The massive industry behind mental health in the U.S. is largely corrupt, and it s leading to unscientific methods for treating depression and anxiety that then lead to poor outcomes, especially in children. Explaining this corruption today, and providing us with better solutions, is Dr. Roger McFarlane, a clinical psychologist and co-host of the podcast Radically Genuine.
00:02:15.960So, Ali, like our chemicals in our brain are so complex, we don't really even understand it.
00:02:22.280So, I'm not going to try to create some bioreductionist simplified idea that our thoughts or our emotions are related to one chemical.
00:02:30.280In fact, if we found ways to measure serotonin and it was after you did a run in the morning in beautiful weather and bright sun and after you meditated or you prayed and you did some gratitude work,
00:02:45.840then the chemicals in your brain or areas of your brain are going to light up differently, right?
00:02:51.020And if I had you think about or watch news or think about something that was war destructive, that might have some different changes in your brain.
00:03:03.580Does that to say that you're outside of your control or you're biologically vulnerable to experiencing that?
00:03:13.260But what happens is when you sell that to the American public, when anyone's struggling at any one given time, they can then internalize it as I'm broke.
00:03:27.960That idea is so toxic for your mental health and to be able to respond to the adversity that life is going to bring because there's no doubt, you know, there's going to be pain.
00:04:28.320And I actually made good grades and all that stuff.
00:04:30.880And now I just, you know, have a job doing what I was always not supposed to be doing in class growing up.
00:04:36.860But I had friends who did go on ADD medication who actually weren't really precocious like me, but they weren't doing that well in school.
00:04:43.220And so the teachers would say, oh, she's not doing well because she can't pay attention because she has ADD.
00:04:48.920And I remember in high school, friends who had ADD medication or who took it, we would joke, oh, she took her medicine today.
00:04:58.540So she's not going to like laugh at your jokes.
00:05:01.240She's not going to be chatty with you.
00:05:02.980She's not going to want to like talk to you.
00:05:05.000It was kind of like a joke that we all told each other that we knew that if that person took their ADD medication that day, they would be numb.
00:05:13.720And I just imagine that is multiplied today.
00:05:16.900And with just how normal and mainstream it's become, not just ADD medicine, but depression, anxiety medicine for all these teenagers, it's become so normalized.
00:05:27.320Yeah, you don't want to take me down that road because we could be here for a long, a long time.
00:05:35.000I was in the schools probably when you were going to school in the early 2000s.
00:05:50.060I did transition eventually into a school counselor before I got my doctorate, while I was getting my doctorate.
00:07:10.900There are just a number of various symptoms.
00:07:13.560And if you meet this criteria, if you meet that criteria, then we can give you this diagnosis or label and then we can sell you a drug.
00:07:20.360And it's very connected to the allopathic kind of medical model that is really funded and pushed by the pharmaceutical companies.
00:07:27.660The one thing that you find in these trials with the pharmaceutical companies, because people ask these questions, well, how does it get to this point?
00:07:33.920Can this guy be, is this guy really for real on some of the things that he's saying?
00:07:41.680There's books written about it, how the pharmaceutical companies would hire academics to ghostwrite their papers.
00:07:49.060So people, I don't know if people understand that the pharmaceutical companies are the ones who control their trials.
00:07:54.880And then they'll hire outside academics from some of the most elite institutions in the United States, Harvard and Duke and so forth.
00:08:02.980And they'll have those academics be first authors on the paper.
00:08:07.000They weren't even involved in the study, but they'll put their name.
00:08:10.240And then they'll be hired by the pharmaceutical companies as thought leaders.
00:08:15.340And then these thought leaders then write the books, the textbooks and the continuing medical education units that are required for doctors.
00:08:26.240They're going to go to their conferences and these thought leaders are going to talk about this brand new drug that we have to be able to treat depression.
00:08:34.240And mental illnesses are similar to diabetes and drugs are going to be insulin for diabetes.
00:08:40.880A bunch of nonsense that just have brought us to a prescription drug culture and created so much harm.
00:08:47.820The thing that is so important for me to communicate when I'm speaking publicly is informed consent is a legal and ethical imperative.
00:08:59.720If your doctor isn't informed, then you can't consent.
00:09:03.860So you have to ask, what are the alternatives?
00:09:11.040What is the plan to get off this drug?
00:09:13.000All these things that are just not asked, we just get that prescription, go home, and we take it.
00:09:18.420And people will take these drugs for an extended period of time.
