The Mysterious Case of the Veneration of Peter Breggin (Revised)

Banging into a Brick Wall

Apart from the actual symptoms, the most alienating aspect of psychiatric drug withdrawal is the invalidation by the medical community. I spent much of 2012 – the year I hit tolerance with benzodiazepines - visiting my doctor, knowing something was wrong and suspecting the medication, only to be encouraged to pursue other – more well known – avenues of treatment.

The key discovery at the time came when I stumbled on the Ashton Manual – the online guide to benzodiazepine tolerance, withdrawal, and discontinuation. Written by a neurologist with impeccable credentials, Dr. Heather Ashton spent years running a clinic for people trying to get off the drug. Her clinical description of symptoms associated with the medication, tolerance and withdrawal, mirrored my experience. It was the first time I felt like I wasn't descending into insanity.

But despite the nearly unimpeachable rigor of the manual and the ubiquity of benzodiazepine prescriptions worldwide (xanax is the number one most prescribed drug in the US), my physician had no knowledge of the manual or the syndrome and neither did most other established healthcare sources I pursued. Her research and methodology, however, was unimpeachable and my doctor was willing to go along with her tapering protocol after I showed him the manual. 

Her manual gave me a modicum of legitimacy in my attempt to convince my doctor that I was having a PHYSICAL reaction and my symptoms were not a manifestation of a "mental health disorder."

Trying to find a Sheriff or a Mayor in the Wild West

When you get off the main road of established medical conditions and treatments like I had to do with psychiatric medication withdrawal, you find yourself in a dense forest of uncertainty. The online community of alternative medicine and support groups for benzodiazepine and SSRI withdrawal in general is a living embodiment of the wild west. There are no rules. Because of the dearth of research into drug discontinuation - what you encounter for coping strategies is anecdotal and often times contradictory.

What I wanted more than anything were more voices of medical credibility to back up the Ashton Manual. Heather Ashton for all her brave work, did not create a movement or get heavily involved in advocacy. She also doesn't seem to have too many other colleagues in the field who have studied the long-term cognitive effects of benzodiazepines and the drawn-out symptoms some people encounter when they get off. So who do people turn to for legitimacy when trying to get awareness and acceptance of this phenomenon?

Fortunately, there is a burgeoning psychiatric reform movement with compelling voices, led by serious professionals like Robert Whitaker (an independent journalist who has uncovered an amazing amount of data that throws cold water on the efficacy of psychiatric medication), Peter Gotzsche (an internal medicine specialist and expert in clinical trials and the drug industry), and David Healy (a psychiatrist who runs an excellent prescription drug database and advocacy site RxISK). Those three alone have helped build a grassroots campaign questioning the validity of psycho-pharmacology. Many other mental health care specialists and former patients have joined them in advocacy for reform and awareness of the harms of psychoactive drugs.

The Self-Described "Conscience of Psychiatry"

And then there's Peter Breggin.

Breggin is a psychiatrist and a long-time critic of biological psychiatry and the medical management of mental health care. He has for decades railed against medicating people with mental health issues and criticized essentially all psychiatric drug use.

Frequently cited by psychiatric reformers, Breggin's adoration often approaches patron saint status – something he seems to relish as he refers to himself on his weekly podcast as “the conscience of psychiatry.” That he was an early critic of psycho-pharmacology definitely plays into this unquestioning respect. But this is not a man whose background is entirely credible and who has made questionable choices in the way he spreads his message.

What motivated me to write about Breggin and how his specter haunts me is the manner in which grassroots critical psychiatry organizations like Council for Evidence-Based Psychiatry (Dr Gotzsche's advocacy organization) and Mad in America (Robert Whitaker's well-known grassroots web page) unquestioningly embrace him. 

Frequent Guest on Hateful Far Right and UFO/Paranormal Programs

But it only takes a quick look at Breggin's career path and associations for me to feel completely uncomfortable with those organizations putting his face on the front of their web pages and trumpeting him as a legitimate medical authority.

Just enter “Peter Breggin” into Google and count the crazy.

For one, you find numerous guest appearances on some of the weirdest, most paranoid programs around. One of the most glaring examples is his presence on the wacky AM radio program called Coast to Coast. On its web site, the program describes itself as “a media phenomenon, Coast to Coast AM deals with UFOs, strange occurrences, life after death, and other unexplained (and often inexplicable) phenomena.”

