What Spirit Rock’s Statement on Buddhist Teacher Noah Levine’s Misconduct Reveals – About Spirit Rock

By Will Hall

The highly popular US Buddhist teacher Noah Levine was recently barred from teaching by the Spirit Rock Buddhist retreat where he trained, and his authorization as a teacher revoked by his mentor, Jack Kornfield, one of the world’s leading Buddhist teachers and leaders. Levine, author of Dharma Punx and celebrated for his work with addiction, was accused of multiple instances of sexual misconduct, including rape.

Levine’s organization Against The Stream initiated an investigation into the charges against him, and Spirit Rock conducted its own investigation. Spirit Rock’s investigating committee decision to bar Levine and revoke his authorization was unanimous; it found that “Mr. Levine’s repetitive and continued behavior, outlined by multiple sources, would be completely inappropriate for anyone, let alone an individual privileged to be an authorized Spirit Rock teacher.”

Spirit Rock writes that Levine is:

“deeply alienated from bedrock values of the Buddhist path: self-reflection, accountability, compassion, and wisdom… (and) cannot be trusted to uphold the minimal requirement of a Dharma teacher – to do no harm. Even in the absence of the initial allegations of sexual assault, Mr. Levine’s behavior has otherwise been so troubling that we would have reached this same conclusion.”

What is disturbing about this is not that revered Buddhist teachers can turn out to misuse their power; after the 1983 scandal with San Francisco Zen Center Abbot Richard Baker, along with many other scandals by Buddhists including Chogyam Trungpa, there is really no question: years of Buddhist practice do not somehow guarantee ethical behavior. Nor is there reason to question Against the Stream and Spirit Rock’s agreement with the allegations against Levine: the investigations seem to have have been careful and thorough. It sounds that Spirit Rock has done the right thing by barring Levine and revoking his teaching authority in the Theravada Buddhist lineage, and Spirit Rock is to be commended for taking prompt action where other organizations might have closed ranks and defended one of their own facing an ethics scandal.

No, there is a deeper problem here.

On February 20th Spirit Rock released a 1120 word public statement about Levine’s misconduct and their decisions in response; this statement deserves careful reading by anyone interested in the functioning of Buddhist and spiritual institutions which claim a higher ground morally, and where senior teachers have been found to violate ethical norms.

I found the statement deeply concerning for the following reason: Spirit Rock acknowledges that

“Noah Levine was authorized in 2006 by Spirit Rock Meditation Center and Jack Kornfield as a fully empowered Theravada Buddhist teacher “to teach the Dharma of Liberation, in the Lineage of the Elders.” … Jack Kornfield led Mr. Levine’s teacher training and is his authorizing teacher.”

And Spirit Rock goes on to “recommend that Mr. Levine cease all Buddhist or meditation teaching and dedicate his energy to the rehabilitation of his own heart.”

At the same time, Spirit Rock and Dr. Kornfield were the ones who trained and authorized Levine as a teacher, sponsoring and endorsing him for more than 13 years after the period of his learning and qualification to become a Buddhist teacher. Nowhere in their statement about Levine is there any self-reflection about Spirit Rock or Kornfield’s own role in misjudging Levine’s fitness. Nowhere do they apologize for their own obviously catastrophic mistake in authorizing him as a teacher and endorsing his work for more than a decade.

Spirit Rock and Dr. Kornfield set up a training center to certify and attest to the ethical character of Buddhist teachers. When a prominent teacher is judged to repeatedly and flagrantly violate ethical norms on the basis of the training center’s own investigation, why doesn’t Spirit Rock and Dr. Kornfield then ask themselves, What did we do to miss this? Surely something must have gone terribly wrong in their training of Levine, their original decision to approve him as a teacher, their ongoing affirmation and endorsement of his qualifications, and their repeated sponsorship of him as a Spirit Rock teacher? Doesn’t their own failure to correctly assess Levine’s fitness to be a Buddhist teacher in the first place also deserve scrutiny? He was a colleague and sangha member all these years: what went wrong?

Further, isn’t one of the Buddhist teachings to understand that when we look at the other we always see part of ourselves, that all of us are connected? Isn’t dependent co-origination, or pratītyasamutpāda, a key principle? What causes Levine to be who he is – is it within his own individual failing as an individual, separate from the people around him, as the Spirit Rock statement so strongly denounces? Or is he connected to us, and especially those close to him – such as those who taught him and are part of his community? Along with denouncing and barring Levine, isn’t there also a need for Levine’s teachers to look at the web of co-origination that connects all of us together? Reading the Spirit Rock response it looks to me that an opportunity to use Buddhist insight has been lost, an opportunity to look into what causes reality and individual action as interconnectedness. Instead we have a statement that sounds more like Catholic judgment of the sins arising from Levine’s soul, separating us from each other.

Instead of this self-reflection, the very teachers and that failed in their original judgment of Levine’s fitness now assume, without any irony whatsoever, that today their judgment is somehow immune to whatever mistakes they made to begin with. Isn’t their capacity of judgment itself worth reconsidering? We are told that Spirit Rock has conducted its own investigation and that we should trust it, putting the same institution that trained Levine in the role of now judging his failings. By elevating its own correctness as judges, Spirit Rock attempts to convey that the same institution that failed in its authorization of Levine is now to be invested with the moral high ground — at exactly the moment when that institution itself instead deserves scrutiny. What needs to happen is to recognize that Levine started as a student authorized by Spirit Rock, and Spirit Rock therefore needs to take a look at Levine’s teachers – themselves.

It is in no way meant to excuse Levine’s actions or to question Spirit Rock’s decision to bar him; again, this seems like the right thing to do. I have found Jack Kornfield’s teaching to be illuminating, know people who have benefitted from studying at Spirit Rock, and a dear friend teaches there. In responding to what is going on at Spirit Rock in all this, I don’t want to deny the light in pointing out the shadow. (Surely even as we denounce bad behavior we are beyond simplistic and rigid black or white thinking of good guys and bad guys – if Buddhism can’t teach moral nuance then it can’t possibly be a positive force in the world.) The authority to judge someone “fit” as a Buddhist teacher, to carry something as weighty as deciding who can and cannot teach the Dharma, the decision to set approved teachers up to the world as models to study and emulate as embodying ultimate truth and goodness – this is a huge power. Spirit Rock created the role and status for Levine that was then part of what was looked up to and trusted in him: this power, given by Spirit Rock, set the stage for the betrayal of that trust, the misconduct and abuse that Levine went on and perpetrated. For 13 years Levine was authorized as a teacher and for more than 13 years, it sounds like from the statement and reports, Levine was behaving unethically. Doesn’t Spirit Rock want to understand why, and how, someone they trained and stood by actually was doing this, right alongside them, a colleague part of their community?

The Spirit Rock statement reads between the lines as an attempt to affirm the righteousness of Spirit Rock. Clearly a community has failed, a teaching program has failed, a sponsorship has failed – but instead it is the Other, Levine and only Levine, who is to be held responsible. Where is the apology that says We, Spirit Rock, I, Jack Kornfield as his teacher, failed all of you by sponsoring this man who did so much harm? In the strong and unambiguous denunciation of Levine Spirit Rock seeks to take moral high ground as his judge. But as his teachers, Levine’s failings are to some degree theirs as well. And until Buddhist organizations learn the lessons of humility that scandals teach, we have to ask if these organizations are truly capable of preventing future misconduct. They trained and authorized Levine, after all. Spirit Rock revealed a much deeper problem than the failings of one teacher, it is, in this statement, raising the question of its own failings.

Buddhism, or at least the sort of Buddhism represented by Spirit Rock, is in part appealing in the West because it fits our individualism and our consumerism. I have a theory of why Spirit Rock takes this stance. Looking at their website, they have a brand to cultivate in the individual search for a commodity to consume. Instead of living community — a word used so widely and cheaply — what we see looks more like a product, a brand. Products and brands must be shiny, you can’t show a real, ambiguous, messy, complicated, realistic picture of products and brands. You have to show a shiny package to the public so you can compete for individual attention. And this emphasis on brand might not only mean Spirit Rock doesn’t look at itself, it may also be part of what allowed them to sponsor and promote Levine for 13+ years to begin with. By training and endorsing Levine, Spirit Rock was licensing him a shiny aura, the brand of “Noah Levine,” with its Spirit Rock and Jack Kornfield seal of approval – which contributed to people putting trust in Levine which led to being misled and mistreated. Now that one of their own turns out to be a bad product, allegiance to the brand means Spirit Rock’s statement about Levine can’t be a mutual reflection on partly shared failings, but has to continue the overall brand promotion. So the statement reads like an advertisement for it’s own shiny, donation-worthy righteousness. Perhaps there is more going on behind this statement, perhaps there is self-reflection at Spirit Rock, but by producing a statement where self-reflection is so glaringly absent, it appears Spirit Rock has not met its responsibility to the community to respond ethically to what happened.

In the Star Wars saga Han Solo’s son Kylo Ren is trained as a Jedi Knight but then turns to the Dark Side. Luke Skywalker was Ren’s teacher, and Luke’s terrible error of judgment and failure in teaching Ren so troubles him that he exiles himself on an island for decades and nearly repudiates the Force. The Jedi Council was similarly thrown into self-reflection when its apprentice Annakin embraced the Dark Side, turned into Darth Vader, and wrought havoc in the galaxy. For all its sophistication, the Buddhism of Spirit Rock failed to grasp the simple human lessons of hubris and shadow that Hollywood succeeds to understand in its Star Wars tale of spiritual awakening. It’s plain to see that the scandal of Noah Levine is also a calling for Spirit Rock, and everyone, to take a look at ourselves. We should be cautious about those who won’t heed that call.

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More by Will Hall

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Will Hall, MA, DiplPW — is a therapist, mental health trainer, schizophrenia diagnosis survivor, and host of Madness Radio. Will trained in Open Dialogue at the Institute for Dialogic Practice and is author of Outside Mental Health: Voices and Visions of Madness and the Harm Reduction Guide to Coming Off Psychiatric Medication. He is a PhD Candidate at Maastricht University and lead researcher on Maastricht University’s antipsychotic withdrawal study.

More of Will Hall’s work on Everything Matters: Beyond Meds

Smoke and Flames: Silence In A World On Fire – By Will Hall

Power does not just corrupt, as is so often said. It also reflects. The sun has gone deep red and the sky obscured with smoke this week, but some clarity has also emerged in that reflection.

When I was 16 years old I wrote a paper for my political science class that was three times the length and involved far more research than the assignment required. It was an “A” paper. I got a “B” on it — and my first lesson in the misuse of authority, and becoming complicit with corruption in the world.

My professor (I started college two years early) wrote in red pen next to my “B” grade that the paper was indeed impressive, but he disagreed with my political views expressed, thus the lower grade. He had a reputation for adulation around campus, fawning students forming his entourage, and I had dared to disagree with him. He was entrusted by the school with supporting my learning, but instead he was advancing his own self interest and punishing me unfairly when I wouldn’t go along with his personal political beliefs. And so there it was, plain to see: he was corrupt.

I then learned my second lesson of the misuse of power. I wanted to speak up for what was right, but when I considered it my stomach twisted, sheets of cold swept my body, and nausea stirred my gut. Growing up I was often the bright kid who stood out at the head of the class, and I paid a price for it: I was violently bullied. And now when I considered speaking up to the school administration about my grade, I was again paralyzed with shame: I feared that the act of speaking up for what’s right would expose me, bring shame down on me, I’d be seen as selfish. And I was afraid the end result would be losing some standing in the school. Memories of the bullying held me back, and I opted not for what’s right but for what I thought was my self interest. I didn’t speak up about my professor’s corruption.

I was going along with his misuse of power, and I realized he was doing to others what he had done to me. I saw that I was in a way now part of his entourage, not adoring him, but carrying some of his secrets with my silence. By not challenging him I kept my allegiance to him. The next student to come along wouldn’t hear about any of this, and when it happened to them they too would feel alone, also too afraid to speak up, and the cycle would repeat. A corrupt world is built brick by brick by such individual acts of shame and silence. And I made my decision, and I was caught up in it.

I moved on with my life. Or so I thought.

The Academy Award winning film Spotlight, about the Catholic Church’s current protection of serial child sexual abuse, makes this same crucial point about how corruption is supported. The team of journalists track the scandal from corrupt priest to corrupt politician to corrupt judge, at each step finding cover-up and denial in a broad web of complicity. Corruption spreads out from the actual violations like concentric pools of blood, leaving stained hands to the very heights of society. And then the journalists make the final devastating discovery of the film. As they probe the depths of denial and cover-up throughout their community, they discover that the complicity extends back to the newspaper they are working for, which for years dismissed evidence of the crimes and wouldn’t investigate. They realize they are part of the very crime they are uncovering. Looking for corruption out there they end up looking in the mirror. The Other was in fact in them.

It might seem that I am blowing a trivial mistreatment over a grade into a major scandal — that teachers unfairly cut down their students’ grades for petty reasons all the time, and that I should get over it. But years later, after I had left the school, my professor and my B grade behind, I learned how far his corruption had gone: the professor had a sexual relationship with one of his teenage students, had gotten her pregnant, and was fired from the school. It was a community scandal. I was shocked but not completely surprised. The broader pattern was clear; there was consistency in his corrupt behavior. He felt free to use power with impunity to advance his personal interest and agenda, even to the point of hurting others, and he did.

Part of his impunity relied on people going along and not speaking up. Though it was just an unfair grade, if I had spoken up it might have formed one part of a counterforce to his behavior. Others might have paused to think, scrutinize him more closely, or be more cautious around him. It might have emboldened more people to speak up. If I could have made a stand and done the right thing, it might not just have been for the sake of saving my A grade, I might have played a part in preventing the more serious harm that was to come. But my own self interest about how others would see me, my own shame and fear, held me back.

