Dr. Stanley Goldstein - Author and Psychologist

A recent Wall Street Journal aarticle ("One Surprising Psychosis Treatment That Works: Learning to Live With the Voices"/December 21, 2024) aroused these thoughts. Schizophrenia is vastly misdiagnosed particularly with substance abusers, and no medication can "cure" it since its symptoms reflect faulty early-childhood development of the basic critical ego capacities governing control of thinking, behavior, and more, apart from the debilitating side effects of psychotropic medication when used for more than briefly. The benefits of psychotropic medication tend to be exaggerated by drug companies and doctors with their side-effects downplayed.

Long ago a gifted psychiatrist/psychoanalyst in my training told of treating a hospitalized VA patient who frightened others by talking aloud to himself. The doctor advised him that if he continued this behavior he would be given electric shock treatment, which neither of them wanted. So when he felt compelled to behave like this he should go to the bathroom and talk into the toilet. Years later the patient's sister thanked the doctor for the remarkable improvement in her brother's behavior. Sadly, America's National Institute of Mental Health prioritizes drug treatment of emotional disorders though a study fifty-years ago showed the highest rate of recidivism (re-hospitalization) of severely disturbed psychiatric hospitalized patients was of those who were prescribed psychotropic medication in the hospital and following discharge, the lowest recidivism rate was with patients prescribed no medication in the hospital or after discharge, and the in-between recidivism rate was with patients who were prescribed medication in the hospital but not after discharge. Nuff said.

A recent Wall Street Journal article inspired this blog ("Three Killings, One Suspect, and a sister Who Warned Her Brother Needed Help" - Nov. 30, 2024). Forty-one-year-old Chris Ferguson struggled with mental illness since his twenties, working as an unskilled cashier despite being a college honors graduate.
Though experiencing a dozen psychiatric hospitalizations and prescribed psychotropic medications his improvements were brief and tenuous. Longer than his provided three-day hospitalizations was barred without his consent or a court order, causing recurring experiences of deterioration. Despite his sister's plea that he was losing control, the hospital refused to admit him without his consent, which he refused to give. He was finally hospitalized after murdering three elderly neighbors, having been arrested while staggering through the neighborhood shirtless and barefoot with bloody footprints, recorded by security cameras. His latest trip to the hospital was his fourth in five months.
While the prediction of violent behavior will always be imprecise, several factors seem relevant here and with similar events: the reliance on psychotropic medication to allegedly "cure" mental illness; the limited knowledge of child psychological development and developmental psychopathology by doctors who have had minimal training in psychotherapy, today's psychiatric residents receiving only ten-percent of the training in psychotherapy they did seventy-years ago.
While state psychiatric hospitals were imperfect they did provide a place of safety for patients and the public. Their closing with the promised savings promised for supportive housing and outpatient services never occurring, the myth that medication can cure complex problems of living having been accepted..
An exhaustive study of severely disturbed, hospitalized psychiatric patients conducted more than fifty-years ago found that the lowest rate of recidivism (re-hospitalization) occurred with patients who were given no medication in the hospital, the next lowest rate was those provided medication in the hospital but not upon discharge, and the poorest prognosis was of patients taking medication both in the hospital and following discharge.
While legal and treatment changes cannot guarantee against crimes like Ferguson's, continuing present policies will guarantee their occurrence.

During my first job, as a psychologist at a psychiatric hospital, I told my psychoanalyst/supervisor my adolescent patient’s statement. “That’s psychotic,” the doctor replied. Though able to define “psychotic,” until that moment I hadn’t grasped the power of this condition.
Similarly, when the latest horrors became public–the mass murders  Read More