Jan 20 2015
Jan 19 2015
Alfredo and the Psychiatrist: Episode One
(Starring Wayne Moran as “The Psychiatrist and Alfredo Zotti as himself)
I have decided to publish this first episode, of a series of short films, about my mental disorder (bipolar 2) and my struggles in therapy. The events are fictional but draw on real life experiences. Today I am more of an expert than a patient but given that I do not like the term expert I prefer to say that I have vast knowledge and experience of mental disorders. I help many people, online, who suffer with depression. bipolar disorder and schizophrenia as a volunteer.
Jan 11 2015
This is my band, The Future 4 performing Richard Clapton’s Capricorn Dancer. We have a charity night to raise funds for Gosford Hospital on the 21th of February and we are going to have three different bands playing on the night.
Jan 10 2015
For quite a while I have been looking for problems with psychology particularly how it is taught in Universities.
It no longer interests or benefits me to ask the question why, especially when it come to mental disorders or my particular disorder. I used to want to know what mechanisms and by what actions were at the root of bipolar disorder. Learning what little I did, did nothing for my understanding of my condition or that of another. At best, much of what goes on in the brain is barely observable and any insight is a generality and only part of that which makes one persons disorder, which may be given a diagnosis that is also a generality but not close to the unique and individual disorder of one person. Psychology can only define the general characteristics of a whole disorder but fails the individual in understanding the intricacies so unique to the person. The person is complicated where the characteristics that make up a disorder are few and generalized.
I spent much time trying to understand the neuroscience and psychology, only to come closer to a general description of a disorder, which would fit all that met the criteria and farther away from knowing myself. Even knowing myself and anything that may have a bearing on any symptom is impossible. A complete understand is impossible, so accepting I am the way I am and no amount of understanding will change this seems the logical path. In a way this is being. There is no use in complicating life and always benefits to simplifying.
Yes, Psychology is tantamount to an art, as the individual is extremely complex and Psychology impressionistic, in that many of the theories are not based on concrete facts about the working of the brain/psyche, as much is inaccessible or not observed directly.
Jan 4 2015
Recently I gave a talk to some mental health professionals at a doctors’ conference. I was asked, as someone who suffers with Bipolar Disorder, and as a person who has some experience in the field of mental health, what do I think about psychology and psychiatry ? What do I think about the way psychology and psychiatry are taught in Universities today?
A psychiatrist, to me, is just a person who specialises in diagnosis of mental disorders and someone who tries to find suitable medication for sufferers. (not to say that psychiatrist cannot be good people who are aware because that would be wrong. Many psychiatrists think exactly like me) That is about it. This may be useful when people are unable to help themselves and need medication or for those people who will need to take some medication for life. But it is not suitable for those like me who prefer to control their mental disorder by working on their will and develop strategies.
As far as psychology I think that it has taken a turn for the worse. Psychology, the one that we need in therapy, was never meant to be a hard science. Therapy for me has to do more with art or the ability of the therapist to enter into a person’s mind, learn about their life stories and use the imagination and positive thinking to help their client. It is all about art and yes it can be suypported by science but this does not mean that science has automatically the right to claim that things like mindfulness and art are part of science because science has research to prove that these really work to improve mental health.
Psychology, for the most part, is an art that needs the support of science. But an art first where the creative skills of the therapist have little to do with scientific training and more with creativity and the power of the imagination. Psychology is an art, I say, that needs to be supported by science.
But all I see today is science taking over psychology at the expenses of art, creativity and the power of the mind. This is a sign of ignorance.
Psychology is an “ART” but an art that needs to be supported and guided by science not the other way around. Unfortunately the other way around is the situation in our western world. Sign of great ignorance
Alfredo Zotti I help quite a few people with mental disorders on the internet and I do this mostly by discussing art, poetry, music and creative writing. There is no science in my voluntary attempt to help people. This is what is motivating me to write my next book. If I need no science to help the people that I help, and if these people tell me that I truly help them and that their health is improving for the better, I am doing this without any science. And if this is so why is there so much emphasis on science, in psychology, when it is more then clear that creativity, art and creative writing can be so powerful in helping people to help themselves? Clearly something is very wrong with our scientific ideology and that something is far too much emphasis on science and very little on art and creativit
Oct 31 2014
Psychologist Dr. Robert Rich speaks about Alfredo Zotti’s book: ‘An Artist’s Creative Life With Bipolar Disorder’ which was published by Modern History Press early in 2014, and edited by Bob Rich. Many thanks to Matt Cairns for filming Dr Bob Rich and for editing the greatest part of of this short film.