That was decades ago. And last night a powerful synchronicity lit all this up again for me and brought me to a new place of speaking up.

I was in my kitchen playing Jenga with several friends. Jenga as you likely know is about building a tower of blocks that someone inevitably has to bring crashing down. One of my friends turned to me and said that his parents teach at the same school where I got my degree in Jungian psychology, the Process Work Institute of Portland. I had known this friend for a few months but didn’t realize the connection. It was a stunning coincidence. We started chatting, and I asked him why he didn’t get his own training as a Jungian at the Process Work Institute, but went to a different Jungian school instead? The Process Work Institute is great, he said, there are many good things about it, but, “it has some problems…”

I immediately knew what he was talking about. The uncanny scene, there by the Jenga tower with the son of two of my teachers from school, sent a cascade of memories — and new clarity — into motion within me.

After dropping out of a San Francisco graduate program in 1999, sinking into a crisis and going back into a mental health facility, I eventually pulled my life back together seven years later to try again, this time studying at the Process Work Institute. The Process Work theory and approach were much more sympathetic to the patient survivor movement perspective, and a school where RD Laing’s Politics of Experience and Jung’s Red Book were held in regard promised a supportive context for me to start again and pursue a Masters in Counseling.

For the most part my expectations were met. The school taught me a great deal and I did finally get my degree and start my work as a counselor. I consider Jung and Process Work to be a valuable approach, with much more to offer than most other therapy approaches I have looked into. At the same time, however, I kept running up against a kind of discipleship hierarchy at the school, where critical thinking about Process Work and Arnold Mindell — Jungian analyst, the school’s founder, and creator of Process Work — met automatic resistance, a closing of ranks by those at the top of the school pyramid. There was a clinical air combined with a spiritual insularity, with expertise and enlightenment vested in the higher ups. The school, it seemed, wasn’t as comfortable facing its own shadow as it was in pointing out the shadows of others.

I tended to shrug off these reservations and keep going, and eventually made my way through the program and to my goals of an MA and a Diploma in Process Work. I was enthusiastic with my new skills and soon I had an office at the Institute, a thriving private practice as a therapist, was teaching Continuing Education Credit courses, running a highly regarded community group Portland Hearing Voices, and lived in my own apartment a short walk from Forest Park. I got off Social Security and the disability checks I had been receiving since 15 years earlier. I was growing roots into a new life.

Then one day I unexpectedly ran headlong into the schools’ discipleship and shadow I had been trying to avoid. The Director of the Institute walked into my office to chat, as we often did when we had a break from clients or a pause in our work. He sat down, and said, in a casual and indifferent manner, sort of oh-by-the-way: “You know,” he said, “I lost my license to practice as a psychotherapist.”

“Oh?” I said.

“Yes, I had a sexual relationship with a client,” he said.

“Oh?!” I said, alarmed and confused.

“Yes,” he said. “I got unlucky.”

I looked at him in growing shock and dismay, and he said, “Yes, I got a borderline.”

“I got unlucky. I got a borderline.”

Suddenly, just as I was getting my own career going as a counselor, I was grappling with unethical behavior by the Director of the very institution I was affiliated with and had invested many years of my life contributing to. I was grappling with him presenting no indication of remorse or self-reflection about the wrongness of his actions. I was grappling with his vile use of a misogynist clinical interpretation to justify himself and discredit his client. And most crucially, I was grappling with the possibility that the Institute knew about all this and was keeping quiet, protecting him in his position as Director. I had realized long ago that, broadly speaking, psychotherapy is a corrupt industry, rife with the harmful misuse of power and classifying people as higher and lower. Diagnosing clients as sick to defend harmful behavior by therapists is one of the most egregious forms of this corruption. I just hadn’t expected the corruption to reach to my own school.

I was immediately paralyzed with shame. Should I speak up about this? Or, just as I had feared challenging my professor years before, would that risk exposing me and I would become the problem?

In my boiling shame, I froze. I failed to take action.

I buried the shocking encounter with the Director somewhere inside me. Like my school professor, he had dumped one of his secrets on me and pulled me into his corruption. And so by failing to act, I became part of his misuse of power. He remained practicing at the Institute. The Institute was not transparent to students, clients, or the school community about his history of losing his license and being fined for it. Behind closed doors the school must have had its reasons, believing they should hire him anyway and remain quiet about his history. They must have deemed him rehabilitated and remorseful and worth protecting from scrutiny, but here I had clear evidence that he wasn’t. He remained Director. My therapy office was down the hall from his. It was business as usual, except that I had a neighbor who seemed to think he was “unlucky” for sleeping with his therapy client and losing his license because, well, she was “borderline.”

None of this felt okay of course, being in that shame trap. I was frozen but unresolved, in a no-escape bind. My time in Portland started quickly to unravel. The ingredients for renewed madness were beginning to work on me. I had a lot of new factors in my life, and I didn’t go into a self-destructive crisis like I had so many times before, but I was at a loss. The corruption I had run into started to fit with other hesitations about the Institute, and I had also seen before how poorly the Institute responded at times when challenged. I was there holding the shadow of my school and I couldn’t handle it. My own sense of despair and confusion took deep root.

I responded in the hurt and powerless manner shame had taught me throughout my life: I became invisible, quiet, small. I slowly distanced myself from the Institute and Process Work, I gave up my office and apartment, I turned away from my growing income as a teacher at the Institute, I let go of and stepped away from the life I had spent years working to build. All in a cloud of confused shame. And silence.

In the kitchen playing Jenga, in the wild coincidence of sitting there with the son of two Process Work faculty I knew and had studied with, something was shaken inside of me. The life pattern around shame, stretching back to my professor and school bullying and my family history of trauma, came into greater clarity. Something fell apart — my own inner story about it all couldn’t hold up any more. It was wrong for the school to hire a Director with this history and not tell anyone about it, and consider him rehabilitated when he clearly wasn’t. It was wrong that a male therapist blamed sleeping with his female client on her being “borderline.” But the realization became clear in me, that regardless of what I was afraid of happening, I was wrong not to speak up, because I was now with my silence complicit in the misconduct. I realized that shame not only hurts us, but drives us, out of fear of exposure, to be part of things that our hearts would otherwise want no part of.

I started to see how self-serving and wrong it is to think of “corruption” as something “out there” in other people.

I deeply regret that I did not sooner address this publicly. It was my decision to not speak or act, mine alone. I can’t say the reason I kept quiet is because others also kept quiet, or because the several people who I did tell thought it okay to keep quiet, or because speaking up at the Institute meant facing a possible pushback. It was my decision to not speak up. And with that decision I became part of the problem. I should have done something more.

So with my new clarity, I took to today’s public square, Facebook. I was shaking with fear of what might happen, all the shame stretching back to my childhood clawing at me to hold back. I feared I would be exposed and lose some standing for stepping out into the light with all this, and would now be seen as the problem, something wrong with me. But I spoke up anyway. I offered my public apology. I apologized to all the people hurt.

And the shame set in, eating me away inside like a poison.

When I was 16 and didn’t stand up to my corrupt political science professor, I had all the shame from bullying in my family and school holding me back. Now there was that same twisted feeling in my gut, the same cold waves running down my body. But now I was speaking up against a therapist, and publicly challenging other therapists in a school and clinic where I had worked — some of them had even been my own teachers and my own therapists.

I was afraid diagnosis would be turned against me, labels that still, after all these years, have their grip and can sow doubt and undermine my stability. Despite a clearly much more open and insightful understanding of madness and psychiatry, I had seen at the Portland counseling school what I had seen at every other counseling school I have ever come across (perhaps with the exception of my Open Dialogue training, and trainings in the peer movement). People are scrutinized and then devalued for some defect related to pathology. Those lower in the hierarchy bear the brunt of the clinical judgments of those higher. Whether it’s “schizoaffective disorder schizophrenia” and being delusional, as I was labeled with at Langley Porter Psychiatric Institute, or the “having relationship edges” and being a “difficult person” needing more enlightened awareness in the language of Process Work, clinical institutions wield a power of labeling that cuts deep. I could be discredited because something is wrong with my personality and even my spirituality. I was making it up. I was acting out. I was playing out some hurt or wound or pattern. I wasn’t compassionate enough. Me speaking up was just my own “self-sabotaging” pattern, more pathology. Speaking up wasn’t a principled act, a desire to do the right thing and embrace the truth. Speaking up wasn’t about the issue, it was about something wrong with me, my broken self, now being exposed, my stigma showing, my own self-interest.

The Director had put all this clinical power on display when he dismissed the woman he violated as “borderline.” Seen through the label, she wasn’t acting on the side of truth when she spoke up and got him to lose his license, she was exposing a symptom of her personality disorder. Seen through the label, he had gotten into trouble not because he had done something wrong, but because something was wrong with her. The message was clear: If we just would accept the fact that she is “borderline,” and if we knew the full story, we’d see that, instead of this being about the clear prohibition on sex with clients, well, it was actually more of a grey area, she was at fault, she was acting out her damaged personality.

Now I was afraid that by speaking up I would join her. I was afraid the Institute I had been part of, the teachers and therapists I had worked with, would deploy their own categorizing and labeling against me. I knew they were good people and I believed many or even most would take the side of supporting me standing up… but there was also that fear… I knew, from years of training both at the Process Work Institute and at the California Institute for Integral Studies, that the mentality to use labeling and diagnosis comes swiftly to skilled therapists and becomes reflexive in learning to defend themselves when challenged. The Institute counts itself as a caring place, and I’ve seen a great deal of healing there, and Jungians might wrap it all in a more sophisticated language, but the message is clear: There is something wrong with you, you are not one of Us here at the top, you are one of Them, down below. It’s an insidious dynamic, and I have even caught myself doing it sometimes (and I am thankful to people who have spoken up to me against this).

I might also be given a kind of spiritual diagnosis: not being caring and self-aware enough. I shouldn’t speak up, because I would just end up making things worse, turn the tables and now I would be the one doing the public shaming and diagnosing, by outing the school Director. Shouldn’t I just keep it all quiet, maybe speak up at a secret committee meeting to keep it under wraps, instead of risking, because something is wrong with me, reversing roles, and becoming a bully myself? Wasn’t speaking up just changing places with the person doing wrong, because I wasn’t worthy, enlightened enough, skilled enough to speak up?

In our world of media poison and political slur, scapegoating and righteousness, it is very hard to imagine how to challenge a specific behavior without launching a broad attack on the badness of the Other. Pointing out another’s wrong behavior can quickly spiral into attacking them as a person, discounting their good side and shaming them for being bad. By speaking I was risking being exposed for doing that. I’m sure the Director has done good work as a therapist, helped many people, and I knew him to be a perfectly nice and caring person… and yet here was his corruption. He also had a huge horrific blind spot. This dilemma shouldn’t hold us back; I had to find a way to challenge his misconduct and the school’s protection of it, and at the same time not just flip it around and make him and the school in a sense a new victim — now with me as the accusing perpetrator. How to challenge the behavior, and also be concerned and compassionate for the other side? Without ending up being paralyzed and protecting misconduct with silence, as the school had apparently done and I had gone along with?

(I’ve known of this dilemma since I was a teenager and learned about Dr. King’s nonviolence, which aims to respect the humanity of the other while being ruthlessly outspoken and militant in confronting their behavior. In King’s legacy today we tend to remember the peacemaker and the preacher of tolerance, and forget that King and Gandhi’s nonviolence actively provoke fierce outspoken confrontation, trigger a dramatic response, and bring injustice dramatically out into the open. King was a troublemaker and a disturber, not, as he has been so often revisioned, someone just on the side of being “peaceful.”)

That night playing Jenga I decided that all the reasons not to speak up just meant I was doing what I had done with the professor who had given me the lower grade. I was becoming part of the protection of the misconduct itself. And I had kept the whole thing going not just out of fear of retaliation and exposure but out of what amounted to my self interest — self interest in my status and standing among colleagues at the Institute. I had been selfish in going along with their decision to keep his behavior quiet and give him the benefit of the doubt, when he was in fact taking no responsibility and was going around blaming his client for being borderline. That’s a much harder reality for me to face, the real shadow of the shiny self-regarding view of myself: I had been selfish and self-interested. It’s one thing to admit I had been afraid, quite another to admit I had made a selfish choice to advance my own status over doing the right thing.

In a way I had done the very thing that a corrupt professor or an unethical therapist does: put self interest first. And when I started to see it more clearly this way, as about my own status and standing and selfishness, I realized I had made a choice I didn’t agree with. It just wasn’t worth it. I had made the wrong choice before, and now I needed to make the right choice. I needed to speak up, regardless.

* * *
On the phone with another colleague trying to make sense of all this, I was told something that stopped me in my tracks. “You know, Will, you can’t really speak out about things, because of your own misconduct. People will use it against you.”

It was like a whole picture coming into focus, him telling me this. I think I knew what he was referring to, a wrong I had done 13 years ago, and even though he was advising me to keep quiet, on reflection I instead felt more emboldened, more sure I needed to speak up. I began to see what might be at the heart of this shame and corruption dynamic in our society, and to sense, maybe, a pathway out of it, for all of us.

