關於單詞的詞 在本書中，我使用了諸如注意力缺陷/多動障礙 (ADHD)、雙相情感障礙、重度抑鬱症和精神分裂症等診斷術語。 如果我每次使用這些術語時都表達我對這些術語的科學懷疑，那麼這本書就會因不斷的中斷而受損。 相反，我想從一開始就確定我使用這些診斷術語只是為了與我所引用的各種來源中的當前用法保持一致，例如臨床研究、研究報告和食品和藥物管理局 (FDA )-批准的藥物標籤。
A WORD ABOUT WORDS Throughout this book, I use diagnostic terms such as attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, and schizophrenia. If I were to express my scientific skepticism toward these terms each time I used them, the book would be marred by constant interruptions. Instead, I want to establish from the beginning that I am using these diagnostic terms only for the purpose of consistency with current usage in the various sources on which I am drawing, such as clinical studies, research reports, and Food and Drug Administration (FDA)-approved drug labels.
正如本書將指出的那樣，這些診斷類別並不反映有效的疾病或與阿爾茨海默病、中風或糖尿病相當的疾病。 儘管有相反的說法，但這些精神疾病沒有經過證實的遺傳、化學或生物學基礎。 他們不能被診斷出有身體症狀或實驗室檢查。
As the book will indicate, these diagnostic categories do not reflect valid diseases or illnesses comparable to Alzheimer’s disease, stroke, or diabetes. Despite claims to the contrary, these psychiatric disorders have no proven genetic, chemical, or biological basis. They cannot be diagnosed with physical symptoms or laboratory studies.
當然，沒有人否認人們會變得高度非理性，與普通現實脫節，或者變得自殺或暴力。 但是，一種極端的情緒反應，無論多麼具有破壞性，本身並不需要根植於生物功能障礙的解釋。 沒有任何潛在的醫學疾病，人類具有極端心理反應的能力，尤其是在壓力下。
Of course, no one denies that people can become highly irrational, lose touch with ordinary reality, or become suicidal or violent; but an extreme emotional response, however destructive, in itself does not demand an explanation rooted in biological dysfunction. Without any underlying medical disorder, human beings have the capacity for extreme psychological reactions, especially under stress.
當然，真正的大腦疾病或失調，如內分泌失調或癡呆，會改變和破壞人類行為。 在這本書和藥物瘋狂（出版中）中，我描述了精神藥物如何導致導致混亂、謀殺和自殺的腦部疾病。 事實上，FDA 終於開始確認我很久以前就抗抑鬱藥引起的精神和行為異常所做的觀察。 然而，除了由精神科藥物引起的腦功能障礙和生化失衡外，經常尋求精神科醫生和 xxiii xxiv 幫助的人的大腦中沒有已知異常。
Of course, genuine diseases or disorders of the brain, such as endocrine disorders or dementia, can change and disrupt human behavior. In this book and in Medication Madness (in press), I describe how psychiatric drugs cause brain disorders that lead to mayhem, murder, and suicide. Indeed, the FDA at long last has begun to confirm observations that I made long ago concerning antidepressant-induced mental and behavioral abnormalities. However, except for the brain dysfunction and biochemical imbalances caused by psychiatric drugs, there are no known abnormalities in the brains of people who routinely seek help from psychiatrists and xxiii xxiv
who become diagnosed with disorders like ADHD, schizophrenia, and major depressive disorder.
給患有多動症的兒童貼上標籤，或者給患有精神分裂症或重度抑鬱症的成年人貼上標籤，就是給他們貼上破壞性的、令人沮喪的標籤，並鼓勵或強迫他們接受藥物和電擊等生物精神干預。 在我自己的精神病學實踐中，我不會用傳統的診斷術語來思考或告訴患者他們患有所謂的精神障礙。 相反，我試圖了解每個人的生活故事——他或她的個人傳記——在其所有微妙的複雜性中。 通常，我讓親人和家人參與進來，以幫助他們相互了解。 在這種真正理解的基礎上，而不是千篇一律的診斷，我更有能力幫助人們過上更令人滿意、更成功的生活。
To label children with ADHD or to label adults with schizophrenia or major depressive disorder is to stigmatize them with damaging, discouraging labels and to encourage or coerce them to submit to biopsychiatric interventions such as drugs and electroshock. In my own psychiatric practice, I do not think in conventional diagnostic terms or tell patients that they have so-called mental disorders. Instead, I try to understand the life story of each individual—his or her personal biography—in all its subtle complexity. Often, I involve loved ones and family to help them understand each other. On this basis of genuine understanding, instead of cookie-cutter diagnoses, I am far more able to help individuals lead more satisfying, successful lives.
