Episode 08 Part I: When Treatment Becomes the Problem - How modern psychiatry lost the human being

Episode 08 Part I: When Treatment Becomes the Problem - How modern psychiatry lost the human being

"These are not the side effects of the medication. These are the effects of the medication." — R.D. Laing — — The former head of the American Psychiatric Association once called Robert Whitaker "a menace to society." Bob says he'd put it on his gravestone. In this conversation, Michael traces the through-line from the unlikely apprenticeships that taught Bob to take seriously the people most of the world had discounted - driving a New York cab with no partition in the late 1970s, working the overnight desk at an SRO hotel, running a tutoring program inside Attica prison after the riots - to the 1998 Boston Globe investigation where he found himself holding two irreconcilable narratives: one from the experts, one from the patients. The book that followed, Mad in America, did something simple and unforgivable. It took the patients' story seriously, followed the data, and found that the data agreed with them. They walk through the World Health Organization's own cross-cultural findings, the Harvard study showing long-term outcomes had declined, the Harrow-Jobe data Bob brought back to the researchers themselves, and the central tragedy his decades of work circle back to: a model of care that transforms what could be episodic difficulties into lifelong chronic conditions. The good news, Bob argues, is that the official narrative has collapsed in the research literature. The bad news is that prescribing practices haven't. — — "We have a form of care that transforms what could be episodic problems into chronic conditions." — Robert Whitaker — — Relevant Links Follow us on psychophobia.com [http://psychophobia.com] | Substack [https://psychophobia.substack.com/] | LinkedIn [https://www.linkedin.com/in/drmontgomery23/] | Instagram [https://instagram.com/psychophobia_project] | Youtube [https://www.youtube.com/@psychophobia_project] Follow Bob Mad In America [https://www.madinamerica.com/] Books Mad In America [https://www.madinamerica.com/mad-america-book/] | Anatomy of an Epidemic [https://www.madinamerica.com/anatomy-of-an-epidemic-2/] | Psychiatry Under the Influence [https://www.madinamerica.com/psychiatry-under-the-influence/] Send us a message: https://www.speakpipe.com/psychophobia [https://www.speakpipe.com/psychophobia] — — Robert Whitaker is an American journalist and author who has won numerous awards as a journalist covering medicine and science, including the George Polk Award for Medical Writing and a National Association for Science Writers' Award for best magazine article. In 1998, he co-wrote a series on psychiatric research for the Boston Globe that was a finalist for the Pulitzer Prize for Public Service. His first book, Mad in America, was named by Discover magazine as one of the best science books of 2002. Anatomy of an Epidemic won the 2010 Investigative Reporters and Editors book award for best investigative journalism. He is the publisher of http://madinamerica.com/madinamerica.com [http://madinamerica.com]. He is a Clinical Assistant Professor (Adjunct) in the Lewis Katz School of Medicine at Temple University, Department of Psychiatry and Behavioral Science. — — Dr. Michael R. Montgomery is an existential psychoanalyst whose work explores the far edges of human experience, including complex trauma, extreme states, addiction, and the psychological aftermath of conflict. Trained at Regent's University London, the Tavistock and Portman, and the Anna Freud Centre, his clinical work focuses primarily on community-based care for individuals often excluded from traditional mental health systems. He is faculty, and a supervising analyst at the New School for Existential Psychoanalysis, CA. He is the founder of http://logic23.com/Logic23.com [http://Logic23.com] and http://peacefire.us/Peacefire.us [http://Peacefire.us] and a regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US. He has published more than 30 peer-reviewed works and is currently developing a new book alongside the psychophobia* podcast. — — Episode Chapters 00:00:05 – Intro & Why This Episode Took So Long 00:01:25 – The Yellow Cab: Driving New York 1978-1984 00:04:45 – No Partition: The Vulnerability of the Encounter 00:08:28 – The SRO Hotel, Orwell & The Stories Told at 3 AM 00:11:36 – Inside Attica: Tutoring After the Riots 00:17:59 – A Menace to Society: The Question 00:19:11 – The Boston Globe Series & Two Competing Narratives 00:24:48 – The Harvard Study & The WHO Cross-Cultural Findings 00:30:23 – Why Being Challenged Made the Work Stronger 00:31:27 – Anatomy of an Epidemic & The Harrow-Jobe Story 00:38:07 – Why Informed Consent Is Treated as a Threat 00:42:17 – Michael's Story: Walking Onto the Psychiatric Ward 00:43:39 – Malaysia & The Business of Big Pharma 00:48:25 – Two Impulses Behind Broken Care 00:50:04 – Episodic Problems Made Chronic 00:50:52 – Open Dialogue, The Collapse of the Narrative & Today's Mismatch — — Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychophobia.substack.com [https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Episode 07: Use It or Lose It - The Brain, Lifelong Learning, and the Courage to Stay Curious

“I am still learning.“ — Michelangelo, at age 87 — Sandy Halperin was a Harvard professor so brilliant he could deliver two-hour lectures from memory. A decade into his early-onset dementia diagnosis, Steve Orfield says he was still sharper than most people who didn’t have the condition. When Steve asked CNN’s producers why their ongoing feature kept telling the story of Sandy’s decline rather than what he was still able to do, they refused. It’s the kind of story that runs through every part of this conversation. The founder of Orfield Labs in Minneapolis is a polymath in the old sense -- self-taught in acoustics, lighting, architecture, philosophy of science, and at seventy-something, he says he learns twice as fast as he did in his fifties. He and Michael walk through the principle that anchors his work -- that the parts of the brain you use grow, and the parts you don’t shrink -- and the design philosophy it has produced: facilities for people with dementia where residents start engaging, socializing, and moving like they’re ten years younger; autism buildings that look “boring” to architects because they are quiet and simple, and work for that exact reason; an entire body of evidence that what we call decline is often the environment failing the person, not the other way around. Along the way: the autistic artists whose gestalt perception has taught Steve more than psychology departments, his fractional self-diagnosis of HD without the AD, the international dementia research award his first project won outright, and the worry that AI is quietly making us less able to finish our own setences. If decline is not what we have been told it is -- if the right room can give a person with dementia ten years back, and the wrong room can take them -- then the harder question is what we have agreed to call inevitable, and who pays the price for it. — “In my 70s, I can learn twice as fast as I could in my 50s.“ -- Steven Orfield — — Follow us psychophobia.com [https://psychophobia.com/] | Substack [https://psychophobia.substack.com/] | LinkedIn [https://www.linkedin.com/in/drmontgomery23/] | Instagram [https://instagram.com/psychophobia_project] | Youtube [https://www.youtube.com/@psychophobia_project] Send us a message: https://www.speakpipe.com/psychophobia [https://www.speakpipe.com/psychophobia] Follow Steve Orfield Labs [https://www.orfieldlabs.com/] | Steven Orfield on LinkedIn [https://www.linkedin.com/in/steven-j-orfield/] — — Steven Orfield is a pioneering polymath whose work spans acoustics, lighting, architecture, and sensory science. Founder of Orfield Labs in Minneapolis, he has spent decades designing environments that enhance human perception, from dementia and autism facilities to cutting-edge research in silence and sensory processing. Orfield combines rigorous science with a deep understanding of human experience, challenging conventional approaches to mental health and neurodiversity. He reframes cognitive differences as “filters” rather than deficits, using research and design to improve quality of life. A lifelong learner and innovator, his work demonstrates how thoughtful environments can unlock human potential and transform perception. — Dr. Michael R. Montgomery is an existential psychoanalyst whose work explores the far edges of human experience, including complex trauma, extreme states, addiction, and the psychological aftermath of conflict. Trained at