13 years earlier I had been called out — deservedly — for dating another activist in our advocacy and support group. She was vulnerable and a lot younger than me (15 years younger, she was 24, I was 39), and what I did was wrong. It was a consensual relationship and as a collective I wasn’t in any supervisory or hiring role, but I certainly had power and status that I didn’t take into account how it would impact her. When we ended our dating she was very hurt. I put my self interest in sexual pleasure and easy companionship above my caring for her needs. I chose someone younger and more vulnerable than me and I felt safer and more free that my power wouldn’t be threatened. I pursued a relationship I knew wouldn’t last, on my terms, based on her being more pliant to me as older and more established. And to make things worse, at the beginning when I was challenged I had defended myself, and it took a long time of our group holding me accountable for me to finally realize I had made a big mistake, and for me to apologize. With my apology I didn’t want to deny the facts of what happened, but at the same time when gossip started flying I didn’t want anything inaccurate to be spread about me. And so I also made the move — questionable in hindsight, as I was certainly wielding my power and influence — to approach the woman’s employer and ask to rein in anything inaccurate being gossiped.

I realized how hard it must have been for the woman I dated to speak up when I had more power and status in the community. I saw, reluctantly, that I had been given a valuable wake-up lesson. It kicked off discussions about sexuality and power in my life. I looked at my choices to date and have relationships with people younger than me. I looked at the differences of vulnerability with people I was dating, questioning myself in the relationships I had with other women who I had met in our group. I looked at power and leadership and vulnerability in activist communities. I reached out to female friends to help me look closely at my patterns of relationships and sex, exploring if there was something I wasn’t seeing or was defending unfairly.

This was at a time when I was growing into more status and prestige. The Freedom Center, Valley Free Radio (another project I was part of), and The Icarus Project, a national group I started working for — all were giving me status to some degree in the community eye, and some people were looking up to me. Sex was caught up in “movement” settings that were in some ways mixtures of both workplaces and communities. After hiding for much of my life under the darkness of a mental illness diagnosis, feeling weak and vulnerable, mistrustful and lonely around people, I had to grapple with the reality of visibility, status, and power. I was in a world where I was being seen more, and having more of an impact — and facing my own exposure and shame more. My identity as a bisexual man, being polyamorous, and being unmarried and childfree meant something in a world where these things are all, for some people, bound to invite scrutiny and gossip.

As money and power had started to flow more into the recovery and alternative mental health movement (state and federal contracts, wealthy donors, international coalitions, media interest), there were new dynamics of politics and competition at work. New levels of secrets and backbiting seemed to be taking hold as they do everywhere there is money and power at stake, with everyone vying for positions that hadn’t been so appealing when I first began my volunteer organizing in this movement. Competition and gossip were reality. I was seen and held up and looked up to more often, and under a lot of criticism from people, including those who might be competing. It was a new world for me, a world where the corruption of “the system” was starting to show up more and more everywhere I looked, and where a movement was starting to seem and act more and more like an industry. I struggled with “paranoia” and wanting to hide, but I knew I had to come out more, I had to start to learn how to take more responsibility for my status and influence and understand that the world where I had begun as co-founder of a small community support group was now a different world.

I certainly had done wrong, that was definitely true, and certainly people will (and should) evaluate me for it; I have to accept that, that some will judge me and raise questions. I remain open to talk about it with anyone who asks, doing my best to set aside my prior defensiveness. I tried to learn from it and incorporate it into my life in the process of being a man, having status and authority, and learning from mistakes how to do my best. I really began to understand that we all have our shadow sides we can’t see — me included — and the challenge is not just to be a good person, but to respond well when our inevitable failings to be a good person blindside us. Especially when our first reaction is defensive.

What happened happened and I don’t want to hide from scrutiny — or have it hold me back.

So when my colleague told me I shouldn’t speak up because I would be exposed and shamed for my own wrongdoing, the whole social pattern came into clarity. The usual way that corrupt and unethical behavior gets “called out” is in a righteous tirade of Us vs Them. Perpetrators are denigrated and victims elevated. The spotlight goes out against Them, and everyone starts Othering and picks sides. Then the target you sling mud at slings mud back at you, and we all go to the ground. You will also be under the spotlight. So you better not speak up unless you want to be exposed and have someone talk about you. Speak up, toss the first stone, and get hit back. So we as a society have built walled camps of righteousness against the bad Other, hiding our own shadow as we attack the shadow of those we see as lesser. Democrats and Republicans do it to each other. Men do it to women. Women, certainly, do it to men. And without a doubt survivors, psychiatric survivors, do it to mental health professionals. Scapegoating can become the flip side of complicity, our shared trap of shame. I have seen abuse flow in all directions in families and between patients and professionals. We may have different access to power, we may be in unequal relationships, but it’s in everyone, this Us versus Them shaming dynamic. We all do it.

We are all in these shame traps: Be silent and be complicit? Speak up and be exposed? Bully in reverse through accusation? Keep status or lose it by becoming a troublemaker? Protect the misconduct of others so you can hide your own shadow side from scrutiny?

It isn’t just “them.” It’s also us. When we discover some abuse of power, and we honestly trace its roots, we always will end up finding ourselves in it somehow. We will find the complicity of silence and denial, we will find the unleashing of scapegoating and persecution of the bad guy, or we will find we are hiding our own transgressions from being exposed to scrutiny. My colleague was advising me to turn away from that mirror, to avoid having my own shadow in the open, to not be honest because it would bring shame down on me. I should stay silent and go along and be complicit, so that everyone else would be complicit with me. We should all just keep our heads down, stay silent, cash our paychecks and enjoy our reputations.

But I disagree. I think the opposite is true. I think we all need to face our shadow. In these traps we all suffer, our world suffers, our movement suffers, the future suffers, our hearts suffer. We all sink into stress and despair, we all are pulled into cynicism and giving up. We betray younger generations who have trusted our words and haven’t learned the lessons of listening for our silences. These traps are the ingredients of suffering and madness for all of us. We are all held in these dynamics of shame, and it is setting the world on fire. Hiding and silence help no one.

If we are going to make a world we all can feel at home with, safe in, we often start with movements. In our movement since the early days of Freedom Center I’ve tried not just to advocate for changes out there but also to nurture changes within ourselves. We are survivors who need empowerment both in terms of the system and inside our own healing process. We envisioned Freedom Center as an activist and also a support community. A place to be at home and to be safe. In many ways we joined the nonviolent tradition of Dr. King, where we march against injustice in the world and also create together a “beloved community” of caring for each other. When I was held accountable and challenged for my misconduct 13 years ago, it was painful and overwhelming, but it served the right purpose: holding me accountable and protecting the integrity of our beloved community.

In this movement I’ve found we create in microcosm the things we oppose: looking at the “out there” we also find it “in here.” Not in exact proportion, and the power differences are real, but we mirror each other. We all face shame and the dynamics of speaking up or keeping silent. There are many closets around with skeletons in them — and many people walking around with the keys to those closets. People hold each other’s secrets in webs of complicity to corruption just like people did around my professor, just like around the Director of my therapy school. I’ve been part of that. And I want to start to unravel those dynamics. We are in this movement together, but at times we lose the bigger vision. I’ve heard over and over quiet whispers of gossip hidden from the light of day when what is needed is transparent disclosure — and the gossip protects the person gossipped about and fuels competition and turf battles for funding. I’ve seen corruption and tried to speak up (intellectual property theft, sexual abuse, money mismanagement), then struggled with these same traps of shame and complicity, scapegoating and retaliation. I’ve gotten burned many times, learned to keep quiet…

And then I remember the deeper vision, and I keep trying. I have a commitment to the people I have met and worked with and represent, a commitment to the work of healing. I have to keep taking risks. I am always encouraging clients, support group members, and families, to find courage, to speak up, to live honestly and find their truth. So don’t I also have to do this work myself? Don’t we all have to do this work?

Maybe this is not just #metoo. Maybe this is #ustoo. Maybe we need to commit to not holding toxic secrets, not just for those around us but in ourselves. Maybe we have to face our shadows, together, not just attack the shadow of the other. Can we imagine something new — not “calling someone out,” but calling ourselves out together? Can everyone who is holding back start to speak up in a mutual process of healing our world? Can we let go of the shiny Facebook status updates and the righteous poses for our funders and the media, can we hold back from the media mud scapegoat spectacle, and can we start getting real about the shadows we all have, the corruption we are all part of?

As I write this the sky is literally filled with smoke and the sun is blood red because our world is changing. Our political system is broken. We are afraid and angry. We are descending into an Us vs Them world. Time is running short. We have to start making real changes — real changes. Real changes! And take real risks. We have to find courage. Psychiatry and the mental health system are failing, but they are also just sets of human relationships, relationships we are also part of. Maybe our greatest act of courage is to see it’s not just “out there,” but it’s also inside of us. Maybe we can bear the shame, and the scrutiny, of admitting that it is “our side” that is also part of the problem, that we are dangerously also part of “the system.” Maybe we can break the silence that protects misconduct and corruption around us — even while it means being exposed ourselves. Maybe we can challenge misconduct in the system fiercely and uncompromisingly, and also keep ourselves open and vulnerable to misconduct within ourselves. Maybe we can start being honest with each other.

The Process Work Institute responded to my public apology with a thoughtful email dialogue about what happened and what to do about it. As of this writing they are in a continued discussion internally about their responsibility to be transparent when hiring and hosting a therapist who has lost their license, and what it means that their own judgement of rehabilitation was obviously so wrongheaded. They are looking at how their behind-closed-doors decision harmed others by not giving everyone the facts so we could decide for ourselves. But I also sense all the same dynamics at play, and I don’t know what they will end up doing by way of apology or restorative process now that their actions are more in the public light. They might just close ranks, say they did nothing wrong, and treat this like a personal problem with me. They might subtly put me back into the client role, and then, as therapists so often do when challenged, say there must be something wrong inside me, something not spiritually advanced enough or psychologically healed enough, in me (and then condescendingly even offer to help my distress). They might see their special skills and philosophy as putting them above playing by the rules. They might just continue to play the corrupt game of power.

But they might do something different. They might instead start to look at all this more clearly, to recognize that even a deep command of sophisticated psychological theory can’t eradicate the fact that we all have shadows, we all have blind spots, we are all in this complicity and corruption together. Maybe instead of consulting lawyers and keeping our secrets close, we will meet together and have an honest conversation, looking at all we have done wrong, all of us, sharing our shadows, together.

That’s a dialogue I’d want to be part of. And a movement worth struggling for.

will hallWill Hall, MA, DiplPW —  is a therapist, mental health trainer, schizophrenia diagnosis survivor, and host of Madness Radio. Will trained in Open Dialogue at the Institute for Dialogic Practice and is author of Outside Mental Health: Voices and Visions of Madness and the Harm Reduction Guide to Coming Off Psychiatric Medication. He is a PhD Candidate at Maastricht University and lead researcher on Maastricht University’s antipsychotic withdrawal study.

More of Will Hall’s work on Everything Matters: Beyond Meds

Survey on Antipsychotic Medication Withdrawal – Please Take And Share

I’m very excited to announce the launch of a survey with Maastricht University on antipsychotic medication withdrawal. I’m working with Dr. Jim van Os, Dr. John Read, and Dr. Sandra Escher on this international survey, just released in English with translations to additional languages coming soon. – Will Hall

The survey aims to improve mental health services by better understanding medication withdrawal. Service users/survivors/consumers from around the world gave input to the survey development. The study is sponsored by Maastricht University in the Netherlands; co-sponsors include the International Institute for Psychiatric Drug Withdrawal.

You can take the survey if you have you ever taken antipsychotic medication (such as Zyprexa, Seroquel, Abilify, Risperdal, Haldol, Geodon, Stelazine, and others), for any condition or diagnosis, with or without other medications;  and you have ever stop taking antipsychotics, or tried to stop taking them. You also need to be 18 years or older at the time of taking the survey.

Please take and share the survey here:


editors NOTE it’s a long survey…but one can come and go and not do it all in one sitting. (as long as you have cookies enabled on your browser) your answers come back when you do!

and there is a Facebook page here

Press release here:

Media Release: Maastricht University Launches

Antipsychotic Medication Withdrawal World Survey

Date: June 1, 2018

Contact: Will Hall +14132102803  —  will.hall@maastrichtuniversity.nl

Maastricht University School for Mental Health and Neuroscience

PO Box 616, 6200 MD Maastricht The Netherlands

Maastricht University School for Mental Health and Neuroscience, The Netherlands, today launched a survey for patients who have withdrawn or tried to withdraw from their antipsychotic medication.

The survey is online at http://www.antipsychoticwithdrawalsurvey.com. Translations are also available soon.

“How patients discontinue antipsychotics is not well researched in the clinical literature,’ says Will Hall, lead researcher and PhD candidate at the School for Mental Health and Neuroscience. The study will gather data across multiple countries to better understand if, when, and how to best withdraw from antipsychotics such as risperdone and haloperidol, which in some patients can cause severe adverse side effects including diabetes, heart disease, and neurological disorders.

Antipsychotic medications are a class of drugs prescribed primarily to treat psychosis, a debilitating condition which affects more than 21 million people globally according to the World Health Organization. In recent years their prescription has expanded to include anxiety and depression, and antipsychotics are today the third most prescribed class of psychiatric medication. 1.6% of the US population takes antipsychotic medication, according to a 2017 review in the Journal of the American Medical Association (1). Commonly prescribed antipsychotics include Abilify, Seroquel, Geodon, Haldol, and Risperdal.

Lead researcher Hall was himself diagnosed with schizophrenia; he took antipsychotics before discontinuing the drugs and later resuming work. He says the survey meets a need shared by clinicians, patients, and family groups to better understand medication risks and benefits. “One size does not fit all when it comes to psychiatric treatments; our aim is to expand the research base to inform better clinical practice.”

Dr. Jim van Os, Head of the Division of Neuroscience at Utrecht University Medical Centre and a member of the Royal Netherlands Academy of Arts and Sciences, is sponsoring the research through Maastricht University. “This survey is the first of its kind to compare a large sample of patients’ firsthand experiences internationally” said van Os. “Once patients start taking these drugs it can remain unclear if, when, and how to stop. The data from this survey will help fill a gap in the existing research.”