Breggin has not just made one or two appearances on the program, he has his own link on the page as a recurring guest. Program titles he's been a guest on include “Psychiatric Drugs/UFO Disclosure”; “Supernatural Realms & Psychic Work,” “Satanic Ritual Abuse,” and “Advanced Beings and Reincarnation.” His portion of the segments are grounded in his work and criticism of psychiatry, but the surrounding content is literally not of this earth.

The crazy takes a more pernicious turn when you discover Breggin is also a frequent guest on the Alex Jones Show. A vile and grotesque demagogue,  9/11 truther, Sandy Hook skeptic, armed militia supporter, and friend of illuminati wackadoodle theorist David Icke, Alex Jones and his show mines the most paranoid conspiratorial theories, actively encouraging its listeners to buy survival kits for the upcoming apocalypse as well as hatefully endorsing President Donald Trump's most racist elements.

In a June 27^th  2014 appearance, Breggin and host David Knight spend a good 20 minutes in a froth over fears of the government inserting brain chips into the populace. The kernal of truth in the segment is a project by the Defense Advanced Research Projects Agency (DARPA) to record and stimulate brain activity in veterans with issues related to PTSD. It's not nearly as Orwellian it sounds either as it incorporates Deep Brain Stimulation technology which is already a common and popular form of therapy for treatment of neurological conditions like Parkinson's and dystonia (a movement disorder). But to hear Breggin and Knight opine about it, it's the next step before being assimilated by the Borg.

And if that isn't enough, Breggin is a frequent guest of the unhinged, hateful right wing radio personality Michael Savage's show. You may remember Savage from several years ago when he created an uproar claiming that autism was a fraud and that, in 99% of the cases an autistic child is a “brat who hasn't learned to cut the act.” The widespread revulsion of the comments resulted in Savage's nationally-syndicated program losing sponsors and getting picketed by parents groups. But it certainly isn't too objectionable to Breggin.

Savage's show is your typical right wing AM talk radio program, focused on the horrors the Democratic party, and progressives in general, inflict upon our god-fearing country. Breggin has been on the show most of the time to discuss the over-medication of society where he frequently plays into Savage's hand trying to depict the problem as stemming from heavy-handed big government forcing medication on hapless souls. But at least on one occasion, Breggin himself editorialized on the dangers progressives inflict on society by shirking away from “personal responsibility.”

I mean never mind that if it weren't for the gains of progressives, Breggin wouldn't have the ability to access government and corporate records that he uses when he's tasked with being an expert witness in litigation cases against pharmaceutical companies. He certainly wouldn't have the legal avenues open to him for his litigants to pursue wrongful death lawsuits, a lucrative money making avenue of his career. But beyond even that, his gross caricature of progressives as eschewing personal responsibility and likening them to children is so simple-minded and naïve that I can't imagine how he's ever been able to convince anyone of anything.

Dragging him Through The Mud

Dr. Breggin has been at this a long time. That could be part of the attachment to him – he was making these arguments before Robert Whitaker, before Marcia Angell, and the Kirsch Study. Perhaps Whitaker, Gotsche and others feels a debt of gratitude to Breggin for paving the way and getting many things right about the dangers of psychiatric drugs decades earlier. But I still think it's worth debating.

I tried pointing out my reservations about Dr Breggin in the comments section of his youtube video in Mad In America. I cited the frequent guest appearances on Coast to Coast and his June interview on the Alex Jones Show.

I definitely expected some blowback from other commenters, but I did not expect the site to remove portions of what I wrote. Just 12 hours after writing my concerns about him, however, I got an email from the Mad In America website moderator informing me that two comments I made were being removed.

One of the objectionable remarks I made was “Breggin has a relationship with Scientology.” Technically, that's not accurate. Breggin HAD a relationship with Scientology when he worked for the Citizens Commission on Human Rights (CCHR) – an organization created by the Church of Scientology to combat psychiatry and psychiatric medication. He stopped working for the organization in the 70's and completely disavowed Scientology not long after. But CCHR still disseminates his work and criticisms (most likely against his preference) and so it's easy make the assumption of a connection.

But it's the other “objectionable” remark that drew rebuke that really floored me – the moderator removed a sentence that “implied he is a 'zealot.'” I simply was expressing my uneasiness with him as a major figure in the reform movement and the rigid combativeness he exudes when talking about the field of psychiatry. That was over the line, apparently as the moderator told me, “I don't think it would be respectful or responsible for us to offer a platform for bloggers just to let them be dragged through the mud.”