Oct 12 2014
While the material that I am going to provide here could possibly be helpful to people who suffer with almost all mental disorders, I am going to limit myself and say that the material here will be helpful to those who suffer with Depression and Bipolar because I have a good understanding of these disorders.
In other words, if you suffer with Bipolar Disorder or Depression, you could benefit from reading the following presentation Presentation 2.
Please read it carefully and slowly and try not to rush through it. Even if you read one page per day, and ensure that you understand it, that is going to be very helpful to you, I believe. If you do not understand something you can ask me here and I will reply with an answer.
Here is the link, again, to the presentation Presentation 2. You can download it and keep it. I would print it if I was you and keep it close by. The more you read it the better it is.
I hope that many people, who suffer with a mental disorder, or who have a family member with a mental disorder, will read it. This presentation, if understood properly and followed, can lead to recovery.
Thank you for reading this
Oct 11 2014
Conflict of interest in Australian universities and lack of transparency.
A couple of years ago (in 2012) I was searching for an article, on the internet, when suddenly I came across Professor Simon Chapman’s article titled ‘Australian Universities Fail on Conflict of Interest.’
To my greatest surprise, I read that Professor Chapman sent a questionnaire to all 39 Australian universities. The questionnaire’s main aim was to find out how many universities had a central register of public declarations; if the register was publicly accessible without the need for a freedom of information application; and whether the universities published their registers on the internet.
According to Professor Simon: ”Just as you can look up the register of parlamentarians’ interests – for example, you can go and find out what shares a minister has or if they have received any gifts – so you should be able to do something like that with all universities.”
Why is it important to have a public register that is easily accessible? From my perspective, being a mental health advocate and in my position as a volunteer in my attempt to help hundreds of people with mental disorders, with the support of psychologists and psychiatrists, it is important for managing a possible medical conflict of interest. For example, Dr Katelaris wrote that:
“institutions must provide the right environment and policies for their staff, and the institution itself, to encourage “clean” research and practice, leading to valid knowledge and useful treatments.”
In other words, in the face of a lot of media speculation about the influential power of big pharmaceutical corporations, in Australian universities, I feel that I should be able to know, as a citizen and as someone who has studied in a university for many years, if this speculation has some validity, or if it is just a construction of the media.
Moreover, my interest is to establish whether research carried out in universities has the best interest of people with mental disorder in mind, or if it is just geared to test and prescribe more medication and, as we well know, medication for long term treatment of mental disorder has a dismal track record meaning that medication, while extremely helpful in the beginning of the pharmacotherapy, has the tendency to lose efficacy especially if sufferers don’t work hard towards their recovery with other natural interventions. How do I find out if research is “clean” as Professor Katelaris puts it? FOr example this critique of a research may give an example of some of the problems http://download.thelancet.com/pdfs/journals/lancet/PIIS014067361260097X.pdf?id=eaatah0q8hDlUc0k-WWKu
After all, despite decades of medical research and pharmacotherapy research in mental illness, the situation for those who suffer with a mental disorder is worsening everyday. More and more people are ending up in our jails; many commit suicide; and recovery is very rare in the wider society although research shows that therapy has a good chance of leading to improvement.
I have been able to help some people towards their recovery, over the internet, simply by communicating to people who suffer with a mental disorder such a schizophrenia or bipolar, by discussing problems with their families; and by engaging in some readings, narrative therapy and writing/creative therapy. The results of my personal longitudinal research are encouraging. I note that many people that I have attempted to help have been able to recover just like me and my wife and what has made this possible is the development of critical consciousness through special literature; social support; love and care. I feel that this is a New approach based on both my effort combined with that of the consumer empowerment of Canada to empowwer sufferers and help them to recover. See the presentation for a better idea about this New Paradigm of Mental Disorders Presentation 2 If everyone was able to help people as I am, the number of people with mental disorders should be declining.
Professor Simon Chapman informs us that some universities replied although nine did not . Only three universities declined to participate to this research. Of the 27 universities that replied 15 said that they did not require regular declarations from staff and none had policies indicating staff should declare conflict of interest when commenting on an issue publicly. Of the 12 universities with a central register of declarations only two made the list available on request: The University of Southern Queensland and the University of Western Sydney. 3 university provided access to declarations made by a specific staff member: LaTrobe University; University of Canberra, and the University of New South Wales.