The survey is anonymous and can be found at http://www.antipsychoticwithdrawalsurvey.com. It will also available in multiple languages including English, Dutch, French, German, Spanish, Arabic, and Japanese. Patients and former patients can take the survey with or without the assistance of their doctor.

  • “Adult Utilization of Psychiatric Drugs and Differences by Sex, Age, and Race,” Moore, T., and Mattison, D. JAMA Intern Med. 2017;177(2):274-275.



For a multitude of ideas about how to create a life filled with safe alternatives to psychiatric drugs visit the drop-down menus at the top of this page or scroll down the homepage for more recent postings. 




Now Available! Will Hall’s New Book Outside Mental Health Voices and Visions of Madness

New book by Madness Radio host Will Hall now available!

$18.00 + shipping, 400 pages, 60+ guests, 10 years in the making

“Required reading for anyone who cares deeply about mental health and its discontents.” 
— Jonathan Metzl MD
Author of The Protest Psychosis: Black Politics and Schizophrenia

“Bold, fearless, and compellingly readable.”
— Christoper Lane
Author of Shyness: How Normal Behavior Became a Disease

An intelligent, thought-provoking, and rare concept…These are voices worth listening to.”
— Mary O’Hara, Guardian newspaper columnist

“This is a brilliant book… Nicely written, and wonderfully grand and big-hearted in its exploration of the world of mental health.” 
— Robert Whitaker
Author of Anatomy of An Epidemic 


Find out more at www.outsidementalhealth.com

Outside Mental Health:
Voices and Visions of Madness

visionsOutside Mental Health: Voices and Visions of Madness reveals the human side of mental illness. In this remarkable collection of interviews and essays, therapist, Madness Radio host, and schizophrenia survivor Will Hall asks, “What does it mean to be called crazy in a crazy world?”

More than 60 voices of psychiatric patients, scientists, journalists, doctors, activists, and artists create a vital new conversation about empowering the human spirit. Outside Mental Health invites us to rethink what we know about bipolar, psychosis, schizophrenia, depression, medications, and mental illness in society.

Interviews include:
Gary Greenberg, Bonfire Madigan, Robert Whitaker, Eleanor Longden, John Horgan, Alisha Ali, Christopher Lane, Clare Shaw, Ethan Watters, Paula Caplan, Jonathan Metzl, Jacks McNamara, Tim Wise, Kalle Lasn, Arnold Mindell, and dozens more…

Will Hall’s Madness Radio has long been for many a refuge and an oasis from the overblown claims and corporate interests of American psychiatry and Big Pharma. This collection of interviews and writings—bold, fearless, and compellingly readable—captures Madness Radio’s importance and fierce independence, urging us to think differently and anew about the “thought disorders” involved in illness and wellness, sanity and recovery.
Required reading. — Christopher Lane, author of
Shyness: How Normal Behavior Became a Sickness

 This is a brilliant book… Nicely written, and wonderfully grand and big-hearted in its exploration of the world of mental health and much more. Remarkable in scope, Outside Mental Health delves into autobiography, psychology, sociology, philosophy, and spirituality. Will Hall elevates the radio interview format into an art. — Robert Whitaker, author of Anatomy of An Epidemic: Magic Bullets, Psychiatric Drugs,
and the Astonishing Rise of Mental Illness in America

 An intelligent, thought-provoking, and rare concept…These are voices worth listening to.— Mary O’Hara, The Guardian newspaper columnist,
and author of Austerity Bites: A Journey to the Sharp End of Cuts in the UK

 Will Hall’s gentle wisdom shines through in this diverse collection of intimate interviews. Outside Mental Health adds to our collective understanding of the complexity of human suffering, and offers new opportunities for compassion and healing. — Yana Jacobs, LMFT, former Chief of Adult Mental Health Services, Santa Cruz County, California, and current Chief Development Officer, Foundation for Excellence in Mental Health Care

 Thank you so much for all the love and energy that went into bringing the book together. I’m half way through, savoring every story, and finding parts of myself I lost and let go of. It’s a beautiful work of love and kindness.
– Reader from CA

 A terrific conversation partner.— Joshua Wolf Shenk, author of Lincoln’s Melancholy:
How Depression Challenged a President and Fueled His Greatness

 It is an exhilarating challenge and a great pleasure to be interviewed by Will Hall – a widely knowledgeable and widely explorative interviewer.Maxine Sheets-Johnstone PhD, author of
Phenomenology of Dance, University of Oregon Department of Philosophy

 Outside Mental Health is a must-read, not only for those in the mental health field, family members, and those who experience extreme or altered states, but for anyone interested in creating a more just and compassionate world. Hall’s lyric, authentic voice, woven throughout, speaks powerfully to the dominant narrative about mental illness, and provides hope for transformational change in our approach to emotional distress.— Alison Hillman, Open Society Foundation Human Rights Initiative, past Program Director for Disability Rights International, and 2011 appointee to the Presidential Committee for People with Intellectual Disabilities

 There are few books that I come across that make me want to drop everything I am doing and immediately read it on the spot. Outside Mental Health is one such book. Will Hall has given us a real gift: this book offers us a new, helpful, liberating—and dare I say, sane—way of re- envisioning our ideas of both the nature of mental health and mental illness in a world gone mad. Truly an inspired, and inspiring, work.— Paul Levy, author of
Dispelling Wetiko: Breaking the Curse of Evil
and Director of the Padmasambhava Buddhist Center, Portland Oregon

 This extraordinary book will make a difference for therapists and “patients” alike. Interviews and essays acknowledge the overuse of medication and hospitalization, but don’t demonize these treatments… Outside Mental Health reads with fierce emotional intensity: journeys shaped by forced treatments, homelessness, and soul-crushing family conflicts, as well as extraordinary triumphs, creativity, and originality.— Stanley Siegel, author,
The Patient Who Cured His Therapist and Other Tales Of Therapy

 Phenomenal… a tome of treasures, filled with great findings for all kinds of seekers. And it begins with Will Hall’s story, bravely and lovingly told. When I discovered Will’s work after a crisis in my own family, the madness began to make sense. Now in this outstanding book he has brought together a rich trove of fascinating interviews with survivors, philosophers, researchers, artists, psychiatrists, journalists and scientists, all of whom illuminate the darkness and plot innovative strategies for survival and recovery.— Susan McKeown, Grammy award winning singer-songwriter

 Outside Mental Health explores the lived experience of extreme states and psychiatric treatments with openness and curiosity. Will Hall brings lessons learned from his own altered states and work as a therapist to offer fresh perspectives on madness and how to respond to it.Arnold Mindell PhD, Jungian therapist, founder of Process Oriented Psychology,
and author of Processmind: A User’s Guide to Connecting with the Mind of God

The biggest question facing mental health care is: who should be in control and who should make the decisions? Who should say what mental crises are, what treatment should be, and what recovery means? I am truly honored to recommend this book. Will Hall has done an extraordinary job bringing together a wide-ranging and diverse collection, all united by a concern with empowerment. These voices challenge current orthodoxy and constitute a fantastic resource for those who are seeking change.— Dr. Pat Bracken MD, psychiatrist, philosopher, and
Clinical Director of Mental Health Service, West Cork, Ireland

 Clarity, grace, insight, compassion and most of all wisdom: these are the qualities that you will find in these powerful interviews and writings assembled by long time mental health advocate Will Hall. The lessons that spring forth from these interviews are innumerable but one recurs time and again: without true choice, in other words without freedom, there can be no health, healing and recovery.— Gabriella Coleman
Wolfe Chair in Scientific and Technological Literacy at McGill University
and author, Hacker, Hoaxer, Whistleblower, Spy


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New Project for People Who Hear Positive Voices

By Will Hall

Dr. Marius Romme, the Dutch psychiatrist whose pathbreaking work with Dr. Sandra Escher on voice hearing catalyzed the Hearing Voices Movement worldwide, is initiating a new project for people who hear positive voices.

He writes:

 in our society about 4% of people are hearing voices on a more a less regular basis.  Most of these people hear voices that are supportive and inspiring and who function well in society.  There are about 250 million people across the world who have this experience and many are not able to openly talk about it. This is because in our society there is not an open minded attitude towards people having  this human experience, indeed the view is mostly negative. We think it is time to change this and would ask you for your help.

To find out more about the project, or to get involved as a promoter, you can contact Dr. Romme here:

a.romme.escher – at – gmail.com


download the invitation letters from Dr. Romme here:




More on hearing voices on Beyond Meds: Hearing voices: living and thriving as voice hearers


Marijuana for Mental Health Conditions?

By Will Hall

Cannabis (marijuana) is now legal in two states, legal for medical use in 23 more, and roolls show the majority of Americans support legalization. As a counselor working with people diagnosed with psychosis and mental illness I am often asked about my clinical — as well as my personal — experience with medical cannabis.

The issue is not clear-cut, but I think it is time for everyone, especially if you are concerned with the risks of pharmaceutical drugs, to set aside what we think we may know and take a serious look at cannabis as an option for mental health challenges. The decision to use any substance is complex, and along with War on Drugs anti-pot propaganda there is also a lot of pro-cannabis fanaticism to wade through. But this is the reality: despite some risks, cannabis has huge potential for promoting mental health while avoiding pharmaceutical drugs and their devastating adverse effects.

I don’t need to reiterate the research on medical cannabis easily found online, and I have already written about my counseling approach to substances in general in a previous post (‘The Substance of Substance Use”). But here are some more thoughts about cannabis specifically.

People are already using cannabis successfully to treat psychiatric conditions. Cannabis has long been a medicine and sacrament throughout human history, for far longer than the brief period of prohibition. Criminalization didn’t come in 1937 because of any medical assessment, but was instead a political decision. The first anti-pot laws were motivated by racism against blacks and Mexicans, and later Nixon sought to suppress an insurgent youth culture. Today there are extensive studies showing medical benefits for cancer, Alzheimer’s, multiple sclerosis, hepatitis C, irritable bowel, Parkinson’s, pain management, epilepsy, and many other conditions, and this evidence has driven successful cannabis legalization ballot initiatives around the country.

The legalization trend is now convincing even longtime opponents. US President Obama formally acknowledging cannabis as no more dangerous than alcohol, and CNN’s chief medical correspondent Dr. Sanjay Gupta recently reversed his opposition to medical cannabis. Dr. Gupta, who is one of the world’s most influential medical opinion leaders, even apologized for his previous anti-legalization stance and for “not looking hard enough” at the issue.

But what about mental health conditions? Should we embrace cannabis as a treatment?

Around the country, medical cannabis cards are given to people suffering anxiety, depression, insomnia, ADHD, trauma, and mental health issues. The internet is replete with a growing number of testimonies of successful symptom alleviation through cannabis, including people diagnosed with psychotic disorders such as bipolar and schizophrenia, as well as using cannabis to come off psych drugs. These are not just a few anecdotes, these are many thousands of people giving firsthand accounts.

“Since I’ve started smoking regularly I’ve started working out regularly, haven’t had a bipolar episode, no panic attacks, stopped cutting completely”

“When I was in a manic phase, marijuana relaxed me and helped me get to sleep. I often felt as though I had so much energy inside me that I would jump out of my skin, and the cannabis helped tremendously with that.”

As the number of dispensaries, review websites, and legal cannabis consumers increases, testimonies like these are growing. And at the same time, it is not uncommon for me to receive emails like these:

“Our son was doing so well in school, and then he started smoking cannabis and went psychotic and went into the hospital, where he was diagnosed with schizophrenia.”

“Before her delusions began I learned she was experimenting with cannabis…”

So what is going on?

A simplistic prohibition mentality has saturated our culture for years, with media reports and scientific studies thoroughly demonizing cannabis. Just one notorious example was the Heath/Tulane study in 1974, which claimed to show cannabis “kills brain cells” in laboratory animals. This finding, by a mainstream research institution with impeccable scientific credentials, was considered gold standard and was widely repeated in the media. “Marijuana kills brain cells” was paraded by President Reagan in his anti-drug propaganda, and is still today brought out by frightened parents when they discover a joint in their teenager’s bedroom. In the “This is your brain on drugs” television commercial, a broken egg on a hot griddle became the last word on what cannabis does to your brain.

The Heath/Tulane study was later exposed as scientific fraud: researchers were able to demonstrate brain cell death only by pumping so much cannabis smoke into restrained laboratory animals that the animals couldn’t breathe. Brain cells need oxygen to survive, and it was asphyxiation, not ingesting cannabis, that caused the brain damage. This corruption of science isn’t just from the Reagan era, though: it continues today. Dr. Gupta writes that of current US cannabis studies currently underway, 94% are designed to investigate harm, not potential benefits.

Medical professionals should have helped guide us through this confusion. Instead we find the same corruption of a public trust. No leading mental health organization has publicly expressed opposition to the War on Drugs or presented an honest discussion of the pros and cons of cannabis legalization. Even with the prohibition tide now turning, mainstream organizations such as National Alliance on Mental Illness and the Schizophrenia Society of Canada continue to echo cannabis demonization, trailing behind both consensus scientific views and common sense.

Regarding cannabis and psychosis, mainstream mental health opinion makers have stayed firmly in line with pharmaceutical industry and American Medical Association opposition to legalization. Without exception they have elected to emphasize the research linking psychosis to cannabis while ignoring everything else worth considering. Cannabis’ demonstrated usefulness for anxiety, PTSD, depression, reducing psychotic symptoms, helping people discontinue psychiatric medications and get off painkillers – none of this finds its way into the mainstream mental health discussion. Just as the mental health industry has lagged far behind in recognizing the value of holistic health options in general, it is lagging behind on the value of cannabis.

