There is a generation of filmviewers that cannot separate Vincent Cassel, 59, from the 1995 movie La Haine (Hate), where he dominated the screen. Although more than three decades have passed, Mathieu Kassovitz’s film was already exposing the seams of modern France. A Jewish kid from the Parisian suburbs, inflamed by frustration, resentment, the poison of social exclusion, a constant sense of injustice and a desire for revenge after a friend gets killed by the police. Vince, but also Saïd and Hubert, his closest friends, formed a trio that would be unlikely today in the banlieues of the Paris periphery. An Arab, a Black man and a Jew united by that prescient smell of fracture, exclusion and identity conflicts that began to feed the hatred and stoke the fire of the far right.
Production: Nono Vázquez. Photography assistants: Emilio Azevedo and Adrián Wong. Production assistants: Laura Gimenez and Isabel Orozco. Makeup and hair: Anne Bochon. Movement direction: Pauline Gudet. Video: Daniele Vaia. Studio: Paul Le Cacheux Photographer.
When singer Rihanna arrived Wednesday night at the Matières Fécales fashion show—the most provocative, extravagant, and “cool” brand of Paris Fashion Week—photographers from media outlets around the world swarmed around her to capture her from every angle and in every possible format. Her “look,” created by the brand for the occasion, instantly became global news. In other words, the very reason she—and no one else—had been invited as the star guest was more than fulfilled. And yet, on that very same day, Georgian journalist Beka Gvishiani, better known as Style not com, dared to publicly state what no one had pointed out before: that the diva had kept more than five hundred people waiting for her for an hour.
All the journalists at this publication confirm that this habit is deeply ingrained in the artist. In fact, fashion editor Leticia García points out that it’s common knowledge in any city hosting fashion events featuring the singer that delays for everyone in the industry are guaranteed. In other words, Rihanna’s presence is excellent news for brands, which gain visibility, but very bad news for those working in the industry who see their work systematically slowed down. García experienced firsthand a delay of an hour and a half a year ago at an Off-White fashion show, right after having waited an hour for her at the Dior show. In the Style not com post, quite a few reporters allude to other epic delays: author Eva Chen recalls, for example, that Azzedine Alaïa show in New York in 2024, when she kept everyone on tenterhooks for 40 minutes. Patricia Rodríguez was present on that occasion and recalls the brand’s public relations staff saying, “We know she’s always late; what we don’t know is by how much.” Beatriz García, who has been covering the early-morning hours of the MET Gala for years, knows full well that the artist is always the last to appear. She is, quite literally, the most eagerly awaited.
It’s obvious that in this case, the delay is a “marketing” strategy like any other: making people wait is yet another way to create a sense of luxury and exclusivity. The expression “fashionably late” exists for a reason: in the fashion world, it’s very common for high-profile figures to make people wait in order to project a sense of status. To illustrate this, consider a remark made in 1995 by model Kate Moss — who is also notoriously tardy — when she was asked if she was generally as late as her colleague Naomi Campbell. With a horrified expression, she exclaimed, “No one is as late as Naomi!” There is, moreover, a completely different notion of time for divas in the entertainment world — a phenomenon that has been studied both by psychologists and psychiatrists, who argue that creative people easily become absorbed in their train of thought, so that minutes pass differently for them than for other people; as well as by film experts, who discuss how stars expand to occupy space and time in an unconventional way. This is what German film director Rainer Werner Fassbinder coined as “diva time.”
However, Rihanna shatters all boundaries. Last year, at an event in India for her own makeup brand, the hugely popular Fenty, she kept everyone waiting for seven hours. The event began for guests and influencers at 7:30 p.m. on Friday, but she didn’t appear on the red carpet until 3:00 a.m. on Saturday. The delay led to some surreal moments, such as when influencers Parul Gulati and Smriti Khanna posted AI-generated images of themselves with the singer after being unable to take a photo with her in person. Columnist George Whirl comments on Style not com that Rihanna’s attitude is “gauche” — that is, tacky and rude, in French. But an anonymous user points out that this behavior isn’t limited to her brand commitments or her professional life: at her concerts, it’s also common for her to show up at least two hours late to present herself to her audience. Publicist Deshiv Puri, however, proposes a simple solution to the problem: “When we invited Cardi B to a Rahul Misra fashion show and she was late, the show started without her.” The problem is that we may be dealing with one of those rare cases where the show is, in fact, the guest herself.
