medications or at any, you know, the psychosis could become worse, right? So, and there's also a plethora of other effects as well that occur, right? And it's not the environments, you know, and it's case by case thing, right? You know, because around here, I actually,
00:29:28
Speaker
was sort of looking around at your Nova Scotia and, you know, the institution seemed to be okay, right? Like it seems to be, you know, some are nicer than others, of course, and every individual is different the way they act, but they, at least they claim to use a biopsychosocial approach and, but of course there's still the forceful medication or forceful incarceration, whatever it may be. So I think that, you know, there's a role there as well, right?
00:30:00
Speaker
a role for... Sorry, like playing into the condition, not necessarily developing, but persisting, right? Well, look, the way that this treatment system, I'll put it in quotes, or system of institutions is constructed and organized right now, it's not really capable of doing much good.
00:30:28
Speaker
I mean, you can give someone a respite from some really severe, you know, traumatic life, but that only lasts so long. And you're right, the negative effects is almost everyone, everyone's expected to take medications, you know, in that setting. Now, you know, not everybody is forced, there's certain, you know, legal criteria. In some settings, there's a lot more of that. In fact, you know, throughout my training, part of
00:30:57
Speaker
the real reason we were put at a certain site was because they needed us to testify to force medications on people. And so that always made me very uncomfortable. But in some of these cases, like the person was so far gone, it's like almost worth a try to see if they could just come back temporarily so you could reach them in some way. But these were very recalcitrant cases.
00:31:25
Speaker
no one had the ability to try more conservative measures like let's take them out to the country and give them clean air and clean food and space and not force them to do too much other than maybe fold their own clothes and bathe once in a while or something like that. And I bet when those kinds of things have been tried, few and far between, there has been a good response.
00:31:53
Speaker
you know, overall. So, you know, I'll tell you about something totally different that you have to go back and I didn't find this looking for a mental health treatment. I found it looking for evidence about animus. But in the New England Journal of Medicine back in 1932, there's an article published
00:32:14
Speaker
that a doctor did, now this was not a very well done randomized controlled trial, but it was at a state mental hospital with patients that had either, you know, what would be called schizophrenia today. They had a different name for it then. And people with what would be called depression with psychotic features these days or a psychotic depression, a very severe, difficult to treat in today's standards condition.
00:32:43
Speaker
And these patients were treated just with colonics. This was before psychiatric drugs or maybe they had re-serpene, but I don't know if they used it too much. And just from colonics, which is kind of like a big enema with a little bit of pressure, 70% of them were well enough to leave the hospital. And a significant portion of those had no signs of mental illness.
00:33:14
Speaker
just from some colonics. Yeah, that's really, that's really impressive. Yeah. And, you know, if you look back on, schizophrenia is, is considered, you know, incurable today. Yeah. Yeah. No, definitely. Yeah. Well, and we don't, we, we learn from history that we don't learn from history. Right. So, um,
00:33:41
Speaker
When I was talking to Robert Whitaker there, he mentioned the Quakers and their asylums for people with mental health conditions were very much treating them as brethren. It was good environments and good food and responsibilities and playing sports and things of this nature. We're not looking back and learning anything.
00:34:03
Speaker
So, you know, you can find similar things in, you know, indigenous cultures around the world. And there are some European communities where they still embrace this model in the modern era, and they get the extended family together. They have teams that help, you know, do an intervention, which is they where they only use if they use drugs, it's only for very, very temporary, like for a week or a few days. And, you know, so you, you've,
00:34:31
Speaker
Had Robert Whitaker on the show? Well, it's interesting because years ago, he and I were on stage together at a conference talking about psychiatric medications in children, adolescents in Syracuse, New York. And, you know, he, his books were in, I began reading them in my residency. And it really helped, you know, clarify a lot, but I was already
00:35:00
Speaker
beginning to be critical of psychiatry just because of what I was observing. Yeah, that's amazing. Yeah. And what he describes the process that patients go through in an anatomy of an epidemic, I've witnessed that over and over again. I mean, I wasn't the doctor putting them through that. I was the one they saw at the middle or the end of that process when the problems compounded because of the drugs.