00:09:21.960And I think we're taking episodic conditions, emotional conditions that come and go in episodes, and we're making them chronic.
00:09:28.780We're creating an environment where, if you look at the disability statistics, the change that has occurred from the mid-90s to those who are now disabled due to mental illness is such an astronomical rise.
00:09:43.480So we're creating a whole culture of disabled individuals from their own mental health that I often start with a very treatable and understandable condition.
00:09:57.500But I originally, when I was in my doctoral program, I was studying, and I published in the field of eating disorders.
00:10:04.560And so that's been a part of my clinical practice.
00:10:07.800And I noticed, I believe, I'm going to ask you questions about this, but when you were struggling with your eating disorder,
00:10:14.260you had this awareness that there was a lot of emotions that you were experiencing that were just being covered up with your eating disorder or alcohol or partying in your very vulnerable age at that time.
00:10:27.500You know, you could almost sense the vulnerability.
00:10:29.740There was a breakup that occurred, and you had this idea of how you wanted your life to be, and you struggled with that transition and that uncertainty.
00:10:38.760And you can feel better if you get attention, and you can feel better if you're drinking, and you're partying, and if these guys are into you.
00:10:44.780And then you're part of kind of that culture where if I can look a certain way or I can present a certain way,
00:10:50.660that is going to provide me with a sense of wholeness and joy.
00:10:55.620And your awareness of that led you to make changes in your life.
00:11:00.960It was a clarification of values, and you decided to take steps that I think were probably transformative.
00:11:09.560And so if we viewed our own mental health struggles as transformative instead of an illness, then there's opportunity.
00:11:16.740Am I accurate in the way that I was kind of reading that?
00:11:19.620Yeah, I think that's a great analysis.
00:11:21.200Of course, I've never heard it summarized exactly like that.
00:11:23.800But as you're talking about taking normal human emotions and struggles and kind of medicalizing them and making them chronic,
00:11:30.940I'm thinking back to the counselor that I went to who couldn't have prescribed anything because that wasn't her capacity.
00:11:37.500But I'm very thankful that that's not actually something that she recommended.
00:11:41.800Actually, she told me a very difficult truth about bulimia, which is what I was doing, is that it's going to kill you.
00:11:58.900Wow, I never thought about that, that that could have turned into like this lifelong medical treatment that I underwent for something that was really because of both internal and external factors that I just wasn't dealing with correctly.
00:12:13.120Yeah, and if you'd follow the guidelines, and that's how our medical, at least on the primary care setting and psychiatric setting, there's these developed guidelines, and it's almost like they follow these rules.
00:12:22.520So if you would have went into another setting, the guideline would have said, okay, we're going to combine cognitive behavioral therapy with Prozac for the treatment of bulimia.
00:12:33.120And I think you ended up going to a counselor that was aligned with your faith and some of what was your personal values.
00:12:42.040And that person, from a different perspective, knew who you were, understood who you were, and helped you on a process to be able to deal with what you were experiencing.
00:12:51.720And that's so different than placing a label on top of you or saying that this drug is going to help you.
00:12:58.660You said something about the American Academy of Pediatrics, which I thought was especially interesting.
00:13:16.380And as a parent, of course, I'm super concerned about that.
00:13:21.800I saw the dangers of just listening to these experts at somewhere like the AAP during COVID when it came to universal masking, how they would contradict their own findings from several years ago about things like that, seeing faces.
00:13:35.520But then you said that they are kind of bought and paid for by these pharmaceutical companies.
00:13:41.300And it reminded me of a story that I saw not too long ago that suggested that maybe treating obesity in young people, which you mentioned is a big problem, well, they should be injected with a drug.
00:13:51.560And gosh, you know, as I mentioned, like there's so much culturally behind this, behind the whole movement to destigmatize everything, including things that are actually unhealthy, that can be fixed without medicine, that I think is a part of this.
00:14:40.000A lot of the negative feedback that I get is this idea that I am stigmatizing mental illness.
00:14:46.220And that's so problematic because what I want to do is create environments where people can thrive.
00:14:54.800And to do that, it takes an entire shift from how we're actually thinking about what's happening to us.
00:15:01.520And I don't know if people realize that this is sold to us.
00:15:04.980It's sold to us in kind of like a story with step by step by step that destigmatization means that what you're experiencing, you have no responsibility around.
00:15:20.320And that relieves guilt and that relieves shame.
00:15:23.920So if you act a certain way that harms somebody or hurts somebody, we should feel guilty.