Springer Publishing Company 出版了我的第一本醫學書籍《電擊：它的腦功能障礙效應》，很久以前，也就是 1979 年。現在，差不多 30 年後，這本新版的精神病學腦功能障礙治療正值公眾認知 精神科治療的觀點更接近於我在早期 Springer 書中採取的許多看似有爭議的立場。 即使在醫療保健行業，人們也越來越認識到與精神科藥物和休克治療相關的風險比最初預期的要大，而且它們的有效性比預期的要有限。
Springer Publishing Company published my first medical book, Electroshock: Its Brain-Disabling Effects, a long time ago, in 1979. Now, almost 30 years later, this new edition of Brain-Disabling Treatments in Psychiatry comes at a time when the public’s perception of psychiatric treatments has come closer to many of the seemingly controversial positions taken in my earlier Springer books. Even within the health care professions, there is growing recognition that the risks associated with psychiatric drugs and shock treatments are greater than originally anticipated and that their effectiveness is more limited than hoped.
本書原版或其前身《精神病藥物：對大腦的危害》（1983 年）和《電擊》（1979 年）中的基本斷言都沒有被證明是錯誤的。 相反，大量新證據支持我在過去幾十年中一直在發展的主要主題。 在許多領域，食品和藥物管理局在第一版中證實了曾經似乎特別有爭議的斷言，例如，抗抑鬱藥對兒童無效，增加了自殺未遂率，而且還增加了年輕人的自殺率。 我在早期著作中得出的許多其他結論已被主流採納，包括最近證實電擊治療會導致永久性腦損傷和功能障礙。
None of the basic assertions in the original edition of this book or in its precursors, Psychiatric Drugs: Hazards to the Brain (1983) and Electroshock (1979), have been proven wrong. Instead, a mountain of new evidence supports the main themes that I have been developing over the last decades. In a number of areas, the Food and Drug Administration has confirmed assertions in the first edition that once seemed especially controversial, for example, that antidepressants are ineffective in children and increase the rate of suicide attempts and that they also increase suicidality in young adults. Many other conclusions made in my earlier books have been adopted by the mainstream, including recent confirmation that electroshock treatment causes permanent brain damage and dysfunction.
當 Springer Publishing Company 決定推出我的前兩本醫學書籍 Electroshock (1979) 和 Psychiatric Drugs (1983) 時，它需要勇氣。 該公司總裁厄休拉·斯普林格博士和當時的高級編輯卡羅爾·薩爾茨不得不擔心發表如此批評看似已確立的治療概念的觀點。 他們給我的機會有助於鼓勵我在該領域的一生工作。 從那時到現在，我幾乎所有的出版物都從前兩本書中汲取了能量和方向。
When Springer Publishing Company decided to bring out my first two medical books, Electroshock (1979) and Psychiatric Drugs (1983), it required courage. The president of the company, Dr. Ursula Springer, and the senior editor at the time, Carole Saltz, had to be concerned about publishing a viewpoint so critical of seemingly established concepts of treatment. The opportunity they gave me has helped to encourage a lifetime of work in the fi eld. From then until the present, nearly all of my publications have drawn energy and direction from these first two books.
我很感激施普林格博士和她的公司發現我的前兩本醫學書籍具有足夠的價值和重要性來承擔 xxv xxvi 的風險
I am grateful that Dr. Springer and her company found my first two medical books of sufficient merit and importance to take the risk of xxv xxvi
publishing them. If they had not, my career might have taken a different and ultimately less useful direction.