NAMI medical director Dr. Ken Duckworth sums it up on the NAMI website: “The overwhelming consensus from mental health professionals is that cannabis is not helpful—and potentially dangerous—for people with mental illness.” He’s correct – but overlooks that this consensus is a result of politics, not medical science. Dr. Duckworth deploys full War on Drugs propaganda in his NAMI policy writings: “Approximately one-third of people in America with schizophrenia regularly abuse cannabis,” writes Dr. Duckworth, and the implication is clear. But is there a citation for that incredible statement? No, because there is no evidence behind it.

He also rings the alarm bell of addiction, continuing the mental health industry’s conflation of use with abuse. “A significant percentage of individuals who use cannabis will become physically dependent on the drug.” writes Dr. Duckworth. “This means that stopping their cannabis abuse will cause these people to experience a withdrawal syndrome.”

CNN’s Dr. Gupta, however, disagrees. He writes that “In 1944, New York Mayor Fiorello LaGuardia commissioned research to be performed by the New York Academy of Science. Among their conclusions: they found cannabis did not lead to significant addiction in the medical sense of the word.” Dr. Gupta adds, “The physical symptoms of cannabis addiction are nothing like those of the other drugs I’ve mentioned.”

As Dr. Gupta’s reversal of position indicates, there is a clear and growing case for cannabis’ benefits relative to its risks – including for mental health. This reality is slowly coming to light, but in the context of the War on Drugs, legalization advocates have themselves made things confusing. Pro-legalization forces, understandably defensive given the brutal atmosphere of criminalization and imprisonment, have often become cannabis cheerleaders and dismissed any discussion of risks as more propaganda. Left in a vacuum by mental health and medical organizations that should have been providing leadership on the issue, mainstream research studies on medical benefits are often touted and available on aggressively pro-cannabis sites. You feel that you are pulled to one side of the other in this political, cultural, and economic tug of war. The pro-cannabis sites are after all, now burgeoning with advertising revenue from the surfacing cannabis industry. There is a lot of money at stake around legalization. The message today is “cannabis is good for you,” and the next message will be “buy some from us.”

As a society we are thankfully stepping away from both sides of this war. A new honesty around cannabis is taking place in medical cannabis states such as California (where I live) and on the internet. As fear diminishes and people become freer to speak openly, two important facts are emerging as central to this discussion: dosage and strain. 

The cannabis of today isn’t the cannabis of yesterday. But the commonplace claim that “cannabis today is stronger than it was in the past,” and therefore riskier, is far from the whole picture. Yes there is a lot more strong cannabis out there, but that also has positive implications for medical use. Cannabis is being used today in many different ways by many different people, and this increasing sophistication needs to be understood to get the real story.

This is well illustrated by the cannabis experience of New York Times Pulitzer Prize winning columnist Maureen Dowd. In a high-visibility act that formed part of Times reporting on growing legalization efforts in Colorado and elsewhere, Dowd got high on pot in Denver — and promptly had a psychotic episode. She presumably didn’t go on to be diagnosed bipolar, and didn’t need to be hospitalized. But her reporting about her bad trip, replete with delusions of being dead and paranoid fears of the police, reinforced prohibition stereotypes and was considered proof positive by some that cannabis is a bad idea for anyone “at risk for psychosis.”

Dowd, however, was in effect writing a denunciation of wine by binge drinking on tequila. “Alcohol makes you sick and pass out” says more about how, how much, and what we drink, than it does about that we drink alcohol. Simple enough common sense, but that is exactly what has been lost in the discussion around cannabis. Without adequate understanding, Dowd apparently swallowed an entire cannabis infused edible candy. Edibles are notorious for their potency. Then she did what anyone following sensible cannabis use knows not to do – when after a few minutes she didn’t feel any effects, she gobbled up even more of the edible. This doubled the eventual impact of the drug, and after the slow-onset that is standard for eating cannabis (unlike smoking, eating means the cannabis is digested before experiencing amplified effects), she delivered a massive dose to her cannabis-naive body. Hence the overwhelming trip. It could be humorous – Dowd was lambasted in the internet for her irresponsibility – if it wasn’t so emblematic of the impact of prohibition. Rational discussion by a presumably thoughtful professional journalist turns into nonsense, more fuel for simplistic demonization.

Dosage, including the delivery method (and today there are herbal tinctures, vaporizers, and other methods beyond smoking or eating), is an important reality to cannabis consumption. If a drug at one dose is useful and at a higher dose is harmful, does that mean the drug itself is “useful” or “harmful?” If a drug leads to psychosis at a higher dose, but doesn’t at a lower dose, is the problem the drug or how it’s used?

So we begin to see one explanation for how a drug that many people find useful for psychosis can also be a contributor to psychosis for many others. It becomes more understandable why my inbox has emails from people blaming cannabis for mental illness alongside emails from people who’ve been helped.

Dowd also didn’t understand the what of cannabis use. She didn’t chose her supply with any care, and that can make a huge difference: there are hundreds of strains of crossbred hybrid cannabis, with colorful names like Blue Dream, Girl Scout Cookies, AC/DC, and Lemon Alien Dawg. This diversity isn’t just fanciful or aesthetic: strains differ by aroma and flavor, but much more importantly, different strains have drastically different psychoactive effects. Alcohol intoxication might feel a bit different between beer, wine, and spirits, but not by much. The difference between different cannabis strains, however, is like taking completely different substances.

There are 483 currently known compounds in cannabis, and at least 84 different psychoactive cannabinoids. THC is just one. And different compounds lead to different mental experiences. This may explain why some people are using cannabis to alleviate psychosis while others find it makes psychosis worse. Today medical cannabis users routinely share information about the qualities of different strains – some good for sleep, some for anxiety, some for depression – to help each user find out what works for them.

Cannabis users have also long known that the sativa varieties are different than the indica; sativa is associated with a more energetic high, prone to produce anxiety and paranoid in some people. while indica is more sedating. Of the many alkaloids, cannabidiol (CBD) is associated with tranquilizing response without strong mind-altering effects, while THC causes more mind-altering, and is potentially paranoia- and anxiety-inducing. Testing can pinpoint THC to CBD ratios in cannabis, and today dispensaries provide detailed information about their product that was impossible under prohibition. There is strong evidence that high CBD cannabis can alleviate psychosis for the simple reason that CBD is tranquilizing, in the same way that anti-psychotics are for many people helpful because they are tranquilizing. CBD, however, not only lacks the stronger reality-distorting effects of THC that can become so disorienting and panic-induing on some people, but it clearly has none of the devastating side effects of anti-psychotic drugs. No one has ever suffered thyroid damage, tardive dyskinesia, or kidney failure from cannabis.

(The cannabis industry is still only now emerging from the underground, and without the regulation and quality control of other industries, users have to rely on trial and error. It’s not a guarantee that what the dispensary labeled as Blue Dream isn’t actually Kali Mist, or that indica tincture is actually sativa. As in the legal wine industry, users will be served by allowing greater testing and reliability of supply. The proper role of regulation, however, is fiercely debated by growers in the current Gold Rush atmosphere. There are concerns about ecological sustainability, fair trade labor conditions, and the specter of Big Tobacco-style profiteering. In Sonoma County where I live, there is a huge cannabis industry and vast sums of money moving into the state in anticipation of California legalization. The wine industry in the area, despite being legal and regulated, is very shady, and has earned a deserved reputation for greedy disregard for the environment and local community. That might be a cautionary tale: the gentle peace-ecology-love aura of cannabis may, some fear, quickly give way to the cutthroat realities of just another boom industry and agribusiness product. Or, the issue might be upstream: with large monied interests corrupting politics, it may take democratic reform to get all industries – wine and cannabis – more in line with public interests.)

Word about CBD is getting out. Along with the emails from people tracing psychosis back to cannabis use, I now routinely encounter people in my work, lucky to be in a legal state or country or able to risk acquiring pot through the underground, who are turning to cannabis for help with psychosis and mental illness diagnosis. Some have switched to high CBD strains and found different effects, some are using cannabis to help come off psych drugs, some are using cannabis instead of psych drugs, and some – very interestingly – have gotten benefits from cannabis and never gotten on psychiatric drugs to begin with.

Scientific studies on CBD support what I am seeing: a University of Cologne study from Germany, in a four week trial, found CBD as effective as an anti-psychotic in calming psychotic symptoms. A co-author of the study wrote “Not only was [CBD] as effective as standard antipsychotics, but it was also essentially free of the typical side effects seen with antipsychotic drugs.” Harvard researchers who published a different study in Schizophrenia Research wrote that “The amount of THC is particularly of concern, whereas CBD is the component that is thought to have medicinal value even in schizophrenia.” They concluded that “there is no evidence from this study that it [cannabis] can cause the psychosis.”

A glance through research results on CBD from studies around the world shows evidence to support what we know already: CBD cannabis can help mental health conditions. These users are often careful in dosage, some even using just a few drops or “homeopathic” doses to get the desired effects.

(Other research is also intriguing. Numerous studies show anxiety alleviation, and, consistent with research on Alzheimer’s and Parkinson’s, one University of Montreal study published in Psychiatry Research even showed cannabis users diagnosed with schizophrenia to have better memory and prefrontal lobe functioning than those not using cannabis. Those study participants were taking psych meds: could cannabis be not only a substitute for psychiatric medications, but a treatment for the harm they caused? There are other studies that are more troubling about risks, such as those showing memory impairment and youth developmental harm, but these need to address dosage and strain questions to be able to better understand what is going on.)

So the kind of cannabis used, as well as the dosage, may explain part of the puzzle of different reports around cannabis and psychosis. This is in addition to a general principle with all psychoactive substances, a principle that applies to cannabis as well: Response to cannabis use is widely diverse and individual. This is confirmed by a University of Manchester study published in Schizophrenia Bulletin that found that “impacts of cannabis on people with psychosis are quite complex and variable.” (The study even showed that “Cannabis use was associated with an improvement in general functioning” compared to non-users.)

The medical cannabis dispensary community is thoroughly familiar with the fact that as a “medicine” cannabis does not provide uniform “treatment.” Instead, just as each individual experiences an illness differently, each individual has their own response to a medicine like cannabis. What is right for one person might not be right for another – including the need to forgo cannabis altogether. Some people find the “high” contributes positively their medical condition and life circumstances, others seek out strains that have helpful effects without the high. Dispensary staff I’ve met are skilled at helping individuals navigate different strains and dosages for individual needs.

Substance abuse is a serious and devastating problem. Some people find that abstinence is the best strategy, such as following an AA 12 step program. Taking any drug – alcohol, tobacco, or cannabis — involves risks. Cannabis needs to be subjected to the same caution, but overall cannabis is undoubtedly infinitely safer on the body than alcohol or tobacco (zero cannabis caused deaths compared to many millions of alcohol and tobacco deaths). In any direct comparison, cannabis is much safer than any psychiatric medication. That includes the possible link to psychosis, because we know that psychiatric drugs themselves definitely cause psychosis in some people.

The growing legalization and medicalization of cannabis will no doubt be used by some to rationalize their addiction, or rationalize getting high when the drug is not helping them. But this is true of any substance, including alcohol and psychiatric meds. Once we step outside the War On Drugs mentality we can engage this complicated reality more clearly. Saying cannabis might be helpful for some people is not to deny it might make things worse for others.

What about me personally? I found years ago that cannabis only worsens my own anxiety and further disconnects me from reality. I was smoking around the time I was first hospitalized, and though I quit cannabis I still had another psychotic break many years later when I wasn’t using, and hadn’t used, cannabis for 8 years. I do believe that pot was a contributing – but in no way a causal – factor in my first crisis, and that smoking played a role in the several years of decline that led to that crisis. But this was all wildly overblown by the hospital doctors who interviewed me. When I moved to Conard House, an outpatient facility in San Francisco, I was sent to a mandatory anti-drug meeting along with every cannabis user at the house, regardless of the frequency of use or whether or not it was abused or a problem for us. When I challenged the meeting leader by saying that cannabis was much safer than alcohol, which I thought was a commonsense statement, I was summarily kicked out of the program. (I was sent to a homeless shelter at 14th and Mission, right next to a thriving street crack cocaine market where I passed dealers every day on my way to and from my room. A good friend of mine from a previous program, who had been abstaining from cocaine for several years, was sent to the same shelter. I watched as he gradually lost control of his addiction with the temptation of those dealers; he left the shelter and I never heard from him again.)

I think that CBD strains are promising, and I personally would not hesitate to try a small dose of CBD cannabis in a time of emotional crisis where I felt I had run out of other options. I would watch carefully my response, and proceed only if I felt confident I wasn’t going to get paranoid, become anxious, or have my rational faculties impaired. Over the years friends, clients, and colleagues who use cannabis have educated me about its potential if I did ever find myself in need, and now that I live in California a friend has introduced me to the California dispensary system. I’m grateful I live in a state where I can learn about cannabis more honestly. If I ever get out of hand with sleep deprivation or go off the deep end in a psychosis, I’m glad I can first try a CBD brownie (gluten free of course) instead of a dose of Seroquel. And when I’ve seen friends go down to the psychotic vortex and head for the hospital, I wish there was some CBD weed around to try and help them break the crisis cycle, rather than relying on a psych med as a last resort.

