On the podcast this week, we hear from Dr. Niall McLaren. Niall, known to many as Jock, is an Australian psychiatrist who worked for 25 years in the remote north of the country. Also an author, Jock's latest book is entitled Natural Dualism and Mental Disorder, the Biocognitive Model in Psychiatry, and it was published in December 2021. Recently retired after 47 years, Jock joined me to talk about his experiences working in psychiatry and explains why the models that purport to guide psychiatric diagnosis and treatment are not what they seem.  

Jock McLaren – The Biopsychosocial Model is a Mirage, Time for a Biocognitive Model?

Welcome to the Mad in America podcast, a weekly discussion that searches for the truth about psychiatric prescription drugs and mental health care worldwide.

Hosted by James Moore, this podcast is part of Mad in America’s mission to serve as a catalyst for rethinking psychiatric care. We believe that the current drug-based paradigm of care has failed our society and that scientific research, as well as the lived experience of those who have been diagnosed with a psychiatric disorder, calls for profound change. 

On the podcast we have interviews with experts and those with lived experience of the psychiatric system. Thank you for joining us as we discuss the many issues around rethinking psychiatric care around the world.

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Arthur Kleinman is a towering figure in psychiatry and medical anthropology. He has made substantial contributions to both fields over his illustrious career spanning more than five decades. As a Professor of Medical Anthropology at Harvard University's Department of Global Health and Social Medicine and a Professor of Psychiatry at Harvard Medical School, Kleinman has profoundly influenced how medical professionals understand the interplay between culture, illness, and healing. His extensive body of work includes seminal books and numerous articles that have become foundational texts in medical anthropology. These writings explore the crucial role of personal and cultural narratives in shaping medical practices and patient care. In recent years, Kleinman has increasingly focused on critiquing the prevailing practices within psychiatry, particularly the  over-medicalization of mental health issues and the  neglect of broader social and personal contexts that significantly impact patient care. His critiques advocate for a more nuanced and compassionate approach to psychiatry, one that recognizes the importance of individual patient stories and the socio-cultural dimensions of mental health. In this interview, Kleinman explores critical issues facing modern healthcare. He discusses the often-overlooked narrative of patient experiences, critiques the mechanistic approaches that dominate U.S. healthcare, and offers insightful reflections on the global mental health movement. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Context and Care vs Isolate and Control - An Interview with Arthur Kleinman

On the MIA podcast this week we turn our attention to conflicts of interest (COIs) and new research from the British Medical Journal (BMJ). Mad in America has  previously examined the problems with conflicts of interest in research but this time we extend that to look at the potential effect of COIs on diagnostic tools such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). Joining me today are Lisa Cosgrove and Brian Piper, two of the authors of a paper which appeared in the BMJ. The paper is entitled “Undisclosed Financial Conflicts of Interest in the DSM-5 TR: Cross-Sectional Analysis,” and it was published in January 2024. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Undisclosed Financial Conflicts of Interest in the DSM-5: An interview with Lisa Cosgrove and Brian Piper

Swapnil Gupta is an Associate Professor and Medical Director of Ambulatory Psychiatry at Mount Sinai Morningside Hospital. She was trained as a psychiatrist in India and the United States, at SUNY Downstate Medical Center and Yale University, and PGI Chandigarh in India. She is known for her work on deprescribing from and discontinuation of psychiatric drugs. Dr. Gupta’s career began with research on the role of the endocannabinoid system in the pathophysiology of schizophrenia as an academic psychiatrist. Her subsequent scholarship has focused on applying deprescribing, the systematic reduction of unnecessary medications, to psychiatry by rooting it in the principles of recovery-oriented care. She has authored several peer-reviewed papers on deprescribing and co-authored a  book with Rebecca Miller and John Cahill. She is an active member of two organizations that aim to enhance stakeholder engagement in psychiatric research. She is also a part of the editorial board of the Community Mental Health Journal. Currently, she is working on creating educational resources to help people discontinue psychiatric medications and gathering information on the knowledge and opinions of psychiatrists regarding the discontinuation of such drugs. In this interview, we discuss deprescribing from psychiatric drugs, the difficult decisions faced by patients, the importance of psychosocial support during withdrawal, and how deprescribing is central to recovery-oriented practices such as shared decision and patient choice. We will also tackle the complex issue of whether the recurrence of symptoms once a drug is tapered is a mark of relapse or withdrawal caused by the psychiatric medication. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Deprescribing Psychiatric Drugs to Reduce Harms and Empower Patients - Swapnil Gupta

Justin Garson is a Professor of Philosophy at Hunter College and The Graduate Center, City University of New York, and a contributor for Psychology Today and Aeon. He writes on the philosophy of madness, the evolution of the mind and purpose in nature. His most recent book is Madness: A Philosophical Exploration, published by Oxford University Press in 2022. He is also the author of the forthcoming The Madness Pill: The Quest to Create Insanity and One Doctor’s Discovery that Transformed Psychiatry, which will be published by St. Martin’s Press. In this interview, Justin joins us to talk about the ways in which society has attempted to explain or categorize madness over the years. We also discuss the value of looking at madness, not as disease or defect, but as a designed feature. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Is Madness an Evolved Signal? – Justin Garson on Strategy Versus Dysfunction

Deborah Kasdan is author of  Roll Back The World: A Sister’s Memoir, in which she describes her extraordinary late sister Rachel–poet, musician, free spirit–and her decades-long journey through psychiatric treatment until, finally, she found a place of peace and community.  Kasdan is a longtime business and technology writer who pivoted to memoir writing on a quest to tell her sister’s story, joining the Westport Writers’ Workshop. Her book, published in October by She Writes Press, is a moving and nuanced portrait filled with love and grief, candor, and complexity.  *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. To find the Mad in America podcast on your preferred podcast player, click here

Jock McLaren – The Biopsychosocial Model is a Mirage, Time for a Biocognitive Model?

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