00:35:29
Speaker
Cool. That's awesome. Yeah. So I'm curious about the more severe mental health conditions if we want to classify it that way. I know you mentioned it wasn't necessarily helpful, I suppose, maybe just for the purpose of the conversation. No, no, because this goes back to my answer to the first question, right? It has to do about functionality. When someone can't function in any way, they can't stay in school or keep a job or
00:35:55
Speaker
Make money, have a place to live, their hygiene, keep up relationships, right? Then that's obviously more severe of a situation when then someone, they're working, they're supporting their family, but maybe they're a little irritable.
00:36:12
Speaker
maybe they're drinking a little too much, getting into some arguments, you know, like that's a very different functional situation. So if we, you know, talk about it that way, and then, you know, obviously just the nature of psychosis. And when I say psychosis, let me just tell you what I mean is that when
Exploring Severe Mental Health Cases
00:36:33
Speaker
people can't differentiate from the reality that you and I live in, and what's going on in their consciousness that maybe we can't are not a part of, like sort of your private, you know, conscious existence, if you will. And I don't think
00:36:53
Speaker
Hallucinations is really the right word because it's not like a physical glitch in your electronic system that produces a hallucination. It's something else. I don't know that I know fully what it is. But it seems as if they have another entity that is communicating with them. Maybe it's a part of themself. But it is definitely outside of our shared common reality experience.
00:37:22
Speaker
And this communication back and forth involves sometimes actual speech, like that is audible to that individual. And it tends to have a certain type of content often. And then it also includes beliefs and ideas about the world that aren't based in objective evidence.
00:37:44
Speaker
And a lot of times, these are very negative types of beliefs like that. For people that are in a very religious communities, for example, often these beliefs involve religious themes, but they are extreme and catastrophic.
00:38:06
Speaker
The devil sent a demon to torture me unless I do X, Y, and Z, smoke crack all day long. Or I smoke crack to get rid of the, he shuts up when I smoke crack or that kind of thing. But they really seem to fervently believe that it is this demon that was sent by Satan or the devil to control them or harm them or
00:38:32
Speaker
make them do some part of some bigger plot or scheme to cause harm and such like that. So when people have just those experiences by the nature of them, it makes it very, very difficult for them to function in the real world. Because if they start talking about that with other people, other people are going to be alienated.
00:38:57
Speaker
think something's wrong with them, distance themself, et cetera, et cetera. They couldn't do customer relations type of work or all these kinds of things. That's why you do see with many of the folks with these experiences who are higher functioning, they're in doing things in their life that are more under the radar. I'm surprised they haven't tried to label the virus deniers as schizophrenic yet.
00:39:28
Speaker
I guess they tried with you, that McGill article that always comes up, I see, what is it? The psychiatrist who calmly denies reality. I always get a chuckle when I look up your name there in Google. But I'm sure that'll come, right? Well, there was that movie, right? There was a movie where they were, it was the setting was, and I never watched it, I saw a clip, but the setting was, you know, an asylum and there was this person who was obviously at
00:39:54
Speaker
undergoing some sort of psychosis. And they were talking about how germs don't cause disease and how Louis Pestow was a fraud and a plagiarist and all that. So I always get a kick out of that kind of stuff. If you remember that, tell me what it was. I'd like to take a look. But you know, there's always a soft disclosure like that in, you know, in the pop media somewhere.
00:40:21
Speaker
I'll find it and I'll get it to you there because, yeah, I should watch it myself, right? Kind of funny and pertinent to our conversation a little bit, I guess. But, you know, I'm just curious, you know, approaching sort of a severe situation. What's your take on approaching this situation? Obviously, there needs to be some sort of, you know, addressing the underlying health. Looking for the cause, I suppose, is the big thing. But maybe I could just get your insight on that.
00:40:49
Speaker
You mean like if someone has a psychotic break? Sure. Yeah, like more severe sort of mental health infractions. Yeah. Well, I mean, you know, one thing is it can be extremely difficult because there's this principle that there are a few things that do ring true in psychiatry. So not everything I learned, you know, I should be throwing down the toilet, but
00:41:15
Speaker
One of the concepts that was useful is this concept of an egosyntonic or an egodistonic condition. And so it's pretty easy to understand. So just consider that you're going through a period of anxiety or depression in your life. We've all experienced it to some degree. We lost a job. We didn't make the team. We got dumped.