In my work with clients I now consider it unethical as a therapist to not include cannabis in the list of possible wellness tools. I am pro-choice regarding psych drugs, and if I acknowledge that antipsychotic meds, even with the risks, might be a wise choice for some people, I would be completely, well, crazy not to acknowledge that cannabis might be a wise choice for others. I’ve always welcomed herbal medicine and traditional Chinese and other treatments into the range of possible wellness choices, because they have such a demonstrated history of helping so many people with such few risks. Cannabis also has such a history, and I believe everyone working in the mental health field needs to consider taking the same stance I have. There are a lot of states where cannabis is still illegal, and it is wrong for people living in those states to continue to be denied a possible treatment option.

From a mental health advocacy standpoint, cannabis legalization also has many other implications that we as mental health professionals need to take initiative around, because the AMA, APA, NAMI and other groups have failed to take any honest leadership on the issue. An American Journal of Public Health study by a team of economists, for example, examined states that had legalized cannabis for medical use. The study found there was a 10.8 percent reduction in the suicide rate of men in their 20s and a 9.4 percent reduction in men in their 30s. That is extraordinary – we know that psychiatric drug use can exacerbate suicidality (the warning is right there on the drug label), and alcohol of course can contribute to suicidality. It’s not clear exactly why greater availability of medical cannabis might lower suicide rates, but this is a very, very significant finding for anyone who takes suicide prevention seriously. (I recently lost a dear friend to suicide, and I am convinced benzodiazepines and alcohol played a role in killing her. I wish her therapist and doctors had explored cannabis as an alternative – she needed any alternative – and her death is one of the things motivating me to write this blog post and “come out” with my clinical practice decisions around cannabis.)

Studies also show legalization leads to reduction in alcohol use. That in itself has huge mental health implications. Alcohol is an extremely dangerous and socially destructive drug with notorious mental health harms. The National Council on Alcoholism and Drug Dependence reports that alcohol use is a factor in 40 percent of all violent crimes in the United States, including 37 percent of rapes and 27 percent of aggravated assaults. In 1995 alone, college students reported more than 460,000 alcohol-related incidents of violence in the US. A 2011 study found dating abuse directly associated with drinking among college students, and a 2014 study showed cannabis was significantly lower than alcohol in association with domestic and partner violence. As pro-legalization comedian Bill Hicks remarked, imagine you are at a sporting event and some guy in front of you is screaming and picking a fight: is he high on cannabis or is he drunk on alcohol?

Reducing alcohol use in society will likely reduce violence; and reducing violence means reducing trauma. When did we lose sight of ending violence as a way of preventing the cause of so many mental health problems? The decline in alcohol use associated with legalization has already reduced traffic fatalities from drunk driving. Each traffic death sends out shockwaves of trauma and grief, and turns many people to alcohol or psychiatric drugs.

Marijuana legalization is an upstream mental health solution with enormous implications. From a public health standpoint there is really no argument: just considering the effect of bringing down alcohol consumption alone makes cannabis legalization clearly worth it.

And that is just one effect. Cannabis legalization also reduces the market and illegal demand for opiods: according to the Centers for Disease Control, abuse of prescription opioids such as Oxy-Contin and Vicodin is a national epidemic that kills 16,000 people annually and is destroying lives and families.

Legalization of cannabis also has important implications for young people – once we understand the complexity of substance use. The War on Drugs has devastated the US black community, and it is shameful that white-dominated mental health organizations have not spoken up against prohibition. Prison and the police are a traumatizing factor that directly interfere with mental health recovery. While legalization, according to the Journal of Adolescent Health, has not led to an increase in teen cannabis use, it does give families and youth more flexibility. For young people using cannabis, it might be more realistic to switch the kind of cannabis they are using as a harm reduction approach, rather than giving cannabis up completely or punishing them with prison. Many young people are committed to cannabis as a lifestyle, a form of religious expression, and a pathway to independence. Under prohibition it is impossible to talk openly about their cannabis experiences, and difficult to differentiate cannabis strains they are consuming. It may be easier for a teen to hear “use CBD, not THC” than for them to hear “you have to stop smoking entirely;” “You can smoke pot, but in moderation” might work better than “you can’t get high at all.”

Collaborative relationships require honesty: young people today know that different strains do different things, and they know the hypocrisy of a War On Drugs that sends people to jail for smoking a joint and then sells their lawyers whiskey at the bars next to the courthouse. A harm reduction perspective is best served by legalization. Overgeneralized associations between cannabis and mental health problems, including psychosis, ignore a complex reality.

Adolescents using cannabis who get into emotional and psychological difficulties are like any adolescents who get into emotional and psychological difficulties, for whatever reason. They need help and support. The family needs help and support. The problem is never “cannabis plus genetics equals psychotic disorder.” The cannabis may, or may not, be part of the problem. When families — and doctors —are blaming the cannabis it is usually a sign of a deeper problem being avoided. Prohibition is based on fear, the search for a simplistic answer, something to grab ahold of as the solution when things feel out of control.

Cannabis use often becomes a power struggle in families. As a therapist I have seen time and time again families where a son or daughter has been psychotic after using cannabis, and the family’s response, likely reading articles such as Dr. Duckworth’s on the NAMI website, is to ban their son or daughter from using. So what does the young person do? They keep smoking, of course, except now they have a new problem: hiding their use, a power struggle with their parents, and the beginning of a cycle of isolation. I have to work hard to stay in a trusting relationship with both sides, and that job gets harder the more prohibition fears entrench intolerance. The solution is to create conversations about the substance; even if the parents are strongly against any cannabis use, it’s important to respect all sides, but on an equal playing field where the young person can be validated for a choice that has some science on its side. Dismissing the other side when you have the power of the police to back you up won’t help or lead to compromise. Doesn’t it make more sense to say Let’s talk? than to say Just Say No?

I have no doubt that cannabis use has played a role in many people’s problems with psychosis. I routinely encourage people to stop smoking when they know it can lead to crisis. I’ve seen people off cannabis start using again and end up hospitalized. And cannabis can certainly lead to habituation for some people and play a role in substance abuse problems. Educating society about these risks makes the same sense that educating society about alcohol risks makes sense – as long as the risks are not exaggerated. (Personally I would like to see cannabis avoid the commercialization of alcohol, and instead become an accepted – but not promoted or advertised – personal option. We really don’t need any more consumerism than we already have.)

And what about the correlation between first break psychosis and a higher rate of cannabis use? There is in my view some validity to that concern — and it also may be misleading. What if the causality is in the other direction? What if people who end up psychotic are drawn to altered states of consciousness to begin with, what if they first seek out in cannabis what they eventually end up seeking out later in their break to a psychotic reality? Working with young people over many years, I see the need to get “high” comes first, not after, the substance. Few families have honest discussions about the need to get high and get away — a human need that everyone has. And getting high repeatedly may be an escape hatch out of untenable life circumstances and confusing options. Maybe a young person is drawn to cannabis by the same inner need that will eventually draw them to psychosis, correlating the two – but not indicating causality? And as continued research shows the complexity of these relationships, is the fear of a cannabis-psychosis link just another artefact of the War On Drugs, used to shut down open discussion and spread prohibition politics in the mental health field? It certainly seems to be working: mental health professionals I talk with tend to parrot the psychosis-cannabis link research as the final word in the discussion in much the same way people parroted the “killing brain cells” research.

As we come to terms with the devastating impact of psychiatric drugs, we face a compelling question: What if there was a substitute? I believe mental health problems arise from emotions and life circumstances, and wouldn’t advise anyone to just “numb” out meaningful emotional responses with any substance. Numbing things out can interfere with a natural healing process. At the same time, there is no reason to be either-or. One can still come to terms with emotional challenges while receiving some relief from a substance or holistic treatment. And emotional crisis sometimes becomes so overwhelming that grappling with it directly might feel out of reach or impractical.

Someone considering a benzo, or an anti-psychotic, or an anti-depressant, is about to embark on a risky treatment option that might work out fine, or might end up destroying their life. That is the reality of the risks of psychiatric drugs. The Soteria House alternative and the Open Dialogue approach, it should be remembered, do rely on psychiatric drugs as a last resort. What if everyone had, on a wide scale, the option of choosing something with a lower side effect profile, and thereby avoid a risky pathway? Legalization of cannabis may be making that option real for many people. And if that is a possibility, this raises the question: what exactly do we know of Pharma’s influence in opposing cannabis legalization? The American Medical Association and APA have long opposed legalization; does medical cannabis represent a threat to their markets?

There is a clear nest of financial interests benefitting from cannabis prohibition, and the same public policy corruption promoting psychiatric drug use is behind efforts to block legalization. Dr. Herbert Kleber of Columbia University, an impeccably credentialed academic, is widely quoted in the press warning against cannabis – and also serves as a paid consultant to huge prescription drug companies. Oxy-Contin manufacturer Purdue Pharma and Vicodin manufacturer Abbott Laboratories are among the leading funders of the Community Anti-Drug Coalition of America and Partnership for Drug Free Kids – both prominent prohibition advocates. (Other funders include Janssen and Pfizer.) When Patrick Kennedy’s so-called Project SAM (Smart Approaches to Marijuana) worked against Alaska’s legalization initiative, activists counterattacked by pointing out the organization’s extensive  financial ties to the liquor and beer lobby. Legalization opponent Dr. Stuart Gitlow, President of the American Society Of Addiction Medicine, went on the media circuit disputing President Obama’s statement that cannabis is no more dangerous than alcohol: Gitlow serves as medical director for Pharma opioid manufacturer Orexo. Former Drug Enforcement Administration head Peter Bensinger and former White House drug czar Robert DuPont (yes that was his title) now run a commercial firm that specializes in the market for workplace drug testing. And while some police in the US have come out against the War on Drugs, many police are lobbying in favor. Is it because under drug money seizure and assets forfeiture laws they receive millions in funds for their departments to use? One sheriff who led opposition to legalization in Florida even stated openly that drug asset forfeitures were important for county law enforcement revenue. California legalization was opposed by another police lobbyist who made a career of funneling federal War on Drugs grants to state law enforcement. The economy of influence is clear.

Just as under alcohol prohibition, marijuana prohibition sinks deep roots of corruption into society as public good is diverted to individual gain. Speaking of federal grants and asset forfeiture, Los Angeles Police Department Deputy Chief Stephen Downing told The Nation, “The only difference now compared to the times of alcohol prohibition is that, in the times of alcohol prohibition, law enforcement—the police and judges—got their money in brown paper bags. Today, they get their money through legitimate, systematic programs run by the federal government. That’s why they’re using their lobbying organizations to fight every reform.” Legalization means challenging economies of influence and politics of corruption that have made drug policy and criminalization big business. Importantly, ending alcohol Prohibition in 1933 involved a vast clearing out of  corruption from the federal to the local level; hopefully the grassroots drive for cannabis policy reform will likewise have wide anti-corruption implications.

Even when we support cautious consideration and avoid blanket endorsement, cannabis is a powerful psychoactive plant that involves risks. Small controlled doses – a few drops of tincture, a small puff from a cigarette, a bite from an edible candy – are still unpredictable, and might launch someone onto an unpleasant altered state, make working or relating in public difficult, trigger insomnia, interfere with driving, set someone down a path to addiction, or worse. Memory and cognition harms might reveal themselves after long-term heavy use. There are risks: it’s not a one size fits all solution. It will take some time to sort out research honestly and get a realistic sense of cannabis in the wake of a politicized and corrupted research legacy.

And this underscores one of the central limitations to the cannabis policy discussion: is cannabis a medicine, or is it something more?

Legalization activists wisely chose to emphasize medical uses as a pathway towards greater acceptance. Demonstrating specific medical benefits challenged the War On Drugs classification of cannabis as a schedule one substance with no medical use. But in practice, as a plant medicine, cannabis has never been and probably never will be a targeted medical treatment. It is a living botanical life form, not a pill. Pharma has fanciful ideas about keeping the plant illegal and marketing derivative products like synthetic THC, but cannabis is not like penicillin. There is a reason why it is associated with spiritual practice and shamanism throughout history. Since prehistoric times cultures using cannabis have considered mind-body and spirit as one, and seen medical and religious practices as the same. People get ill, after all, not just bodies. The goal of a plant medicine is to support the holistic health of the whole person in their life and community context, not treat specific diseases separate from that broader reality.

Cannabis is very complex chemically, and the human body actually has an endocannabinoid system that cannabis is uniquely suited to interact with. The endocannabinoid system affects a vast number of life processes, and is vital to maintaining health and preventing illness in a comprehensive way. This appears to be why cannabis has such extremely wide health uses and has been effective in treating so many different conditions. Western medicine, however, is mechanistic and doesn’t look holistically at the mind and body as a single unified organism. It prefers to break down illness into specific component parts with specific treatments. This is one reason mainstream medicine is skeptical of plant remedies valued by traditional cultures for their broad effects.

So it would be a mistake to consider cannabis simply as a new western medical treatment. When people find cannabis useful for psychiatric conditions or for coming off psychiatric medications, it may be more meaningful to think in terms of a relationship to a substance, just as traditional cultures have thought in terms of relating to a plant spirit. And that substance or spirit can be very powerful. Like any substance, it can be misused and is not for everyone, and like any substance it means understanding our own personal responses and needs holistically. Like alcohol and caffeine, cannabis, even in its low THC varieties, changes consciousness and can produce a “high” that some people will enjoy, some people will not enjoy, and can cause problems for some people.

From food to movies, wine to video games, sexuality to long distance running, altering consciousness and “self-medicating” are widespread social practices. We need to acknowledge that we all, to some degree, choose to get high. We all make choices that change our consciousness. And this is what we have overlooked in our understanding of psychiatric drugs – they too are very powerful mind altering substances that get us “high.” They are high-tech, experimental, and risky highs compared to the plant medicines people have used for millenia, but they are still highs. Psychiatric drugs are not what we think of as a recreational drug, but we are still altered when we take our Zyprexa or our Prozac: and some psychiatric drugs of course, such as the benzodiazepines and the stimulants, are widely sold on the street for their recreational uses.