Regent’s University London, the Tavistock and Portman, and the Anna Freud Centre, his clinical work focuses primarily on community-based care for individuals often excluded from traditional mental health systems. He is faculty, and a supervising analyst at the New School for Existential Psychoanalysis, CA. He is the founder of Logic23.com [http://logic23.com/] and Peacefire.us [http://peacefire.us/] and a regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US. He has published more than 30 peer-reviewed works and is currently developing a new book alongside the psychophobia* podcast. — — Episode Chapters 00:00:05 – Intro & The Anechoic Chamber Challenge 00:02:00 – Peace, Polymaths & A Mind Without Boundaries 00:07:08 – 25 Years of Invisible Disabilities: Autism, Asperger’s & The Daily “Replay” 00:15:44 – Schizophrenia, Stubborn Children & The Limits of Diagnosis 00:18:44 – A Daughter Diagnoses Her Father: HD Without the AD 00:25:42 – How Orfield Labs Began: A Storefront, A Chamber & A Building Prince Walked Away From 00:34:51 – Use It or Lose It: The Brain at Seventy & The Sandy Halperin Story 00:40:44 – Filters, Not Deficits: Designing for Autism & Dementia 00:52:41 – Kumbaya Meetings, Veterans & Whale Sounds in the Chamber 00:56:54 – Carl Beam, Ojibwe Art & The National Gallery 01:01:32 – Objective Reality, The Frog & The Limits of Perception 01:10:59 – Stupidifying the Population: AI, Education & The Loss of Liberal Arts — — Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychophobia.substack.com [https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Episode 06: The Seduction of Certainty - Curiosity, Complexity and the Unknown

“I mean Negative Capability, that is when man is capable of being in uncertainties, Mysteries, doubts, without any irritable reaching after fact & reason.” -- John Keats — Certainty is seductive. It simplifies a noisy world, ends evaluation, and offers the relief of a settled answer. But the moment we feel certain, something else quietly closes down: curiosity, and with it, the capacity to perceive what is actually in front of us. In this follow-up to her first appearance, Emma Orfield returns to the conversation after Michael’s visit to Orfield Laboratories, and what began as a discussion about silence widens into a meditation on perception itself - how the anechoic chamber doesn’t add awareness so much as subtract the noise that obscures it, why contrast is the precondition for seeing anything at all, and what happens to a mind when the external world falls quiet enough that it begins to observe itself. From there they move into more uncomfortable terrain: hypersensitivity and the years spent masking it, the over-pathologizing of difference, the McDonaldization of clinical encounter, and the political fragility of nuance in a culture that rewards the tribal answer. They ask what it would take to build environments - therapeutic, social, even internal - where people feel safe enough to tolerate complexity rather than collapse it into judgment. If the mind retreats to simple categories the moment it feels threatened, then the deeper question isn’t how to argue people into nuance - but how to make the world quiet enough that they can bear it. — — Relevant Links* Follow us on* psychophobia.com [https://psychophobia.com] — Substack [https://psychophobia.substack.com/] — LinkedIn [https://www.linkedin.com/in/drmontgomery23/] — @psychophobia_project [https://instagram.com/psychophobia_project] — Youtube [https://www.youtube.com/@psychophobia_project] Follow Emma Orfield Labs [https://www.orfieldlabs.com] — Emma Orfield on Linkedin [https://www.linkedin.com/in/emmaorfieldjohnston/] — — Emma Orfield-Johnston is a researcher and executive at Orfield Laboratories, a multi-sensory design and research firm focused on human perception. Her work explores how environments, sound, light, temperature, and other sensory factors shape human experience and well-being. Emma leads the lab’s therapeutics program, researching the psychological effects of extreme silence using the facility’s renowned anechoic chamber, often described as the quietest place on Earth. Her work focuses particularly on sensory sensitivity and invisible disabilities, including autism, PTSD, and other perceptual differences. — Dr. Michael R. Montgomery* Dr. Montgomery is an existential psychoanalyst with international