And that's the mystery in a nutshell. Does Mad In America and the Council for Evidence-Based Psychiatry not know that the person they promote on their web site airs his views on shows so easily dismissed by rational people? Is accurately pointing that out "dragging him through the mud"? I am more of a “victim” of psychiatry than he ever will be (in fact, he's benefited a great deal from psychiatry when you look at his paid efforts of criticism), yet I'm the one being censored for voicing uneasiness with his vaunted status.

Summarizing the Case and Why It Matters to Me

Why is the psychiatric reform movement trumpet this guy so readily? How can such a movement engage in dialogue with the established mental health world, when one of its most-promoted figures so effortlessly associates himself with crazy and intolerance?

This seems maddeningly self-defeating for a movement that desperately needs understanding and awareness.

This is not an academic issue to me. I've been pounding my head against the wall for three years now trying to carve out a space of understanding with doctors, family members and friends. What would any of them say if they saw Peter Breggin's multiple guest appearances on Coast to Coast? How much success could anyone have saying, “just focus on what he says about psychiatric medication and ignore the fact that he goes on shows about UFO's, lizard people and paranoid conspiracy theories.”

If I had used Breggin as my source rather than Dr. Ashton's, how seriously would I have been taken? It's not an academic issue for me. 

But I feel like I'm the only one. And I don't understand it. Where are the people - those fighting for acceptance, awareness and more research into this field - vigorously objecting to the inclusion of Peter Breggin as a reliable and legitimate authority?

When I was at my worst and there was simply no where to turn for support and understanding, I doubted myself. If this isn't a real condition– I thought – then I'M the problem. I'm too weak for this world. There is no one here to back me up, to take the burden of responsibility off me, to say that this is not my fault.

I wanted research that proved what I was going through was not a personal failing, but a genuine medical phenomenon from taking benzodiazepines and SSRIs as prescribed by a doctor. I wanted credible, sensible voices whose work I could share with the physicians and counselors I was going to for help. And so have scores of people before me, scores of people right now trying to work with their doctors for help, and scores of people who have yet reached tolerance.

There is so little out there in the mainstream medical world validating this experience that isolated me and many others. So much is unknown because the research is lacking. So much still needs to happen for this condition to be accepted and understood. It's not that the numbers of people suffering what I've gone through are dramatic, it's that the experience for those who do suffer from it is so traumatic and disabling that many resort to suicide. I know this for a fact because no fewer than three people I encountered on message boards and support forums took their lives while I was frequenting them.

So this is the place I'm coming from when I raise this case about Dr Breggin. I personally feel that his poster-boy status is harming those of us fighting for awareness and legitimacy and I genuinely want a dialogue on this so I can either understand why he's so prominently featured or plant seeds of concern about him and the questionable baggage he carries.

Clearing My Name

During the middle of the worst of it, while I was on a three month emergency medical leave, I put words to a feeling I'd had for weeks.

About four and a half months after my last .5 milligram tablet of valium, I was facing a weekly battery of intensively probing questions about my childhood and the person responsible for conditioning me to suppress expressions of anger. It was intense psychodynamic therapy with the underlying premise that my current emotional lability, depression and anxiety stemmed from a childhood experience of shaming. That someone important in my life taught me to suppress any outward sign of anger, predicated on the famous adage that depression is anger turned inward.

“But how did that make you feel?”

“Can you express what your primary reaction to (whatever life event we were discussing) was?”

“No, that is a rationalization, I want to know how you REALLY felt?”

“Of course you felt sadness at your father's death, but what ELSE? “

“There's something more you felt, wasn't there? Can you access it? This is important.”

“I want you to notice your body language right now. Why can't you look me in the eye? Who taught you that you weren't good enough?”

During the last of the weekly debriefings with my wife after a particularly fruitless and intensive session, I finally found the strength to say how I REALLY felt: “It's like being accused of a crime I didn't commit.”

And that is the crux of what so many people experience when they seek professional help for the overwhelming subjective hell of a brain off its hinges from benzodiazepine withdrawal. Especially if you're more than a month from discontinuation and your taper was a judicious 10% cut a month as mine was. The therapist I saw humored me to the point of accepting that the withdrawal was making things worse. But his approach was firmly rooted in a belief that my problems were fundamentally psychological.