In other words, only 5 Australian Universities are able to show the register of declaration so that people can look into problems.
For example, if Sydney University made available their register of declarations, people would have been able to look into Professor’s Ian Hickie’s problem to do with his close association with Servier and consequently, Lancet’s publishers could have decided to let someone else write on the research to avoid conflict of interest..
The problem was that Professor Ian Hickie had failed, according to the Lancet, to provide information about his complete association to Servier, a French pharmaceutical company, before he agreed to write an article on agomelatine, a substance for depression.
According to the Lancet, the conflict of interest here, which has forced their journal to change their policies about how they present research articles on pharmaceutical substances, from a presentation of sound research to mere professional opinion, is that Professor Hickie had been a high profile key opinion leader appearing at a Servier Valdoxan briefing in April 2011 and presenting at Servier funded masterclasses and symposia http://www.theaustralian.com.au/news/health-science/campaign-targets-depression-guru/story-e6frg8y6-1226269135293
According to the Lancet, someone who cooperates in this way with a pharmaceutical company that has created the drug should not be writing an article on research that explains the value of such substance. Clearly the research article should have been written by an independent professor not associated in any way with Servier. And Lancet’s argument is that if Hickie had told them about his full ties with Servier, they could have decide to let someone else write the article to avoid conflict of interest.
West Australian Labor MP and anti-ADHD drug campaigner, Martin Whitely calimed that Hickie’s reputation is under question and it is entirely appropriate to question whether he should be a leader of mental health reforms and research in Australia. While I am not here taking sides I am concerned.
It is problems like the above mentioned that create suspicions in people’s mind and hence why it would be so important to have transparency in universities and for people to have access to a public register of declaration. If there was an accessible register at Sydney University, perhaps the Lancet may have been able to read about the close association between Hickie and Servier given that Hickie also works for Sydney University..
The problem here is how are we to know what goes on in universities? How do we know if pharmaceutical corporation have bought enough influence to decide which research is to be accepted and which is to be rejected? Which subject is to be studied and which is not, especially in psychology or psychiatry? And would not this be conflict of interest in terms of sound research designed to truly help people? How do we know what is going on if there is no transparency? After all universities can have an influence on society at large.
The situation is complex and while we have no solid evidence to suggest that pharmaceutical corporation have great influence in universities the fact that all Governments have the tendency to cut funds to education (for example the federal government is going to cut billions to education this year) universities could be forced to rely on sponsors and corporations that may have less than ideal intentions. If there is conflict of interest, which should be established, then this may end up costing extra billions to Australia in terms of mismanagement of resources, useless or inadequate research aimed at increasing profits rather than helping people, and training of mental health professionals who will not be able to help sufferers very much because of lack of humanitarian approaches so important in psychology and psychiatry.
I feel that if governments and mental health interest groups want to truly help sufferers, we have to take a closer look at what is happening in Australian universities. What is happening is that there seems to be too much emphasis on science when it comes to studying mental illness and not enough focus on the person and the fact that people who suffer with a mental disorder, like me, are people first not a disease. We need structural and social support. We are intelligent people who need help not only in a medical sense but following a model that consider our psychological well-being, our social support and our body. This, sadly, is not happening in universities today. The biopsychosocial model, much admired by mental health professional, has never shaped into a solid framework that could be used to truly help people. I wonder why??? Because I use it everyday with great results
Perhaps another relevant point is that pharmaceutical drugs is only one of many examples. There are others where society is endangered by conflict of interest of researchers.
Some would say that as long as the conflict of interest is disclosed in advance, that should be OK. After all psychiatrists do test new drugs on their patients and do need to work closely with pharmaceutical corporations. But how do we know if they are honest or not? if there is no way to establish transparency of dealings and conduct. that is. I feel that things are not as simple as that. The debate remains divided and I personally feel that full transparency, in all dealings, is a must and that in its absence we have a problem on our hands even if this problem is uncertainty and doubt. I do not know Professor Ian Hickie and I prefer not to pass any judgement or take any sides. But I would prefer a Mental Health Commission that focuses mostly on social and psychological support with medication being considered only an additional help if absolutely necessary.