expertise in complex trauma, extreme states, addiction, and conflict resolution. He trained at Regent’s University London, the Tavistock and Portman, and the Anna Freud Centre. He is the founder of Logic23.com [https://logic23.com] and Peacefire.us [https://peacefire.us], and his clinical work is primarily community-based, focusing on patients typically excluded from quality care. A regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US, he has over 30 published peer-reviewed works and is currently developing a new book alongside this podcast. — — Episode Chapters* 00:00:05 – Psychophobia & Reunion with Emma Orfield 00:01:55 – Freud, Authority & The Unconscious 00:03:25 – Anechoic Chamber Aftermath & Public Reactions 00:06:33 – Anechoic Silence: A Multi-Sensory View 00:11:09 – Darkness, Stillness & Internal Perception 00:17:19 – Homeopathy, Root Causes & Integrative Health 00:20:02 – Anechoic Chamber as Accelerator to Awareness 00:29:55 – Building the Anechoic Chamber Therapeutics Program 00:32:53 – Set, Setting & Safety vs Punishment 00:41:06 – Hypersensitivity, Neurodiversity & Misdiagnosis 00:52:22 – Nuance, Contrast & The Seduction of Certainty 01:23:31 – Scaling the Anechoic Chamber Beyond the Lab — — Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychophobia.substack.com [https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Episode 05: Fierce Compassion - Mystification, and the Living Lineage of R.D. Laing

psychophobia* podcast '“Ultimately, we have just one moral duty: to reclaim large areas of peace in ourselves." — Etty Hillesum — — In a Rome Bookstore, Nita stumbled on R.D. Laing’s The Divided Self in her early twenties. She never quite recovered. What followed wasn’t a career path - it was a calling. Drawn to London in the early 1970s, Nita Gage entered the orbit of Laing’s radical communities, living inside households where people emerging from psychiatric institutions were met not with control, but with curiosity and compassion. Those years dismantled everything she thought she knew about healing, sanity, and what it means to truly be with another person. Fifty years later, Nita and Dr. Montgomery move through breathwork, altered states, and the imaginal journey - into the harder territory of microaggressions, self-righteousness, forgiveness, acceptance, and why detoxing off a substance puts you at Ground Zero with your pain staring back at you. At the center of it all is a single, quietly radical idea: the healer was never the therapist. It was always you. "If you do this well, your students will leave you, do much better than you in the world, and forget they ever learned any of it from you. That's the sign." — Nita Gage — — Follow us on psychophobia.com [https://psychophobia.com] — Substack [https://psychophobia.substack.com/] — LinkedIn [https://www.linkedin.com/in/drmontgomery23/] — @psychophobia_project [https://instagram.com/psychophobia_project] — Youtube [https://www.youtube.com/@psychophobia_project] Follow Nita Soul Whispering by Nita Gage [https://www.amazon.com/Soul-Whispering-Awakening-Shamanic-Consciousness/dp/1591432251] — Nita at Hoffman Institute [nita@hoffmaninstitute.org] Send us a message: https://www.speakpipe.com/psychophobia — — Nita Gage is a psychospiritual teacher, retreat leader, and author whose work integrates psychology, embodiment, and shamanic practice. She trained in psychoanalysis in London with R.D. Laing and colleagues at the Philadelphia Association during the 1970s, an experience that profoundly shaped her understanding of consciousness and healing. Over the past four decades, Gage has worked in clinical settings, addiction treatment, and transformational retreat work. She is the author of Soul Whispering: The Art of Awakening Shamanic Consciousness and continues to lead workshops and retreats focused on personal transformation and expanded awareness. Dr. Michael R. Montgomery Dr. Montgomery is an existential psychoanalyst with international expertise in complex trauma, extreme states, addiction, and conflict resolution. He trained at Regent’s University London, the Tavistock and Portman, and the Anna Freud Centre. He is the founder of Logic23.com [https://logic23.com] and Peacefire.us [https://peacefire.us], and his clinical work is primarily community-based, focusing on patients typically excluded from quality care. A regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US, he has over 30 published peer-reviewed works and is currently developing a new book alongside this podcast. — — 0:00:00 – The Book That Changed Nita’s Life 0:02:30 – Entering R.D. Laing’s World 0:07:30 – India, Mysticism & Disillusionment 0:15:50 – The R.D. Laing Symposium 0:22:00 – Breathwork Explained 0:34:45 – Micro-Harm & Radical Self-Reflection 0:49:10 – Conflict, Fear & Human Needs 1:06:50 – Acceptance vs Forgiveness 1:23:00 – Addiction & Trauma 1:40:30 – Hoffman Process & Self-Compassion — — Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychophobia.substack.com [https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Episode 04: Alcohol and Agency - The Question of Informed Choice

psychophobia* podcast “The chains of habit are too weak to be felt until they are too strong to be broken.”— Samuel Johnson — — Alcohol is one of the most culturally protected forms of psychological escape - normalized, celebrated, and rarely examined with the seriousness it demands. Beneath its social acceptability lies something more unsettling: a substance that numbs not only pain, but possibility. Michael sits down with Gary Allen, nearly eight years alcohol-free, to explore what happens when someone steps outside drinking culture entirely. Together they examine the mythology surrounding alcohol, the quiet ways it becomes a solution to existential discomfort, and how removing it often reveals deeper psychological terrain beneath. Moving beyond addiction narratives, the conversation turns toward informed choice, cultural conditioning, and the illusion that alcohol helps us face life when it may actually help us avoid it. If alcohol numbs across the board - dulling anxiety, but also clarity - what happens when the numbing stops, and you’re left with yourself? “If people are liberated to see that they have agency and they have choice, they are empowered and potentially self-liberated.” — Dr. Micharl R — — Follow us on psychophobia.com [https://psychophobia.com] | Substack [https://psychophobia.substack.com/] | LinkedIn [https://www.linkedin.com/in/drmontgomery23/] | @psychophobia_project [https://instagram.com/psychophobia_project] Follow Gary garyallen.ie [http://garyallen.ie] | Gary Allen on LinkedIn [https://www.linkedin.com/in/coachgaryallen/] Send us a message: https://www.speakpipe.com/psychophobia [https://www.speakpipe.com/psychophobia] — — Gary Allen, PCC is an alcohol-free coach, group facilitator, and advocate for a more conscious relationship with substances. After stepping away from alcohol nearly eight years ago, he experienced profound shifts across his emotional, physical, and professional life, ultimately transitioning from a 30-year career in IT into coaching and human development work. Today, Gary helps individuals examine their relationship with alcohol, explore ambivalence without shame, and reclaim agency in a culture where drinking is often treated as the default, emphasizing informed choice, curiosity, and sustainable change over rigid labels or all-or-nothing frameworks. Dr. Michael R. Montgomery Dr. Montgomery is an existential psychoanalyst with international expertise in complex trauma, extreme states, addiction, and conflict resolution. He trained at Regent’s University London, the Tavistock and Portman, and the Anna Freud Centre. He is the founder of Logic23.com [https://logic23.com] and Peacefire.us [https://peacefire.us], and his clinical work is primarily community-based, focusing on patients typically excluded from quality care. A regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US, he has over 30 published peer-reviewed works and is currently developing a new book alongside this podcast. — — Episode Chapters 00:05 — Intro to Psychophobia & Meeting Gary Allen02:50 — Eight Years Alcohol-Free & Life Transformation06:39 — One Day at a Time & Building New Habits09:56 — Reframing Sobriety & Drinking Culture17:39 — Alcohol, Numbing & Underlying Mental Health22:24 — Gary’s Story: Disability, IT Career & Coaching38:27 — Agency, Relapse & Curiosity Over Shame49:58 — The Cost of Drinking vs. The Cost of Not Drinking53:29 — Alcohol, Habit & Informed Choice1:19:54 — How to Start & Where to Get Help — — Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychophobia.substack.com [https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1]