There is more happening and more being done about psychiatry and the brain now than ever in the history of the world.  I like the idea of “consumer-run” organizations and I love the idea of this one:

Like most things I find on the internet, it is hard to describe how I got here.  Probably it has something to do with “keywords” and “searches.”

This is a consumer-led psychiatric group that is trying to empower psychiatric patients by teaching what amounts to “different ways of thinking.”

This organization is one of “consumers” of psychiatric services, which is far and away the most “politically correct” term for “psychiatric patient” I have ever heard.

The organization has a “medical director,” who is allegedly “in recovery from schizophrenia.”  So they have my complete attention and I need to check this guy out. Daniel B. Fisher, M.D. and PhD, was interviewed by the folks at Medscape, a group of folks reporting on goings-on in medicine in clear-thinking and generally trustable ways.

They interviewed Dr. Fisher on his “Recovery Model.”

Two things immediately became evident from the interview.

1.  Typical, allegedly “normal” doctors or psychiatrists are well-represented by the interviewer. who seems more than a bit “scared” by this recovery model and the ensuing empowerment of patients.

The real answer, which Dr. Fisher never directly says, is that would only be a danger if psychiatry continued in the basically irresponsible way it is practiced now.  With the abrogation of uninformed consent, and “pill pushing” medicine.

2.  The way Dr. Fisher recommends treating patients, seeing medication as one tool in a variety of tools is an open admission that medication prescription is not (and probably should not be) the most important tool we have.

He gives an example of how he, as he was recovering from his own illness, seemed to develop the ability to do “reality testing,” and even gives a specific example of how he can now deal with a law enforcement vehicle being on the road behind him, and how he could tell this was not necessarily a danger.  He could tell feelings of paranoia were not part of reality.

This is the kind of mechanism that helped the schizophrenic lead character in the movie “A Beautiful Mind.”  It may indeed be real and possible — for a mentally ill patient with enough intelligence to learn such skills — as well as the patience and persistence of the psychiatrist and other people who teach such skills.

Flash memory — when I was a resident, my chief wanted me to review books about psychiatry for prestigious national medical journals.  I got a book about residential homes for schizophrenic patients, where gentle, patient “cognitive therapy” minimized the necessity for medication and seemed to get schizophrenic patients into the workforce earlier.

My review was favorable.  I’ll never know why my residency chief actually did, but he did tell me such treatment was “more controversial” than I could imagine.  I never felt it was a coincidence that I was never asked to review another book in this manner.

There are too many factors in this picture to explain and follow in detail.  The effect of antipsychotic medications on a schizophrenic brain or the evolution of schizophrenia itself may have a factor in the patient’s  ability to profit from a cognitive type approach.

Dr. Fisher has reviewed the treatment of schizophrenia in others.  Frankly, folks seem to do better.  Here is the medication statement from the National Empowerment Center.

I am staying tuned.  This is worth watching closely.