Nearly three decades later, and after the retirement of Dr. Springer, Springer Publishing Company and Sheri W. Sussman, Senior Vice President, Editorial, have continued to support my work with a new paperback edition of The Heart of Being Helpful (1997b) and now with this new edition of Brain-Disabling Treatments in Psychiatry.
Springer Publishing Company also worked with me and my wife,
Ginger, in developing the peer-reviewed scientifi c journal Ethical Human Psychology and Psychiatry, sponsored by the International Center for the
Study of Psychiatry and Psychology (ICSPP; http://www.icspp.org). The
journal is now enjoying a decade of publishing under the leadership of younger professionals and provides a unique opportunity for scientists and clinicians to publish independent research in the light beyond the shadow of the psychopharmaceutical complex.
I also want to thank the many members of ICSPP who have been so supportive of my work and each other’s work in the reform movement.
As in many of my books, my research assistant Ian Goddard continued to provide much-needed help obtaining original articles, sometimes under considerable time pressure, often delivering them along with a big dose of his own original ideas and remarkable insights. Beyond that, he read the entire manuscript and made many useful editorial observations.
This new edition is a better book because of Ian.
And now, approaching 25 years together, my wife, Ginger, continues to provide the strength and often the inspiration behind so much of what I do. It is because of Ginger’s encouragement that the book now has two concluding chapters on treatment and my 20 guidelines for therapy with disturbed patients. She insisted that I needed to write them, and then she helped to edit them.
Confirming the Science Behind
the First Edition
這本書是針對專業讀者的，但希望它寫得足夠清晰和解釋清楚，以供非專業人士閱讀。 當前版本已進行了非常徹底的修訂，但基本的科學主旨基本保持不變。 過去幾年已經證實了精神病治療的腦殘原則，作者的許多看似有爭議的結論也得到了更廣泛的接受。
This book is aimed at professional audiences, but it is hoped that it is written with sufficient clarity and explanation to be read by nonprofessionals. The current edition has been very thoroughly revised, but the basic scientific thrust remains essentially the same. The past several years have confirmed the brain-disabling principle of psychiatric treatment, and many of the author’s seemingly controversial conclusions have become more widely accepted.
A THOROUGH UPDATE OF THE SCIENCE (xxvii)
在本書的這一版中，腦功能障礙治療的概念已經更新和擴展，增加了藥物施法的概念（中毒失知症）。 神經安定藥章節已更新，包括更多關於新型非典型藥物的材料以及所有抗精神病藥物的神經毒性和細胞毒性的新信息。 大量關於抗抑鬱藥和興奮劑的新信息導致了每種藥物的附加章節。
For this edition of the book, the concept of brain-disabling treatment has been updated and expanded with the additional concept of medication spellbinding (intoxication anosognosia). The neuroleptic chapters have been updated to include much more material on the newer, atypical drugs as well as new information on the neurotoxicity and cytotoxicity of all antipsychotic drugs. A massive amount of new information about antidepressant drugs and the stimulant drugs has resulted in an additional chapter on each drug.
The new edition concludes with two entirely new chapters on treatment—one on how to safely withdraw from psychiatric drugs, and the other about psychosocial and educational approaches to very disturbed people, including 20 guidelines for therapy. I am pleased to include how-to treatment information in the book for the first time.
GROWING CONFIRMATION OF THE PREVIOUS EDITION
我對抗抑鬱藥引起一系列興奮或激活效應的觀察——包括激動、敵意、攻擊性和躁狂症，以及陷入抑鬱和自殺——在新的食品和藥物管理局（FDA )-強制改變抗抑鬱藥標籤。 精神藥物具有神經毒性的概念現在已成為科學研究中廣泛接受的原則，特別是關於抗精神病藥物和情緒穩定劑的研究已經開始，研究表明在所有類別的精神藥物中都有類似的神經毒性作用。 許多其他醫學專家現在加入了我對 FDA 未能履行職責的批評以及我對製藥公司對精神病學理論和實踐的腐敗影響的擔憂。 簡而言之，我不再是一個在荒野中哭泣的孤獨聲音。
My observations that antidepressant drugs cause a spectrum of stimulant or activation effects—including agitation, hostility, aggression, and mania as well as crashing into depression and suicidality—have been elevated to the status of official dogma in the new Food and Drug Administration (FDA)-mandated changes in antidepressant labels. The concept that psychiatric drugs are neurotoxic is now a widely accepted principle in scientific research, especially concerning the antipsychotic drugs and mood stabilizers, and research has mounted up that demonstrates similar neurotoxic effects in all categories of psychiatric drugs. Many other medical experts have now joined in my criticism of the FDA’s failure to do its duty and my concern about the corrupting influence of the drug companies on the theory and practice of psychiatry. Put simply, I am no longer quite such a lonely voice crying in the wilderness.