Because psychiatric drugs have such a clear downside, interest in using cannabis instead of psych drugs is here to stay and will only grow as legalization spreads. It’s time for us to leave behind the politics of the War on Drugs and start to have a more honest discussion of the potential benefits, and risks, of all substances, whether they are psychiatric drugs, or cannabis. Cannabis might just be a spirit that our culture needs – and, after years of fear and repression, is ready for.

More by Will Hall on Beyond Meds

On topic from Beyond Meds:

*it is potentially dangerous to come off medications without careful planning. Please be sure to be well educated before undertaking any sort of discontinuation of medications. If your MD agrees to help you do so, do not assume they know how to do it well even if they claim to have experience. They are generally not trained in discontinuation and may not know how to recognize withdrawal issues. A lot of withdrawal issues are misdiagnosed to be psychiatric problems. This is why it’s good to educate oneself and find a doctor who is willing to learn with you as your partner in care. See: Psychiatric drug withdrawal and protracted withdrawal syndrome round-up

Thinking Upstream: Winning Real Mental Health Reform By Joining the Anti-Corruption Movement

By Will Hall

At the end of my talk at the American Psychiatric Association Institute on Psychiatric Services, a psychiatrist in the crowded lecture room put his hand up and posed a surprising challenge: Why was I so concerned about reforming psychiatry and ending iatrogenic harm from medications, diagnosis, and forced treatment when there are so many other issues in society to worry about?

Looking back, the answer was obvious: because psychiatry harmed me personally, and because I saw so many others harmed (including both of my parents), I was inspired to make a difference. I wanted to share what I learned so other people wouldn’t go through what I went through. Like many people who endured injustice personally, I was motivated to do something about it.

An obvious reply now, but not the reply I gave at the time.

Instead, I said to everyone off the top of my head, “I agree, I think we all should be concerned about every issue!” The room burst into laughter, and then I explained that I took his point seriously. The Madness Radio program I host has done shows on many topics including poverty, homelessness, elder care, the environment, birthing, and police, and organizations I’ve been part of, including Freedom Center and The Icarus Project, of have taken multi-issue approaches. My talk at the Alternatives Conference urged us to bring issues together, including discussion of the prison industry, the war on drugs, and the harm to the Black community by our biased criminal justice system.

After all, everyone is concerned about many social problems: even psychiatrists and psychiatric survivors think about issues beyond mental health. We are not single-issue by nature. We worry about affording dental care, we worry about endless wars, about the coming generations growing up in a world of ecological extinction, about the financial system, homelessness, climate change, student debt, the disappearing middle class, and children in poverty. We all worry about these things, but we just choose to narrow our focus onto manageable areas of life where we believe can make a difference. Going smaller, going single issue, seems more realistic. Sometimes that means a career in a field, sometimes that means a role in a movement, sometimes a mixture of both.

I think we’ve got it backwards though. Going smaller and single issue isn’t the way to be effective — going small means we won’t be effective, even in our small single issue.

I was inspired to read Robert Whitaker’s latest research into psychiatry and institutional corruption because Whitaker is taking us in a direction that will inevitably leads to multi-issue organizing and away from single issue. Not by adding concerns and causes on top of concerns and causes, nor by scattering our energies where they should be focused, or just creating laundry lists of change we’d like to see. Instead, as Whitaker and Lisa Cosgrove’s new book points towards, seeing things from a multi-issue prospective is the inevitable conclusion you come to when you follow the money trail of what it will take to actually achieve the institutional reforms of mental health care that we are all reaching for. Corruption of our political system has to end if we are going to provide meaningful mental healthcare to people. Because no other effort, no matter how innovative or appealing, will succeed without the rules of the game being changed, and those rules affect all the issues.

Over 13 years I have sat in many hundreds of support groups, workshops, and events talking with many hundreds if not thousands of people who have been psychiatric patients, on medications, and hospitals. People speak of their lives first and foremost as people. Mental health is about human suffering, and human suffering does not limit itself to a single issue. We may advocate for a better standard of psychiatric care, but often that narrows what someone truly needs for wellness in their whole lives. The well documented intersections of mental health and poverty clearly illustrate this, but we should also consider the roots of mental distress in violence, isolation, and consumerism.

Most of the case managers, social workers, peer specialists and counselors that I meet with and do trainings for recognize this immediately. Aren’t most of the people we work with, I ask, really facing the problem of poverty in our society? Don’t homelessness, the criminal justice system, child abuse, lack of jobs with adequate pay, lack of funding for substance abuse programs — aren’t these the issues we see on a day to day basis when we talk with people diagnosed with a mental disorder? Aren’t these the “stressors” we know that turn coping day to day into collapse and crisis? And among those who are more middle class and privileged, isn’t there a terrible stress around lack of adequate childcare, a heavy consumer and student debt, a scramble to keep up with 60 hour work weeks, a despair about the future in a world of ecological extinction, fear of falling behind, substance problems, failure to prevent or heal child abuse, and a media-saturated and materialist world that seems to have no real space to be human?

When we sit and listen to people we find a society in crisis from multiple issues, a crisis that is affecting everyone. The enormous popularity of the short-lived Occupy movement showed that ordinary people in the US are deeply affected by the decline of the middle class and growing economic insecurity. Many of us watched our pensions and retirement savings suddenly shrink in the 2008 economic crisis. And if you talk with people, all this plays directly into mental health diagnosis and recovery.

What will it take to establish a new standard of care in mental health? A standard of care that serves recovery, avoids iatrogenic harm, keeps people off disability payments, saves money, embodies humanistic values, is preventive, and responds to consumer needs? And what will it take to actually lift people above the suffering that drives mental health crisis? To actually create a society that not only responds to crisis well downstream, but prevents the causes of crisis upstream?

So when we look deeply at people with psych diagnoses facing mental health problems, we find human beings living in a society that has problems that are multi-issue. But then of course we say, Well we can’t address everything, so let’s at least try to focus on the outrageous harm from psychiatry itself, and at least make a difference on that specific area of our lives.  It’s manageable. We can’t tackle everything. We have lived experience or professional training that makes us experts in the single issue. And especially since we’ve now got some momentum – there is more credence to non-medication approaches, the influence of pharma corruption is under greater scrutiny, and the faulty science is finally coming to greater light, some alternatives are being funded (sort of). We can’t address everything, so go more single issue around mental health and keep it smaller.

But, it turns out, as Whitaker, Cosgrove, and others are now starting to suggest (including Lawrence Lessig — who wrote the preface to the new Whitaker book — and his colleagues in the growing “anti-corruption movement”), not only when we listen deeply to people do we discover multiple issues behind their mental distress, but when we look deeply at psychiatry itself, we find that the very solution to the “single issue” of mental health reform necessarily brings in all the social issues.

Just follow the money.

As Whitaker is pointing out, psychiatry harms people despite being dedicated to helping people, because economies of influence create incentives for psychiatry to act in a way antithetical to psychiatry’s public mission. If you want to reform psychiatry, you have to change those economies of influence. And you have to change the rules of the money game that are creating those incentives. Pharma creates payoffs for psychiatrists to embrace a disease model that markets drugs, and in turn enhances the marketing power of the doctors who prescribe the drugs. When problems are framed as diseases to be cured with pills then more consumers will turn to the prescribers. Sickness becomes a commodity and the more illness the more incentive.

This corrupt economy of influence means money will flow into science to twist it to back the model that serves pharmaceutical and professional interests, even at the expense of honest research. (Marcia Angell, former Editor-In-Chief of the prestigious New England Journal of Medicine, writes what is now widely known: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”) The entire industry takes in money for its mutual enrichment, and the public trust of science and human needs is broken. As Whitaker notes, this economy of influence and the rules of the game it plays by is properly named institutional corruption. Not backroom payoffs to “bad apples” breaking-the-rules-kind of corruption (though that happens too, and just results in court battles and fines that Pharma covers as a cost of doing business), but out-in-the-open corruption — legal corruption:  funding through lobbyists, research money, payoffs to researchers, bribery of leading advocacy and lobby groups like NAMI and MHA, a revolving door of legislators, regulators and the industries they should be overseeing. A corrupt – but legal – economy of influence.

And why, we ask, was pharma allowed to corrupt the public trust of mental health care and science so thoroughly? Where is the regulatory apparatus that protects the public from such corruption? Where is congress? Where is oversight as this unfolded? And the answer is very clear – the governmental regulatory apparatus that should be overseeing the public trust and that could be counted on to curb these social harms is under the same system of corrupt economy of influence. The democratic bodies of accountability that might have stepped in and prevented the moneymaking incentives for psychiatry’s social harms have themselves come under the influence of the same moneymaking influence. Both parties, Democrat and Republican — just follow the money. The founding fathers of the US democracy said that government shall be accountable to the people, yet that accountability no longer exists today. Government is accountable to money.

(We see the same pattern in the financial crisis that nearly toppled the world economy and led to an unprecedented bailout of banks, a return to business as usual, and zero prosecution of any of those responsible. The financial sector dismantled regulation, created financial high risk  super profit products that cause social harm and destabilzed global markets in a speculative bubble, finally threw the entire system into crisis — and the financial sector had already captured the regulators that might step in and fix things.)

Pharma spent $2.6 billion on lobbying activities from 1998 through 2012. Oil and gas companies spent $1.4 billion lobbying Congress over the same time frame while the defense and aerospace industry spent $662 million. Yes, an industry with that much influence will shape the whole society in its image. That is why so many people are on psych drugs today. When the rules of the game allow it to, pharma has every rational economic reason to seek maximum profit by turning the entire society into a prescription pad, which it has effectively done over the past thirty years. That is the reason psychiatry continues its social harm: there is clear financial incentive for the government to play along with the rigging of the rules of the game against fairness and honesty. If you want to understand politics, you just need to follow the money.

The power of lobbying and the power of money in politics. The revolving door, the fact that if you want to predict who will win any election just look at who raises the most money, the secret donors swaying election results, the obscene Koch brother legal bribery that is just the tip of the iceberg of political process sold to monied interests, with Citizens United only the latest excess. We are all aware of this to some degree.

But we’ve sort of stepped to the side of it all, in the name of focusing on our manageable, smaller single issue. And now here we find it — at the very center of our concern for mental health reform.

We even have stories of bright examples in the past – Soteria for example, or the promise of the early “recovery” and now “peer” movements – being co-opted and twisted when they are up against the power of this institutional corruption. And so this is the key: the corrupt economy of influence that drives psychiatry’s social harms is a normative economy of influence for every policy issue in the US today, because the entire US policymaking system is based on corrupt economies of influence. Psychiatry’s corruption is just a single example of the standard operating incentive structure of every aspect of our national politics.

As I write this I am becoming emotional. My compassion goes out to everyone that I meet and work with, everyone I listen to and learn from. Each of us is suffering and struggling with the large social issues of our time. I am not talking about left or right here, Democrat or Republic, tea party or anarchist, I am talking about human suffering. I am talking about how hard it is to get childcare, how working families are under extraordinary stress, how it is hard to look at a child today and feel joy when you know the world they are growing into will be a post-mass extinction world. My deepest passion is to meet human suffering in the most ethical and honest way that I can, and my focus on mental health has been a way to use my own personal experience for the social good.

And now I see clearly that if we truly care about each other as suffering human beings — which is what “mental health” is really about— we have to challenge the broader institutional corruption of our society as a whole. I have always sought to bring issues together, and always spoken out for a multi-issue perspective. Now the “anti-corruption” framework of “get money out of politics” articulates a clear imperative. And Whitaker’s new book points to the same inevitable conclusion. Not to add issue on top of issue, but to recognize that no meaningful and widespread mental health reform can ever be achieved as long as the broader corruption remains, broader corruption which affects all issues.

And I struggle to make this clear, to convey it succinctly, and convincingly. I can’t summarize or persuade you of the pressing social issues of our time: child poverty, climate change, species extinction, homelessness, violence, the prison system, the disappearing middle class, endless war, financial giveaways to those responsible for financial crisis. But I want to say that those on the right, Republicans and tea party activists, share a human need to have our social concerns addressed, and that is just as impossible for the right as it is for the left under the corrupt political economy of influence in the US today. Right wing thinkers are waking up the corrupting influence of moneyed special interests in our democracy as well. I am not pitching a mental health reform movement that just joins a broader left. And this is very significant, because the “left-right,” Democrat/Republican, Red state Blue state divide in our country is an image of the corruption itself. The Democrats are just as much a part of this problem – they thrive on it as well. The Red state Blue State divide talk obscures the many common concerns and interests that people have when you look at public opinion polls – commonalities that are obscured by the corrupt economies of influence that capture both sides of the political aisle.

Public opinion polls show broad and overwhelming support for the framework of “get money out of politics” and “end institutional corruption” regardless of political orientation. According to the Pew Research Center, public trust in government, from the left and the right, is at near record lows; shockingly, 50 percent lower than immediately after Watergate. Another poll shows about 81 percent of people surveyed said the current campaign spending rules are “bad for democracy.’ 81 percent – Red state, Blue state. Yet like other broadly supported issues, that doesn’t translate into policy – because of the corrupt economy of influence.

So please take this essay as an invitation to think and research and discover. I don’t have the answers, I don’t have a grand strategy or solution. But I do know this: We have to start talking about getting money out of politics – not just to win real reforms of psychiatry but for all social concerns. We may not know exactly how to do that, but no real mental health reform will be possible when the political system is sold to monied interests invested in preventing reform. It just is not going to happen. Some of us continue to push for our single issue, but where are those who are asking for a winning strategy? I personally am not interesting in pushing for change, calling for change, advocating for change. I want the change to actually happen.