I was supposed to be doing neurofeedback with him. But during the intake he latched on to my emotional insecurity and started digging. Which led to regular talk therapy. It's difficult for me to confess how susceptible I was to treatment suggestions that I knew deep down weren't going to take this pain away. The few who experience traumatic, prolonged misery from discontinuation of benzodiazepines slowly learn to accept that the only salve is time.

But I doubted my own mind, my own own experience, because my already shaky self-esteem was magnified ten fold from withdrawal. I even convinced myself that some good could come out of it. For one, it would show loved ones that I was taking the problem seriously, I was getting treatment. Not just sitting on my hands while fear, paranoia and hysteria festered within. I even felt that it might help me find insights on the cause of the rapidly blossoming self-hatred I felt every day I sat at home not working.

So I went to the therapist for about a month and a half. Throughout, I felt like a naked child talking to an adult who knew things about me that I didn't. I even played a sick game of expressing anger about things that didn't anger me because I knew that's the only way I could make “progress.” The more we talked, the worse I felt, the more I blamed myself for my problems and the more powerless I felt to defend that self-attack. At one point, he accused me of backing away and distancing myself from my real emotions. That was it. No more of this.

As I said earlier, I KNEW what was (and is) wrong with me. Those who have gone through this know. They know because there can be no more profound, yet existentially horrifying, experience. And I say that with 100% certainty despite my relatively inexperienced life.

It's like in Lord of the Rings, when Gandalf the Grey is replaced by Gandalf the White. He tries to explain what has happened to him after falling down into the abyss past Khazed-dum with the ancient Balrog beast. He says, “Time is short. But if there were a year to spend, I would not tell you all.” So much had he been through since he had seen his companions last that he had forgotten his name. His time transformed him into a wholly different person inside yet, by all appearances, he was the same. To the others, only a few weeks had passed, to Gandalf “each day was as long as a life age of the Earth.”

And in a sense, that's how profound of an experience each day at its worst of benzodiazepine withdrawal is for me. On the days the fog of symptoms clear and the mysteriously fickle windows of clarity re-emerge, I am aware just how much I've silently felt and experienced. And sometimes when I see someone I haven't seen while in the throes of withdrawal, it's as if ages have passed since we last spoke, that I must have much to tell them. You just can't go through that and think your own psychology and the burden of the worst of your life experiences could cause your brain to act that way. Not without help.

So here it is more than nine months after my last dose of Valium and I have made incredible progress. As the fabric of my self slowly gets knitted back together, I feel a moral obligation to try to explain that this is a real phenomenon. That, despite the implausibility of such an experience being due to the withdrawal of a prescribed medication (always taken as prescribed and at a low dose); despite the fact that by all accounts, a very, very small number of people experience the mental degradation and existential annihilation of consciousness that I have going off this drug; despite the fact that there is not any clear and conclusive physical evidence that something has gone radically awry in the brain; despite the fact that almost any doctor or psychiatrist you encounter will deny profound symptoms like that could be attributed to a medication; despite everything that my therapist tried to pin as the cause of my problems; despite all of that – I know that my problem was the drug.

One day during a window of normality a while back, I wrote the following message to myself to read when going through a wave of neurological symptoms:

“It's not your fault. It is not your self-esteem issue. It's not your dad's death. It's not your upbringing or your past anxiety. It's the effect from the drug. Believe it. No one can feel like that on their own. It's impossible.”

It's now my turn to try to convince you the reader and hopefully others in the mental health community of the same. The depth of the problem is not in the numbers of people who suffer this (and there are many, many others who do) but the depth of the suffering and the dearth of resources and knowledgeable people out there to help.

So that's why I say this is “clearing my name.” I don't mean that literally – what I mean is that I'm trying to prove that this happened to me from a medication and not from a psychological failing of my own making. That despite the fact that I “have a past record”of mental health issues that include depression and anxiety, I am cleared of culpability for the past 19 months of suffering.

My far-reaching (and far-fetched) hope is that this case could be put before an actual jury of the general public for consideration so that this issue will not continue to create small, out of the way enclaves of benzo withdrawal sufferers forced to communicate with people they don't know for support. These support groups which I have spent time in are both much-needed affirmation of the experience and electric magnifiers of fear. So little consensus on the nature of the process exists that the void often gets filled with misinformation, half truths, and rubbish.