Having said all of this, the Mental Health Commission of New South Waless, guided by Commissioner John Feneley, is doing a terrific job showing that there is always room for improvements no matter what. I admire the effrort and integrity of Commissionar Feneley. The PDF of their direction, for future intervention in Australia, is found at the following link http://nswmentalhealthcommission.com.au/
Apart from the fact that Medicare sponsored visits to psychologists, for therapy, had been cut by the previous Labour government from 18 to 10 visits per year, with danger that these could be cut even further, everything in thei PDF document is informative and shows a clear vision for better mental health. If this it to be realised, in the face of the above problems such as government budget cuts, debates and tensions to do with conflict of interest, and the predominant biomedical direction that universities have taken, which present the dangers that pharmacotherapy mey become the dominatn way of helping and treating people (even though statistics show that this may be making the situation worse as we now seem to generate mental illness and related problems that increases annually ) remains to be seen.
I tend to agree with Professor McGorry who calls upon the Governments to increase fundings rather than reduce expenditure. As he rightly points, while mental health receives 6 to 7 percent of Australia’s combined health budget, mental ill health is responsible for 13 percent of the total cost burden. If we were to dig deep and look at the long term costs of inadequate fundings, in terms of incarceration of people with mental disorders (about 20,000 in jail now); if we look at the disruption and cost to families of people with mental disorders such as schizophrenia who cannot get assistence either financial or from the mental health professionals due to limited availability of beds and resources; and if we look at lost opportunities, suicide and substance abuse, the cost would probably reach the 20 to 30 percent of the total cost burden of mental ill health in Australian society.
I respect the ideas and visions of Professor Mc Gorry and I know that he is a psychiatrist with an adedquate understending of psychology and of the need for a bio-psycho-social model of health. Because medication is only one tool which is not the most important but which nees to be used with other tools such as social support, psychological support and the ability to look past the mental illness or disorder so as to find the person, get in touch with that person, and work with the person towards recovery.
I suspect and speculate that McGorry’s fear is that Governments will try to cut costs and save money even if these cost cuts are going to be astronomically expensive in the long run.
Guess what happens when government cut on costs without providing additional support for people with mental disorders? We rely more on medication, as a nation. In this sense, when the government cuts funds for the sake of saving money, pharmaceutical corporations benefit and drug sales go up. But anti depressants and anti psychotics have not reduced the problem of mental illness, not to mention the side effects, reduce life expectance, and all the problems that are associated with pharmacotherapy alone treatment. To the contrary, despite all the research on pharmacotherapy and the brain, we are witnessing an astronomical increase in numbers of mental ill health cases as more people with mental disorders end up in our jails costing the government billions of dollars. Perhaps the money should go to help people directly first, and only as a second attempt to brain research and new drugs. Exactly the opposite of what we are doing now.We are people not biological machines.
In Finland, they currently treat psychosys with the Open DIalogue Method which has an 85% success rate in treating psychosys. Here is the link to a uTube documentary about it https://www.youtube.com/watch?v=HDVhZHJagfQ and this is a research paper to go with the documentary http://www.theicarusproject.net/files/OpenDialog-ApproachAcutePsychosisOlsonSeikkula.pdf
Oct 9 2014
I have been a student of the University of Newcastle (Australia) since the early 90s and studied, on and off, in various degrees, till 2012. I have recently given a presentation on a New Paradigm of Mental Disorders at a few Australian Universities. To view or download this presentation please click on the follwoing link Presentation 2
Today I help many sufferers, with mental disorders, as a volunteer, and I must admit that without tertiary studies none of the volunteering work I do would be possible. Not only do I help sufferers, supported by two psychologists and one psychiatrist, but thanks to the studies I have been able to recover from bipolar 2 disorder. The University has empowered me and all the knowledge and critical consciousness made the recovery possible, mostly thanks to the old philosphical and humanitarian subjects that are today becoming scarce in Universities.
Because of my voluntary work, I have good experience of mental disorders from an inside perspective, a perspective that many mental health professionals and academics find powerful and insightful.
I respect the University of Newcastle very much. It is a very tolerant and outstanding University and, in fact, given that I help many students from almost all Australian Universities, who either suffer with a mental disorder or who need a hand with their studies, especially statistics, I know that Newcastle is one of the most tolerant Universities towrds people with disabilities and mental disorders.
Nevertheless, like with anything in life, it is not completely free from problems.