確認從 1983 年開始的長遠觀點 (xxviii)
CONFIRMING THE LONGER VIEW STARTING IN 1983 (xxviii)
這個新版本的譜系始於 1983 年的《精神病藥物：對大腦的危害》，這本書開創了新的領域，首次廣泛審查了神經安定藥誘發的癡呆這一主題。 它還堅定地認為，精神安定藥經常導致年輕人遲發性運動障礙 (TD)。 兒童的 TD 已成為公認的現實，因此該部分的尺寸已縮小。 遲發性精神病正在獲得越來越多的認可，如果緩慢的話。 遲發性癡呆仍然存在爭議——儘管不應該如此——而且越來越多的證據支持我之前對神經安定藥引起的認知缺陷的觀察。 此外，實驗室正在更公開地研究精神藥物的神經毒性。
The lineage of this new edition began in 1983 with Psychiatric Drugs: Hazards to the Brain, a book that broke new ground with the first extensive review of the subject of neuroleptic-induced dementia. It also took a fi rm stand on the view that neuroleptics frequently cause tardive dyskinesia (TD) in young people. TD in children has become an accepted reality, and so that section has been reduced in size. Tardive psychosis is gaining increasing, if slow, recognition. Tardive dementia remains controversial—although it should not be—and an increasing amount of evidence supports my earlier observations on the cognitive deficits caused by neuroleptics. In addition, the neurotoxicity of psychiatric drugs is being studied more openly in laboratories.
在 1970 年代，當我第一次開始對精神藥物、醫學模式和精神藥物綜合體進行詳細評論時，我在很多情況下都在開闢新天地，而且最初的支持者寥寥無幾。
In the 1970s, when I first began offering detailed critiques of psychiatric drugs, the medical model, and the psychopharmaceutical complex, I was, in many cases, breaking new ground, and initially, there were few supporters.
到 1997 年第一版《精神病學中的腦損傷治療》時，我已經可以引用許多從不同角度對生物模型和物理治療提出強烈批評的書籍（Armstrong，1993；Breeding，1996；Caplan， 1995；Cohen，1990；Colbert，1995；Fisher 等人，1989；Grobe，1995；Jacobs，1995；Kirk 等人，1992；Modrow，1992；Mosher 等人，1989；Romme 等人，1993； 夏基，1994）。
By the time of the first edition of Brain-Disabling Treatments in Psychiatry in 1997, I could already cite many books that voiced strong criticism of the biological model and physical treatments from a variety of perspectives (Armstrong, 1993; Breeding, 1996; Caplan, 1995; Cohen, 1990; Colbert, 1995; Fisher et al., 1989; Grobe, 1995; Jacobs, 1995; Kirk et al., 1992; Modrow, 1992; Mosher et al., 1989; Romme et al., 1993; Sharkey, 1994).
尤其是在過去幾年中，越來越多的作者，其中許多來自醫療機構內部，一直在強烈批評這個強大的利益集團，尤其是製藥業的主導影響（Abramson 等，2005； Angell, 2004, 2007; Glenmullen, 2000, 2005; Healy, 2004; Jackson, 2005; Kean, 2005, 2006; Medwaret al., 2004; Moncrieff, 2006a, 2006b; O’Meara, 2006; Rost, 2006)。
Especially in the last few years, an escalating number of authors, many from within the medical establishment, have been offering strong criticism of that conglomerate of powerful interest groups, and especially the dominating influence of the pharmaceutical industry (Abramson et al., 2005; Angell, 2004, 2007; Glenmullen, 2000, 2005; Healy, 2004; Jackson, 2005; Kean, 2005, 2006; Medwaret al., 2004; Moncrieff, 2006a, 2006b; O’Meara, 2006; Rost, 2006).