00:41:43
Speaker
you know, whatever happened, someone died, right, there've been experiences that were difficult, and we got sad and down and out. When you're feeling that way, you don't like feeling that way, and you want there to be relief. And sometimes we even, you know, distract or medicate ourselves, you know, with alcohol or sex or junk food or things like that, right to provide the relief. Now in
00:42:11
Speaker
Other kinds of conditions or situations like psychosis, which I was mentioning, and also mania, which I didn't really describe, is also like this. It's what you would call egosyntonic, which means that the individual who is thus affected doesn't feel that there's any problem.
00:42:36
Speaker
It'd be like they would say, Doc, I'm not the one with the problem. You're the one with the problem. And this is someone who's homeless and only wearing one shoe and is talking to themself when no one's around and hasn't bathed in three months and that kind of thing. So obviously, there is something wrong, but they
00:42:59
Speaker
And there's a related concept known as agnosia nosia. And there's a famous neurologist who wrote about this also. And that's when you have a neurologic deficit of some kind, but you don't realize that you have it. So you're kind of walking around thinking you're normal, but you actually can't speak. Or when you speak, no one can understand you, but you don't realize that that's the case.
00:43:28
Speaker
And so there's some of that as well. So in terms of how do you help someone like that? Well, often they don't, they don't want help. They don't even recognize that there's a problem that would need help. So it can be very, very challenging. Now this doesn't happen a hundred percent of the time. And especially early on when it first develops and the individual is kind of going through this process as they're manifesting it. And those are like real opportunities.
00:43:55
Speaker
for some way to address it. And I've seen doing a thorough detox protocol be extremely successful doing a very strict elimination type of diet.
00:44:10
Speaker
be very successful. These days, I would recommend a zero-carb diet because that gives a maximum. Ketosis would be the best condition for the brain and provide all the right brain repairing type of nutrition. And various psychological exercises. I had one client based on the work of Jerry Marzynski,
00:44:38
Speaker
This was an adolescent. This is my last, you know, actual psychiatry job when I was trying to do things differently, but the system wouldn't really let me. And there was a teenage boy and he was very, very psychotic. I even, I actually tried to get him in the hospital because he was not appropriate at the facility that we were at, but the hospital
00:45:01
Speaker
wouldn't take him, and they wouldn't really give a straight answer why. I mean, this guy was walking around naked trying to fight people on the campus, just out of the blue for no apparent reason, stuff like that. And in fact, he was so impaired that the staff thought that he was developmentally delayed, intellectually impaired.
00:45:29
Speaker
even though we didn't have records confirming that. And he took several different antipsychotics. They didn't make one bit of difference. But he was not happy. And so I had learned about this process from Jerry Marzynski, where a person just, when they hear voices, they recite Psalm 21.
00:45:54
Speaker
And this kid, it turns out that his mom took him to church every Sunday and he felt he identified as a Christian and he was familiar with Psalm 21. So when I told him about this, he actually perked up a little bit and thought it was a good idea. I was totally surprised because all I could get was like yes or no head shake from this kid. He didn't say a word. And even when this happened, all I saw was his eyes brightened up a little bit and he shook his head yes.
00:46:23
Speaker
So I printed it out. You know, his counselor was there who's with him like at his, at his residence day in and day out and gave this to him. And I didn't have much confidence that anything would happen. Right. But he came back a week later and actually said a few words to me, like not just shaking his head, yes or no, but actually spoke. And basically it was working.
00:46:51
Speaker
And then he could tell me a little bit about what the voices were saying, which was they're basically berating him. It's called a running negative commentary, you know, saying things like, Oh, you're a loser. You're never going to get it right. You're stupid. You know, stop doing that, uh, this kind of thing. And so he was, that's why he wanted something to lighten that up and this worked. And so he kept with it. It kept working more. And then,
00:47:18
Speaker
Jerry Marzynski partnered up with this woman, Sherry Twiney, who actually had a psychotic break herself and figured out this way to overcome it psychologically. And then he used her technique, and then pretty much the psychosis was totally cleared up. And then after talking with him a little, you could tell that he wasn't slow, like he was probably of average intellect.