One important problem that I have noted is that it follows, disproportionately (in terms of a biopsychosocial model) the biomedical and behavioural sciences to study mental illness in the health disciplines and especially in psychology. Of course all Australian universities are similar in that they also follow the biomedical and behavioural models. What I want to say here is that these models are not really working in the open society because, on their own, without consideration of social support and humanitarian concerns, are incomplete and largely ineffective.
Evidence for this is complex but basically three main factors are important to mention: the increasing numbers of mental illness cases in Australian jails which seem to have become the new institutions or psychiatric hospitals; the fact that a great number of people with mental illness committ suicide, do not recover and/or are jailed each year; and the fact that the standard of living of people with mental illness is decreasing annually, all point to the failures of our system. Mental illness is increasing throught the Western world
What I want to say to my university, that I love so very much, is that if it continue on this biomedical/behavioural path, it will be left behind by other more advanced countries and the statistics are already showing worrying signs.
It is not only important to advance with research and knowledge, but it is mostly important to reduce mental illness cases in Australia and to help people who suffer towards some sort of recovery. This is not happening and I cannot emphasize this more. It is simply not happening. To help people towards recovery we need to change and follow principles of the proposed New Paradigm of Mental Disorders (see Presentation link at the top of this page)
If academics or mental health professionals would like to comment, and possibly suggest how we could persuade governments and universities to make some change, so as to work towards a recovery approach to mental disorders, I would love to hear from them. We do need to change because we cannot simply remain as we are. It is preventing progress and it is not helping the society. Most importantly, the majority of people are aware of what is going on, most people pretend not to know but it is clear that the biomedical model is the domionant one throughout the world.. About 80 to 90% of university students know that the biomecial model is used disproportinately, in all universities of the world, and that it does not really help people with mental disorders, perhaps such concentrated scientific method may be adding to the problem creating more mental illness along the way. It is almost common knowledge.
I believe that the University of Newcastle is amongst the best in Australia. But I truly would like the University to become one of the best in the world and I feel that it has the right academics and the right environment to achieve this.
The problems are enormous. It is common knowledge that Pharmaceutical Corporations have tremendous influence on medical schools of universities, something that is in our literature today, and Newcastle may be not immune from this problem. It is also true that Governments are short sighted and think about balancing the books today, forgetting that by balancing the books today, and cutting on funds, they are creating huge debts for the future in terms of social failures, illness, barriers to recovery, the cost of poor health management, and all the other problems that pile up as time goes by.
When a sufferer does not have adequate social support and ends up doing something stupid, committing suicide or ending up in jail because of punching someone, it costs the government huge amounts of money. To keep a person in jail costs the government over 110,000 Australian dollars per year and it is also a fact that people with mental disorder, who end up in jail, deteriorate further so that they end up costing al lot more money in all senses of the word not least in terms of health.
This costs billions, billions that could be used to truly help now rather than save money now by creating huge debts for the future. I also call on Governments to become more aware and perhaps start working in a less political way if they want to help Australia.
We are up against these tremendous problems and I know that many academics and mental health professionals are well aware of these problems, suffer in silence, and are unable to do anything to change.
We have failed and our methods are not helping people with mental disorders directly. The statistics are telling us that the biomedical model does not lead, on its own, to recovery and that the behavioural approach has also failed. It is time to change.
Do we really want to help people with mental disorders towards recovery? or do we want mental health professionals, researchers and academics to profit on the misfortunes of those who suffer? Can we continue this way when people are ending up in jail; when people cannot afford to live; when people are committing suicide? No, we cannot afford to go on this way. It is time to change. Because to continue to do inadequate research that does not help directly, to take money away for things that do not help directly, is to be less than a good citizen. Research must lead to real improvements that truly help people in a practical way.
I am currently working on my new book that will come out next year. The book will offer a New Paradigm of Mental Disorders; it will look into the Biopsychosoclial method of doing things; and it will suggest that the New Paradigm that I propose, following the Consumer Empowerment of Canada, combined with a biopsychosocial model of mental disorders, can lead us to the ability to help people directly, towards recovery. It will provide lots of statistics and feedback from mental health professionals who work everyday with clients. Such testimonies and statistics cannot be ignored.
If Governments are serious about saving money, they are not going about it the right way because their policies increase illness and related spending in the long run. Mental Health agencies that advise the government would do best to make this clear that to save money we need to help in a real sense not hide the problems away.
If you are an academic, a mental health professional, or a sufferer, please, I would love to hear from you with a contributing post.
Thank you very much for reading this and for your time