So I hope you find this interesting and I hope you can see the currently unseen – those poor souls trying to survive day to day with a broken mind not of their making. They need help, they need acceptance and they need the jury to rule in their favor.  

The Overrated and Understudied Brain

I bought a 2004 Toyota Prius this week. I call it “future car” because it starts not by turning a key, but pressing the “on” button. Despite being nearly 10 years old, this impressively engineered vehicle doubles the gas mileage of most other new cars. Looking at how it's designed, it's almost impossible not to be impressed at the sophistication – a testament to the complexity of the human brain.

But what does it say about us that the very same brain that we all admire for creating a car like the Prius is also responsible for the catastrophic problem of global warming to begin with? And why is it harder for us to praise the simplicity of an act like walking to work than it is to marvel at the invention of something that, despite improvements, still spits out greenhouse gases? 

Because, look, if some mysterious higher power were to evaluate the status of our planet and find the element most likely to cause its demise, the human brain would be at the very top of the list. In fact, it would probably be the only thing on the list. And after everything that I have gone through over the past two years and counting, I feel pretty secure in saying that our brains are both fantastically sophisticated and horribly designed to live the way we do.

Consider that for hundreds of thousands of years, humans lived and evolved in small social groups of hunter gatherers. Over this time, our brain's ability to recognize and respond emotionally to familiar faces became increasingly sophisticated and helped us forge the necessary bonds for survival. To protect us from outside threats, that same sophistication led to equally strong reactions to unfamiliar faces.

And while that was great for us in small tribal groups, it had some horrible consequences in the last few hundred years when our population and range expanded - slavery, war,  genocide...sports. In fact, I would argue the amygdala and its primal power within our reactive minds is now far more destructive than helpful.

That's not nearly the only flaw in the human brain either. A friend of mine on Facebook posted the youtube clip below that provides a biological explanation for the universal human trait of marriage.

So that's how we safeguard the brain while it matures - marriage? Not exactly a fool-proof device. Throw in an alcoholic parent, an impoverished couple, or a sexually abusive relationship and the same system required for healthy brain development turns the mind to a dangerous weapon of self-destruction and/or a threat to others. It can also lead to an unacceptable amount of suffering.

All of this and my current experience suffering from benzodiazepine withdrawal shapes one of my primary views of mental health – that our brains aren't as elegant as we think they are. It also makes me more convinced in the biological underpinnings of mental health problems and leads me to the opinion that our current mainstream approach to treating them is, so far, wholly inadequate and primitive.

It also puts me in a strange place in the current debate over psychiatric medication. My sympathies now strongly lean toward the anti-psych medication arm of the discussion but I'm perversely put off by that same crowd's insistence that mental health disorders are not problems of biology. I understand what drives their passion – mental health experts and pharmaceutical companies performed a heinous human crime insisting on a simplistic theory of chemical imbalance to justify the need for medications like SSRIs and benzodiazepines.

But as many researchers have pointed out, that shouldn't mean we throw the baby out with the bathwater. All human behavior is biology and all human behavioral problems are also biological. When I say “biological” I don't mean just our genetic makeup or anything that is a set-in-stone trait. Any true definition of the word encompasses the fact that genes can't be separated from their environment. Much of our DNA are just complicated instructions our body has for how to react to life's events. And how we react to life's events, as much as we insist differently, is not ever entirely within our control.

This belief comes from my own direct experience. The way I have felt and reacted to events put in front of me over the past 19 months is so far afield from how I wanted to react and how I knew I should feel that I either conclude that I'm suddenly astonishingly inept at basic human functioning or that changes in the biology of my brain was so much more profound than the 42 years of life coping skills I developed prior to getting off xanax. I'm just going to go with the latter on that.

We have simultaneously overrated and understudied this bloated pink contraption running the show.

So what I need from readers of this blog as I start writing about my thoughts on benzodiazepine withdrawal, the brain, and the horrific gap between knowledge of withdrawal and the depth of suffering it creates is to accept the view of the brain as a potential loaded weapon. The disruption that causes the weapon to do harm can just as easily be a traumatic life event as a pharmaceutical drug because both effect brain chemistry.

 

Accepting this premise shouldn't make us de-facto proponents or opponents of medication. Rather, it should light a fire under our respective asses to put far more resources into understanding brain function and environmental influences than in creating drugs to treat the maladies we so poorly understand.

Because I'm pretty sure that knowledge is going to result in a collective gasp of horror at how crude our current pharmacological approach has been.