00:15:32.480Those aversive emotions hopefully would be something we'd want to avoid in the future.
00:15:36.780We've become so emotionally illiterate to not think about the full range of human emotions that exist and that they're there for a reason and they're there to serve us.
00:15:45.740So you just see this, people who feel like they haven't been able to accomplish the things they wanted to in life, who feel like they're on the outskirts of society, which I have empathy for, who might be struggling to be able to find love in their life or career or purpose.
00:16:00.220Because they can attach to this idea that there's something wrong with them, that there's something broken with them medically.
00:16:07.420And then they have a mental illness and in that idea, they can search out some medical solution that kind of justifies why they haven't been able to experience the things that they want to in life or the way that they compare themselves to others.
00:16:23.640This word mental illness is loaded, of course, because when we say mental illness, what does that mean to us?
00:16:31.340Does that mean somebody who is homeless because they're struggling with some sort of psychotic condition?
00:16:37.760Or what about the 14-year-old that has social anxiety and doesn't want to give a speech in class?
00:16:43.980When we lump them all together, I believe that's problematic.
00:16:47.540And we use one word, and that's the limitations of our language.
00:16:51.020We use one word to describe all people.
00:16:54.540And so that makes this conversation difficult because what's going to happen is say, well, Dr. McFillin, what about someone with schizophrenia?
00:17:01.380What if someone with a psychotic condition?
00:17:04.060And then I tell them, well, that's a portion, that's a small portion of people who are labeled with mental illness, a small portion of people who are taking psychiatric drugs.
00:17:13.920But even there, the drugs themselves, they're not as effective as they're communicated to the general public.
00:17:20.380They are short-term stabilization for some, and they couldn't be helpful.
00:17:26.640But the longer you start taking these drugs, they're implicated in metabolic illness and a number of problems.
00:17:32.080So it's not like we've advanced the conversation.
00:17:35.600We've advanced the science to be able to treat mental illness.
00:17:38.900In fact, if you look at the outcome data, everything has worsened.
00:17:41.840Something that I think is just emblematic of all of the problems that you're talking about is this rise in gender confusion.
00:17:52.980I don't even think, I mean, you would know better just medically than I would that I could even call it gender dysphoria because I think it might be gender confusion or gender deceit.
00:18:03.120Maybe some of the people in this group have gender dysphoria.
00:18:06.400I'm not sure that we can label all of the people in that way.
00:18:09.900But it's, you know, confusion is being medicalized, and there's a lot of money behind the treatments, so-called, that come with this and the pharmaceutical companies and all of that.
00:18:22.820I mean, what's your take on that as a psychologist?
00:18:26.140This is a relatively new area of mine that I've gotten into.
00:18:29.480I've just recently met with groups of parents of gender dysphoric teens, and so I agree with you.
00:18:36.020This idea of gender dysphoria as a label, as a term is complicated because it's new to society, and there is a social contagion effect that certainly exists.
00:18:49.700So vulnerable teens, and we're seeing this rise, it's called sudden onset gender dysphoria or rapid onset gender dysphoria.
00:19:02.260I think Lisa Littman is a researcher who's been able to identify that, is that we assume that at puberty, that when someone struggles with their own body or their emotional health,
00:19:13.500it's something that we've normalized in the past, especially for young women, hating your bodies isn't anything new.
00:19:21.880Because there is such a transition that occurs in puberty, 20% body fat changes and so forth.
00:19:30.680And traditionally, girls during puberty have put them at great risk, vulnerably to boys whose hormones are going crazy.
00:19:38.880And so this idea that there's body dysphoria or dysphoria of your own body is normal.
00:19:47.520But the idea that if somebody, a child can come to us and tell us that I think I'm of another gender because I hate my body,
00:19:56.100and that we would have to affirm that as if it's real, is the problem that exists in my field.
00:20:02.900Because this is where ideology overtakes science.
00:20:07.980And if you are a clinical psychologist and you have an ethical code,
00:20:15.060and that ethical code is about understanding things like child development and first do no harm.
00:20:23.200Affirming that condition as if it's true and it's real can do indelible harm.
00:20:28.880And we're seeing it do indelible harm.
00:20:30.860Because it's pushing young people into believing there is a potentially permanent medical condition
00:20:40.460that they developmentally cannot consent for or even begin to understand.
00:20:46.360And that's going to solve the sadness or the depression or the emotional struggles that they are experiencing.