THE SITUATION IN PSYCHIATRY WORSENS
Although many of my critiques and criticisms of biological psychiatry and the psychopharmaceutical complex have a broader acceptance, in many ways, the situation has deteriorated as the strength of the drug companies has grown. In the process, my predictions about the growing power of the psychopharmaceutical complex have come true.
在過去的二十年裡，人們對精神科藥物的依賴不斷增加，不僅在精神病學領域，而且在整個醫學、心理健康甚至教育領域。 在私人執業精神病學中，通常在第一次就診時給患者藥物，然後告知他們終生都需要藥物。 家庭醫生、內科醫生和其他醫生大量分發抗抑鬱藥和苯二氮卓類鎮靜劑。 非醫學專業人士，如心理學家和社會工作者，覺得有義務推薦他們的病人進行藥物評估。
The last two decades have seen escalating reliance on psychiatric drugs, not only within psychiatry but also throughout medicine, mental health, and even education. In private-practice psychiatry, it is common to give patients a medication on the fi rst visit and then instruct them that they will need drugs for their lifetimes. Family practitioners, internists, and other physicians liberally dispense antidepressants and benzodiazepine tranquilizers. Nonmedical professionals, such as psychologists and social workers, feel obliged to refer their patients for drug evaluations.
管理式護理積極推動藥物排除心理治療。 成人藥物越來越多地開給兒童。 醫院違背病人的意願強行給病人服用精神科藥物。
Managed care aggressively pushes drugs to the exclusion of psychotherapy. Adult medications are increasingly prescribed to children. Hospitals force psychiatric drugs on patients against their will.
精神病學內部有一個成功的運動，在許多州實施，這使得強迫診所門診病人接受長效藥物注射變得容易。 根據這些門診承諾法，如果患者拒絕來診所，精神衛生工作者可以上門強行進行注射。 與此同時，還有一場運動，對學童，甚至學齡前兒童進行所謂的精神疾病篩查。 這種潛在的災難性運動是由製藥公司的資金推動的，旨在增加其產品的市場。
There is a successful movement within psychiatry, implemented in many states, that makes it easy to force clinic outpatients to take long-acting injections of drugs. Under these outpatient commitment laws, if the person refuses to come to the clinic, mental health workers can come to the home to administer the injections by force. At the same time, there is a movement to screen schoolchildren, and even preschoolers, for so-called mental illness. This potentially disastrous movement is driven by drug company money and aims at increasing the market for their products.
外行也加入了對毒品的熱情。 由於媒體對藥物的支持以及對公眾的直接廣告和促銷，患者到達醫生辦公室時經常會想到一種精神科藥物的名稱。 老師經常推薦孩子進行藥物評估或治療。
Laypersons have joined in the enthusiasm for drugs. Because of media support for medication as well as direct advertising and promotion to the public, patients frequently arrive at the doctor’s office with the name of a psychiatric drug already in mind. Teachers often recommend children for drug evaluation or treatment.
這場藥物革命將精神科藥物視為有益而非有害，即使是一種完全的祝福。 就像胰島素或青黴素一樣，它們被大力推廣為特定疾病的特定治療方法。 通常，據說它們可以糾正大腦中的生化失衡。 這些信念創造了一種環境，在這種環境中，對藥物不良反應的強調受到冷遇，對精神科藥物的批評原則上是不常見的異端邪說。
This drug revolution views psychiatric medications as far more helpful than harmful, even as an unmitigated blessing. Much as insulin or penicillin, they are vigorously promoted as specific treatments for specific illnesses. Often, they are said to correct biochemical imbalances in the brain. These beliefs have created an environment in which emphasis on adverse drug effects is greeted without enthusiasm, and criticism of psychiatric medication in principle is uncommon heresy.