00:47:40
Speaker
and which we were learning for the first time. And he was there for almost an entire year before I found out about this and we tried it. And this was quite amazing. So it was such a simple intervention. And it had profound positive effect. So I think there's a number of things that you can try if you can get some buy-in from the person who's affected. So catch them early when it manifests.
00:48:09
Speaker
and try to find out what part of their experience is unpleasant and then address an intervention at that. And then most people with psychosis, if it's not right at the beginning, they're going to have had a very negative experience interacting with the treatment system. They might have been forced into the hospital against their will. They might have been tased, held down and given injections.
00:48:35
Speaker
they're going to associate any kind of treatment for their condition with that. So you've got to make sure that whoever you are, if you're a family member, a friend, a loved one, you've got to make sure they understand that that's not what you're talking about. You're talking about eating a diet that's going to make them feel strong, for example. You're not talking about
00:48:57
Speaker
forcing them to do stuff or taking chemicals or shots or legal, the legal system, you know, that's, it's not about any of that stuff. Amazing. Yeah. I find it something that really resonates with the individual, right? And working with them seems to be the sort of general, if you can, listen, I've, I've had several, usually parents of young adults with psychosis come to me.
00:49:25
Speaker
you know, wanting to implement these types of things. And in almost all cases, they were unable to get any cooperation or buy in from their child, you know, and I can't, you know, I can't do that for them, because it's like that they're, they're living in the household together, you know, not me, whatever I do, or say on one day or another, it's not gonna, you know, it's not gonna make all the difference in the world. Yeah.
00:49:52
Speaker
And it comes back to the responsibility aspect of it too, right? You know, there's only so much that a practitioner can do as well, right? It's, it's always up to the individual to take charge of their, their health and their wellbeing. Unless we're a child, we are always responsible ultimately for ourselves. Definitely. So I suppose the last thing I want to bring up here is any, you know, any advice or direction for somebody working in this, in the mental health field, you know, that
00:50:22
Speaker
could be valuable, whether it be a psychiatrist, psychologist, like with their whatever it may be. What direction would you give them? Well, if you're in the main mental health system, get out. Because there's really just not much good you can do there. The best I think you can hope for is to reduce the harm that the clients and patients are experiencing as a result of the system.
00:50:49
Speaker
So what I did for the last couple of years that I was still practicing that way is I tapered every one of my patients off their medications, whether they wanted to or not. And not in one case did anyone get worse. Some of them moaned and whined a little bit. Some of them experienced some actual withdrawal, which I always aggressively treated. I never let people just suffer.
00:51:18
Speaker
That's not my style and I don't think it's necessary. People do suffer as a result of their own actions and that is part of learning, but I am not wanting to impose that upon them. That comes from them. Almost all of the people got improved in some way. In fact, I was working at a residential facility for
00:51:47
Speaker
teenagers who are mostly there because of violent behavior and delinquency. And I'd say 80% of them arrived to the facility already being prescribed psychiatric medicines, and many of them it was for really aggressive, for aggressive behavior, which there's no evidence that it actually helps with. But you know, people don't know what else to do, and it's there. And
00:52:13
Speaker
I began systematically tapering them. I would wait until I saw them and did an evaluation and make sure that it was inappropriate and it was always inappropriate.
Natural Health Practices and Resources
00:52:23
Speaker
I tapered them off of it. Initially, a lot of the other staff there, like the teachers, the social workers, the counselors, the administrative staff, they were concerned that the behavior would go through the roof. The place would crumble into chaos.
00:52:41
Speaker
They'd have no psychiatrist to knock people out. But of course, that's not what happened. And I just did what I did anyway. I didn't care what they said because I knew, one, I wasn't going to continue to harm these kids. And then, two, I knew that it would actually be better. And after enough observation time, people started to acknowledge, oh, gosh.
00:53:07
Speaker
These kids, they're doing fine. They're actually a little bit better. They're able to stay awake and pay attention sometimes, whereas before they were always zooted out. And so they became fans of it, and it actually became a boasting point from the administration that we take the most difficult kids who failed other placements, and we take them off the meds because we're so good at our job.
