Mental Health Consulting
from an Alternative Viewpoint
What We Are
Our mission is to provide evidence based alternative (to the currently dominant biomedical model) explanatory concepts and practices for the mental health community. We offer educational materials, lectures, seminars, consultations, support groups, advocacy, and expert testimony.
Our name has its origin in the Soteria project. In a random assignment study the Soteria Project demonstrated that acute psychosis could be treated successfully in the context of caring human relationships without the use of anti-psychotic drugs. Soteria is a Greek word meaning salvation or deliverance. For more information about the Soteria Project see the articles on this website.
The alternative evidence we present stands in contrast to the currently dominant biomedical hypotheses about the nature of major "mental illness". The alternative practice we espouse is not based on the medical model that treats nearly everything with psychotropic drugs. Rather, our model is voluntary, need and problem focused, relationship based, holistic, consumer (including families and social networks) driven and recovery oriented.
While we may offer various drugs (including dietary supplements and herbal remedies) they are viewed as adjunctive and used in as low a dose as possible for the shortest period of time that will allow evaluation of their usefulness.
There is no methodologically sound scientific data that what is labeled "serious mental illness" is genetically determined, is the result of identifiable biochemical abnormalities, is associated with specific brain lesions or is due to known etiologic agents (see bibliography on this site). Basically, the current hypothesis that "mental illness" is a "brain disease" is unsupported by data, making its continued propagation as "true" a myth or a delusion or a fraud. As such, we are in the realm of religious
dogma -- not science. Pity the non-believers, for they shall be punished as deviants.
We do know that there are a number of psychosocial factors associated with the development of problematic behaviors:
- childhood sexual and /or physical abuse
- parental neglect
- dysfunctional family behaviors such as the inability to communicate clearly and cogently, a pervasive family context of hostility and criticism, serious addictions, parental emotional divorce, high levels of stress secondary to chronic intra-familial conflict and an absence of a supportive social network.
Fortunately, by being able to understand the relationship of problematic behaviors to these psychosocial factors the kinds of interventions most likely to ameliorate their impact on those embedded in these psychonoxious contexts can be defined and implemented. Basically, being able to define the nature of a problem makes it possible to develop a potential solution. For example, if family conflict seems to be the main issue, it can be dealt with in family therapy specifically focused on reduction of conflict.
We believe that operating within a psychosocial paradigm can avoid many of the problems associated with the medicalization of what is labeled as "mental illness".
As we see it, the downside of the biomedical model of treatment is:
- A labeling process that does not allow for unlabeling and hence, almost inevitably, produces marginalization and discrimination
- Institutionalization that disrupts family and social network relationships and does little to help find meaningfulness in relation to crises, further escalating anxiety and perplexity in all those who care
- The introduction of the current (but erroneous) biomedical view of serious "mental illness" as being "incurable", "chronic", and/or "deteriorating". Maintenance is possible but-hope-so necessary for recovery, is nearly impossible in this conceptualization
- Medication, viewed by most as a required part of treatment, may actually impede or prevent recovery by aborting a potentially helpful psychological process that needs to be related to and understood rather than suppressed. It has, for example, been shown that the use of the anti-psychotic drugs, at least for what is called "schizophrenia", has resulted in poorer long- term outcomes than was the case prior to their use. In addition, suicide rates have not been reduced as a result of the use of the anti-depressant medications
- In violation of the Hippocratic dictum to "above all, do no harm", excessive reliance on medications has produced enormous rates of iatrogenic (doctor induced) diseases such as tardive dyskinesia and dementia, neuroleptic malignant syndrome, akathisia, suicidality, obesity, reproductive difficulties, and addiction- to name but a few
- The model has induced a sense of powerlessness in individuals, families and social networks because of its ability to use coercion in the name of providing "medical treatment"
- Medicalization has produced a psychiatric/drug company/hospital industrial complex that has such power and control over theory and practice as to make a change to a humanistic, psychosocial paradigm virtually impossible.
Many mental health professionals -- especially psychiatrists -- will attempt to invalidate and refute this argument -- while defending the status quo -- by referring to the "miraculous" effects of drug treatment. In addition they will contend that clinical practice is actually based on a "biopsychosocial model." It takes a very serious case of denial not to see what is before your eyes: Mental health treatment for the so-called "seriously mentally ill" is centered on medication with lip service at best being given to the "psychosocial" part of the model.
Consider these questions: How many adult mental health consumers in the mental health systems you know about are not being prescribed medications? What percentages are receiving regular psychotherapy of any type? How many are regularly able to access peer support groups? Is client input into program planning and development
real -- or is it just tokenism? Are there client run programs? Are the expressed needs of clients taken seriously?
We believe the alternative voice provided by Soteria Associates and other similar organizations that provide accurate information (that is, with no conflict of interest) and education about the realities of today's mental health context
-- via critical examination of current research on mental illness -- is much needed. Without critical dissident voices the real recovery oriented needs of persons with complex and recalcitrant problems will never be addressed.
There are many, many consumers and families coming to the realization that today's treatment landscape is desolate of any real understanding, help or hope for them. Soteria Associates hears from these dissatisfied persons daily by phone, email and regular mail.
Among the many issues they raise, the following are common themes:
- They inquire whether there are any treatment centers that do not use psychotropic drugs routinely -- at present there are five in the entire country.
- They ask to be withdrawn from psychotropic drugs because of the terrifying and painful effects they have experienced from them -- but there are no doctors or facilities willing to take on the arduous task of withdrawing these drugs. Many report that the drugs have not really helped
them -- only caused them problems. Many of those who have tried to withdraw experienced very frightening and unpleasant withdrawal
reactions -- often of sufficient magnitude to make them restart the medication.
- They seek to understand and deal more effectively with their experiences but can not find persons willing to join with them in this difficult collaborative endeavor. Basically, no one wants to hear them out. Psychiatric residents (trainees) are taught that you "can't talk to disease" (ie, "schizophrenia" and severe depression or
- They wonder why it is so difficult to find decent affordable housing with interpersonal support, if needed, in such an affluent country.
- They seek almost any alternative way of dealing with their problems but there are few professionals willing to offer anything outside the current dogma. Even asking, or questioning, may be viewed as non-compliance, further damaging their reputations.
The list goes on, but these are representative examples of what is wrong with the system. We find ourselves empathizing with their powerlessness and hopelessness.
It would be delusional to believe that Soteria Associates, a very small voice in a vast wilderness, can, by itself, address these needs. What is required is the formation of many communities of persons (and their friends) who have been failed by biomedically focused mental health treatment, the formation of groups demanding an alternative: Interventions that are humane, focused on understanding the meaningfulness of subjective experience, and on filling legitimate needs is what we espouse. Soteria Associates will be glad to be facilitators in so far as our resources allow.
However, the system will not change without the mobilization of many voices of angry, disaffected consumers -- and those who care about them -- collectively directed to changing the status quo and replacing those perpetuating it.
(Loren R. Mosher M.D.- Psychiatrist, Director)
Dr. Mosher is dead.
Posted on web site www.moshersoteria.com June 30th, 2003;
revised April 8th, 2005; defunct address to Soteria Associates removed April