Getting money out of politics is the only way to end the corrupt economies of influence driving the social harm of psychiatry. When I talk with people involved in mental health advocacy, they are inspired. Then we talk about corruption of politics by money and how that creates a real bottleneck for true change. They become despairing, cynical, fatalistic. That won’t change. So we have to focus on our single issue area. But if we are honest, we see that is no longer viable – our single issue will never succeed without he larger upstream problem being addressed.

We tend to separate reforming the standard of care for mental health from the problems with the health care system as a whole for example. But seen from the standpoint of institutional corruption, they are the same. As are the issues of climate change, a living wage, a financial sector that won’t keep blowing up, a fair and just police and prison system. How many times have we heard that the US delivers terrible healthcare for the highest cost? How many times have we been told there is not enough money, or no insurance billing, for alternatives? Follow the money and the same picture emerges.

The story of Medicare Part D is just one example. In 2006 US political leadership under heavy pharmaceutical lobbying and campaign contribution influence — under the corrupt economy of incentives that is standard — passed a Medicare law that prohibited the government from negotiating drug prices. (Now bear with me here, because I realize some of you may be saying “We don’t want cheaper psychiatric drugs.” I hope this broader discussion will show the pointlessness of narrow single issue downstream thinking when the upstream cause is what is important.) The Veterans Administration already set a precedent for negotiating prices, but Medicare now could not. Pharma profits rose 33%! From a single legislative act! And the congressperson who wrote Part D went to work as lobbyist for pharma with a $2 million salary. Obama campaigned strongly against this giveaway to the pill companies, and it was estimated his proposal to reform Medicare Part D could save the country $137 billion over 10 years. But Obama too operates under the rules of the corrupt economies of influence, and so $69.6 million in Pharma lobbying meant that Obama broke his promise to end Medicare Part D. Publicly broke a promise at the center of his flagship issue, healthcare reform.

That is how much power the rigged rules of the game have: they routinely overwhelm even explicit campaign promises and commitments at the highest levels. No vision of humane, honest mental health treatment can stand up to that kind of corruption. It just won’t happen.

Currently our strategies look like this: speak out and change public opinion. Engage as Jim Gottstein has written about, in strategic litigation, and build viable alternatives such as peer respites and medication alternatives to point the way to the future.

None of that will succeed unless the more upstream issue of institutional corruption is addressed. The Medicare Part D issue is instructive: it was at the top of so many people’s agendas  and makes perfect logical sense. It was under huge public scrutiny. And it was a corruption of healthcare priorities pure and simple. And still reform was not effective because the incentive structure of corruption was too powerful.

The reality is that we rely on changing public opinion to make change. That is the assumption – get the word out, wake people up, get people on our side. Publicize research showing that alternatives to the medical model work. Convince through great investigative journalism. Appeal to conscience by speaking from lived experience. Reach people. A pluralist assumption – change opinion and it changes policy. Attitudes will shift and there will be a gradual change of society. Right? Sadly, no. That assumes that public opinion and attitudes drive political policy in the US, that the views of ordinary people shape social issues. But people don’t. Money does. There is no pluralist democracy in the US. Activism and education on the assumption of pluralist democracy will fail.

This has been demonstrated again and again if you look beyond the “wedge issues” that distract us so often from real issues and have become the spectator sports of election time. This is clear if you go beyond the single issue, lesser-of-evil logic that leads so many to vote single issue and mocks the very concept of democracy expressing the will of the people. Opinion polls consistently show wide support for issues that never get support on the policy legislative level. While a clear majority of 1% super rich favor cuts in Medicare, education and highways to reduce budget deficits, only about a quarter of the rest of the population agree. Eighty-seven percent of the general population agree that “government should spend what is necessary to ensure all children have good public schools;” while only 35 percent of the super rich share that sentiment. And 53 percent of regular people believe that “government should provide jobs to everyone who can’t find one in the private sector,” while only eight percent of the super rich agree. By overwhelming margins, Americans favor raising the minimum wage, reducing wealth and income inequality, stopping any more NAFTA-style trade agreements, breaking up giant banks, investing in infrastructure, taking measures to avert catastrophic climate change, protecting and expanding Social Security and Medicare. Those are strong public sentiments for humane policies — despite a barrage of media messages pushing these views out of the realm of the thinkable.

But this public opinion doesn’t translate into public policy — money does.

In fact Princeton researchers Martin Gilens and Benjamin I. Page did a careful study (“Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens,” in Perspectives on Politics) looking at who’s opinions actually shape government policy. Using careful analysis of data that the showed that it is money, not people, who run our democracy. They looked at 1,800 different policy initiatives from 1981 to 2002 and concluded that “The central point that emerges from our research is that economic elites and organized groups representing business interests have substantial independent impacts on U.S. government policy while mass-based interest groups and average citizens have little or no independent influence.” They found that when controlling for the power of economic elites and organized interest groups, the influence of ordinary Americans registers at a “non-significant, near-zero level.”

Average citizens – the ones we hope to change the opinions of – have little or no independent influence on government policy. Non-significant. Near-zero.

Personally I have not voted in every election. Voter turnout in the US is very low (in 2014, only 36 percent of eligible voters turned out for the midterm elections. 36 percent) . But when you look at the facts – that ordinary people’s votes don’t really make a difference, it is money that makes a difference — who is more “apathetic?” Someone who votes in a system they won’t actually influence, or someone who votes with their feet against that system by not voting? And many of those non-voters do know, if you ask them, that the game is rigged.

I’m not arguing against voting. But Lawrence Lessig summed it up. There are two elections. The first election is by money. The 1% sets the agenda for this election. Then you and I step in with our vote – once the real election has happened. It is a modern form of what Lessig calls “Tweedism” after the New York corrupt politician Boss Tweed. Tweed said, “I don’t care who does the electing, so long as I get to do the nominating.”

It’s a time honored racket to keep democracy out of the hands of the people, and it continues today. In the Jim Crow south a similar corruption kept racism in place: the “white primary” where only whites did the nominating of candidates, then the general election where Blacks were (nominally) included. Today we have the same – a “money primary” where all the issues and candidates are determined, and then the vote for the rest of us. Isn’t that why, again and again, there is no real candidate supporting an alternative to the medical model of mental illness – despite huge public support for holistic healthcare and huge skepticism of pharmaceutical companies and psychiatrists? Isn’t that why we are reduced to ridiculous “lesser of evil” calculations for our vote that go nowhere? It is because pharma already did the nominating – ensuring that both sides of the aisle were pro-pharma.

I am all for alternatives and for hopeful initiatives. I love to see reforms moving forward. I do them myself. But philanthropy is no solution to the economy of influence, it is moneyed influence in its purest form. I am inspired by the rise of large scale philanthropy around mental health reform that Whitaker’s research (and the failure of the mainstream standard of care) has helped inspire, and excited to see small changes and more open minds among wealthy patrons leading to good causes getting funded. But if we are honest, rather than just career reformers content with endlessly calling for change, none of it will succeed if the upstream issue of corruption of our political system remains unresolved. Philanthropy isn’t just explicitly anti-democratic, it is a reversion to monarchy. A few philanthropists are joining the movement against corruption and the upstream problems, including some in the tech sector who have been following Lessig’s work, and this is good. But philanthropy, because it is pure influence by money, becomes the very gatekeeper that is the problem within the economy of influence itself. We are now beholden to our rich funders rather than county and state contracts, but we are still beholden, and the result is the same: we are now driven to remain single issue, and now this issue becomes the focus and not that one (notice how medications, not trauma and forced treatment, are more and more at the fore in our movement?), we can go and talk so far but not too far, mental health innovations but not multi-issue thinking, downstream focus but not upstream solutions.

Who is talking about preventing child abuse in the first place? Isn’t that a way to deal with mental distress – by preventing it? Why is that issue not part of the broader mental health reform agenda? Do gatekeepers keep the issues separate despite common sense bringing them all together?

Again and again I see this when I give talks and trainings. People working in publicly funded agencies are the same as people working in philanthropically funded organizations. If you talk with them individually they embrace a multi-issue view and agree with getting money out of politics. They get it. I get cheers and applause at my talks. But the work they do publicly? It’s beholden to the language of their funders and contracts, and limited to narrow agendas. They are held back by the same gatekeeping dynamic of the corrupt economies of influence as a whole. Lessig calls this “dependency corruption” — you don’t go against the implicit agenda of your funders or whoever gives you access. You don’t bite the hand that feeds you or the patrons that open doors for you. So as much as I respect the good small single issue work of my colleagues – and I do this work myself — it is a dead end. Just follow the money and ask yourself: what is truly needed to make real mental health reform happen in the US? Real change that will really help people? Reforms are impossible without reforming the rules of the game itself.

There is currently no established mental health advocacy organization that is actually addressing what it will take to get not only meaningful mental health reform but any social policy reform. There is no established mental health advocacy organization that is raising the question of the corruption of our democratic policy making system by monied interests. There is no mental health advocacy group that is joining with other organizations in the society and addressing the upstream issue of political corruption. None. And that needs to change

The only organization I can think of that comes close is The Icarus Project, where I was co-coordinator for many years. At Icarus political reform discussions are routinely woven into discussions of mental health reform and mental health activism is woven with social justice activism in general. But the corruption issue is broader than the left, and Occupy burned itself out on failure to focus. We need a clear focus people can relate to across the false Red state Blue state spectacle that falsely divides us.

Charlotte Hill of the anti-corruption group Represent.US writes “The one-sided nature of many past ‘money out of politics’ campaigns left them vulnerable to opposition attacks painting them as pet projects of liberals intent on shutting down their opponent’s financial support. If we want to avoid a similar fate, we need to call out corrupt behavior regardless of party affiliation, and make it clear that we believe it should be illegal for anyone to use money to purchase political influence.”

I’ve been writing and speaking about multi-issue advocacy for many years, and have begun writing and speaking about institutional corruption of the democratic system and the comprehensive reforms needed to get money out of politics. When I’ve made speeches and shared info about the prison industrial system or Lessig’s work, the response from movement leadership has often been that I am changing the subject, or going off topic, or they are personally glad to hear it but won’t bring it into their daily work agendas. It hasn’t been picked up. But I think this is changing. Whitaker’s new book asks the right questions and points in the right direction.

I’ve already made a personal commitment that I will no longer be speaking as a mental health advocate without also speaking as an anti-corruption advocate. It’s just not honest – calling for something that’s impossible without bigger, upstream reforms. Not as a way of “adding on” new issues. Not as a way of pushing a liberal or left agenda against the right. But as a way of being realistic about what it will take to achieve mental health reform itself: it won’t happen unless the rules of the game are changed.

I am a learner and I am a researcher about this. I’m expanding my thinking and broadening the scope of my awareness. I have begun to find organizations, writers, campaigns and projects that form the broader anti-corruption movement in the US and abroad (because yes, many of our international colleagues are coming to the same conclusions – most much faster than we in the US, especially after devastating economic crisis in Greece and Spain make it impossible to think of any reform without rules of the game reform). I’m not beholden to any specific organization and I am not writing a grant proposal to go solicit funds for some new project. This is about what my heart says needs to happen for us as a society. What I am doing is reading books like Lessig’s Republic, Lost, and his other writing, joining some of the efforts of mayday.us and represent.us, checking out the Sunlight Foundation and Public Citizen, signing up on sites like MoneyOutVotersIn.org, speaking out about the Citizens United ruling, and learning about the American Anti-Corruption Act. I don’t know that these are ultimate solutions, and my thinking is evolving, but I do believe these are in the direction we need to go in. Organizations are always interested in self-preservation, and many of these campaigns have a “we’re doing great work, support us” emphasis where I prefer coalitions and broad discussion communities. So perhaps my directions will shift as I learn more about the issues and find out more about organizations and individuals working on them. But I do know that we as a society – and as a species even – are facing extraordinary social crisis rooted in an out of control political system corrupted by money. We need a fully human response. We need to think upstream. And above all, we need action that has a real chance of winning, not single issue action that fails to address the corrupt economies of influence that have sold our politics in the US and around the world.

Deep electoral system reform is possible. In the 19th century most balloting was public, which led to massive corruption and bribery of voters. That was changed to secret ballots as the result of state by state reform movements in the 1890s. The New Deal dramatically reformed out economic system. The American Anti-Corruption Act is one possible reform direction to deal with bribery of candidates. It would make it illegal for politicians to fundraise from interests they regulate, ban lobbyists from offering elected officials lucrative jobs after they leave office, and create a system of citizen-funded elections to make it possible to run for office without selling out. The Act would also provide for public campaign financing that would put ideas and people, not bribery, at the center of candidacies. New York City, for example, has public electoral campaign funding and much more diverse political spectrum to vote from. In Maine the Clean Elections Act dramatically increased accountability and reduced corruption and could lead to other states headed in the same direction (the Act is under challenge by a push back from the courts, leading proponents to mount a defense to get it re-established). Efforts are growing against the Citizen United ruling, and to make visible the 90% of campaign donations that are “dark money” — unclear where it came from and hiding the influence of monied interests.

Does this seem like changing the subject and “adding on” new issues that will just distract us from the narrower agendas we should be focusing on? Or do we need to join efforts to end political corruption and get money out of politics or else we will never achieve the mental health reforms we are calling for?

Just follow the money.


Some possible links for further learning and action, an incomplete and imperfect list:

Larry Lessig’s Mission to Reclaim Democracy

Study: Congress literally doesn’t care what you think

We Should Be Protesting, Too — Larry Lessig

May Day

Represent Us

Private prison companies are exploiting our corrupt political system to lock people up… for profit.

Sunlight Foundation