00:53:37
Speaker
um, that, that we can do that. And so if you take a risk, even within the system that you're working in now, you might actually find that it has, you know, positive, um, residuals that come back to you. Um, and even if they don't, maybe it's time for you to get out of that system and, you know, learn how to really help people because I'll just, I'll tell you this, you know, one fact, and you might not believe this now or ever.
00:54:07
Speaker
But if you take the time to look for the information out there or try it yourself, you'll see it's true that all these conditions that you try to work with in your patients, but they don't get better or the problem keeps coming back and you know that the rest of their life is going nowhere but downhill, that all of that can be turned around. If you understand what really the problem is and
00:54:37
Speaker
the steps that you can take to allow that individual to heal from whatever is causing that problem. And you can't do it for them. They have to do it. But you can certainly help facilitate that process if you understand it and apply it in these situations. And this information is out there.
00:54:57
Speaker
available. I'm only one of many sources of it, and so this is the opportunity that you have if you want to see that it's available and right in front of you. Thank you. Any final thoughts, anything you want to add to this conversation, anything you want to might have missed or cleared up?
00:55:20
Speaker
Well, I mean, I appreciate that we're kind of talking about this at a higher level. Really what we're talking about here is a shift in a paradigm of looking at health in a much more natural context here, not trying to create artificial categories, not applying technology, including
00:55:44
Speaker
pharmaceutical technology, but this world, this realm, the earth, it was put here and I believed designed with everything present already that's needed in natural form. If we look at animals in nature, even think about the earlier humans in nature before they had technology in an organized society,
00:56:13
Speaker
All the elements for optimal health are present. We don't see animals taking supplements, doing surgery. Now they occasionally do use plants for healing. Like recently there was a report of a simian, I believe it was a baboon, but it could have been a chimp or a bonobo. I'm not sure a hundred percent, but it was using some kind of chewed up leaf to put on a wound.
00:56:41
Speaker
right? Because that's already there in nature. And we know there are many things in nature that have can help our bodies like, you know, they produce a response by our bodies that accelerates or facilitates healing. But we don't have to invent those things. They're already existing in nature. And if we embrace that, then we can really return and achieve an amazing state of physical, mental and spiritual health.
00:57:11
Speaker
Awesome, thank you for that. And how the listener can support you and follow you and learn more from you? Well, you know, everything is on my website at andrewkaufmannmd.com, and I am now registering people for a free mini course, which is a three-lecture mini course called the True Masculinity mini course, and it is premiering in early June.
00:57:38
Speaker
So we'll make sure that you have the link or you can find it right at the top of my website and register for that because I love teaching and I am giving you know free lectures courses master classes.
00:57:54
Speaker
all throughout the year. So take a chance to check out some of this information and see how you can use nature to help your body heal and you can achieve all your highest level of functioning as a result of learning this information. Awesome. Yeah, we'll put the links down below there. Dr. Coffin, thank you so much for coming on today. I really appreciate your time. I appreciate all the words and wisdom that you shared today.
00:58:22
Speaker
My pleasure. It was a good talk. Thank you all for listening. You should all know that this is not medical, psychiatric, psychological advice. This is for your informational purposes only. But also remember that we're all responsible, sovereign beings, capable of thinking, criticizing, and understanding absolutely anything. We, the people in the greater forest, are together self-healer, self-governable, self-teachers, and so much more. Please reach out if you have any questions, comments, criticisms, concerns, whatever it may be. You find me on Instagram. Go follow me on YouTube, too.
00:58:51
Speaker
post some nice content there, looking at a lot of psychology, psychiatry, things of that nature. We've also been looking at logic, how to think clearly, reasoning. We've been looking at how to assess scientific papers as well. I did a pretty comprehensive playlist on that topic. So go check it out. I'm pretty proud of that work. So go subscribe on YouTube. We're giving away a book too, Structure, Scientific Revolution. So go do that. And if you're listening to this on YouTube, awesome. Give us a like, share, comment,
00:59:18
Speaker
review, whatever you got to do on the platform you're on, help support us, help us grow. Sharing is the best way. I appreciate you all. Remember, there are two types of people in the world. Those believe they can, those believe they can't, and they are both correct. Thanks for listening, guys. Take care.