製藥公司大力宣傳這種未經證實的推測，即他們治療的問題是生物學上的，是由生化失衡造成的。 廣告標語被用來證明藥物處方的合理性。 例如，抗精神病藥物 Risperdal 的製造商 Janssen（2005 年）提供了一個“關於雙相情感障礙”的部分，該部分於 2006 年 2 月從其網站下載。它宣稱，精神疾病是一種醫學疾病，就像高血壓或 心髒病。
Drug companies heavily promote that unproven speculation that the problems they treat are biological in origin and result from biochemical imbalances. Advertising slogans are used to justify the prescription of medications. For example, Janssen (2005), the manufacturer of the antipsychotic drug Risperdal, offers a section “About Bipolar Disorder,” downloaded from its Web site in February 2006. It declares, Mental illness is a medical illness, just like high blood pressure or heart disease.
Janssen 網站繼續說：“人們還認為雙相情感障礙可能是由該疾病的遺傳易感性引起的，因為它傾向於在家庭中傳播。” 再次注意，沒有聲稱科學真實性。 但是，這些不科學的生化和遺傳推測的重複仍然使人們相信精神科藥物是針對遺傳、生化疾病的特定治療方法，就像治療高血壓的抗高血壓藥物或治療糖尿病的胰島素一樣。
The Janssen Web site goes on to say, “It is also thought that bipolar disorder may be caused by a genetic predisposition to the illness because it tends to run in families.” Notice again that no claim to scientific veracity is made. But the repetition of these unscientific biochemical and genetic speculations nonetheless conditions people to believe that psychiatric drugs are specific treatments for genetic, biochemical disorders, much like antihypertensive drugs for high blood pressure or insulin for diabetes.
這本書採取了與生物精神病學截然不同的觀點。 它提供了理論和證據，表明精神藥物通過引起腦功能障礙來實現其主要或基本作用，並且它們往往弊大於利。 我將證明精神藥物不是針對任何特定的所謂精神障礙的特定治療方法。 精神藥物不是糾正生化失衡，而是導致它們，有時是永久性的。
This book takes a decidedly different viewpoint from that of biological psychiatry. It provides theory and evidence that psychiatric drugs achieve their primary or essential effect by causing brain dysfunction and that they tend to do far more harm than good. I will show that psychiatric drugs are not specific treatments for any particular so-called mental disorder. Instead of correcting biochemical imbalances, psychiatric drugs cause them, sometimes permanently.
醫療保健提供者和公眾也被廣為宣傳的猜測所迷惑，即腦部掃描可以證明精神障礙的存在，甚至可以診斷它們。 實際上，沒有任何精神疾病可以通過腦部掃描 (Jackson, 2006a) 或任何其他醫學或生物學手段證實或診斷。
Health care providers and the general public have also been bamboozled by the much-advertised speculation that brain scans can demonstrate the existence of mental disorders, and even diagnose them. In reality, no psychiatric disorder is demonstrable or diagnosable by brain scan (Jackson, 2006a) or by any other medical or biological means.
這本第二版書討論瞭如何停止服用精神科藥物，並提供了 20 條治療指南。 在其他地方很容易獲得關於如何在不訴諸藥物或電擊的情況下幫助受干擾和乾擾的人的更多信息（Breggin，1991a，1992a，1997；Breggin 等，1994a，1996，2002）。 Reclaiming Our Children (2000b)、Talking Back to Ritalin (2001c)、The Antidepressant Fact Book (2001a) 和 The Ritalin Fact Book (2002b) 中的章節也涉及治療方法。 關於我幫助他人的方法的最佳總體總結可以在 The Heart of Being Helpful (1997b) 中找到。
This second-edition book discusses how to stop taking psychiatric drugs and presents 20 guidelines for therapy. Considerably more information on how to help disturbed and disturbing people without resort to drugs or electroshock is readily available elsewhere (Breggin, 1991a, 1992a, 1997; Breggin et al., 1994a, 1996, 2002). Chapters in Reclaiming Our Children (2000b), Talking Back to Ritalin (2001c), The Antidepressant Fact Book (2001a), and The Ritalin Fact Book (2002b) also deal with therapeutic approaches. The best overall summary of my approach to helping people can be found in The Heart of Being Helpful (1997b).
Finally, Medication Madness: True Stories of Mayhem, Murder and Suicide (in press) can be viewed as a companion to this book, providing real-life cases of the devastating impact of these drugs on individual lives.