The Trump administration’s immigration policy and the state of the economy are prompting a shift of Latino voters back toward the Democrats. Although many remain undecided, a new poll shows that in the November midterms, Democratic congressional candidates will receive between six and 10 percentage points more of the Hispanic vote compared with Kamala Harris’s 2024 results. By contrast, Republicans would lose five points of the votes Trump won among this electorate. On November 3, all seats in the House of Representatives and one-third of the Senate are up for election, as well as 36 governorships.
There is a phrase in Trumpist newspeak used to indicate that the president of the United States is on top of matters — “maintains laser focus.”The problem, just a little over a month before the midterms, is that polls show voters are not satisfied with the issues Trump is pointing that laser at.
What follows is twelve documented findings compressed into one sitting. It is written for the reader who has been prescribed one of these drugs, or is caring for someone who has, and who wants to know what the fifteen-minute consultation did not include. Every claim is drawn from the profession’s own literature, its own regulatory filings, its own package inserts, or the admissions of its own senior figures. Where an item is developed at greater length elsewhere in this series, that is noted. The purpose here is not depth on any single item. It is the cumulative weight of the twelve landing together.
Opening
Three percent of the 4,041 patients enrolled in the STAR*D trial remitted, stayed well, and remained in the study through the one-year follow-up.¹
The trial was announced with a cumulative remission figure of 67 percent.² When Ed Pigott and colleagues spent more than five years reanalyzing the data with fidelity to the original protocol, they found the 3 percent figure. When journalists put the 3 percent number to Maurizio Fava, one of the lead investigators, he acknowledged it was accurate. The investigators knew.³
The paper has not been retracted. It is still cited in psychiatric textbooks. The American Journal of Psychiatry ignored a petition signed by more than 1,800 people asking for retraction. The New York Times, repeatedly notified of the fraud, published the 70 percent figure again in a 2024 article praising the drugs.⁴
STAR*D was the largest depression trial ever conducted. It was funded by the National Institute of Mental Health. It was designed by the profession’s most senior researchers. What it proved, when honestly analyzed, was that the drugs did not work.
That fact has been available for over a decade. It has not reached the patients being handed the prescriptions.
What This Essay Draws On
Six of the twelve items below have been developed at greater length in earlier essays in this series: chemical imbalance theory, benzodiazepine dependence, ADHD stimulants, antipsychotic brain damage, SSRI withdrawal, and long-term antidepressant outcomes. Readers who want depth on any of those threads should follow them. The purpose of this essay is different. Twelve items, four sections, one sitting.
The evidence throughout is drawn primarily from Peter Gøtzsche, Robert Whitaker, Peter Breggin, Gary Greenberg, David Healy, and Joanna Moncrieff. What the twelve items share is that none of them are contested at the level of documentation. They are contested only at the level of what the profession chooses to tell patients.
What They Told You Was True
The prescription is written on the basis of a mechanism, a diagnosis, and a trial. Each has failed on its own terms.
1. The chemical imbalance was never demonstrated
The theory that depression results from a deficiency of serotonin was never established in the scientific literature. Joanna Moncrieff and colleagues published a comprehensive umbrella review of the serotonin theory in 2022 and found no consistent evidence for its central claims.⁵ The theory was abandoned by serious researchers decades earlier. It continued to appear in direct-to-consumer advertising and patient education materials because it served a function. It explained why the pill was necessary and why the patient would need to keep taking it.
Steven Hyman, director of NIMH from 1996 to 2001, later observed that “the gold standard was the DSM criteria. It struck me as a fool’s errand to try to develop a biomarker for a fictive category.”⁶ The chemical imbalance was the mechanism proposed for a disease no one could measure, in a category no one could validate.
After four decades and hundreds of millions of dollars in federal research, not one disorder in the Diagnostic and Statistical Manual of Mental Disorders has a confirmed biological test. Not depression. Not schizophrenia. Not bipolar disorder. Not ADHD. Not anxiety. Not any of the more than three hundred conditions the manual lists.
Robins and Guze proposed a five-step validation process in 1970: clinical description, laboratory studies, exclusion criteria, follow-up studies, family studies.⁷ The five steps were meant to establish, over time, which alleged disorders were real diseases and which were figments. Four decades later, Darrel Regier, who chaired the DSM-5 task force, told Psychiatric News that “validity tests have not lived up to the expectations of Robins and Guze.”⁸ Kenneth Kendler, the field’s leading nosologist, wrote that the diagnostic categories in use had been “heavily influenced by expert opinion” and were “fuzzy constructs that shift when viewed in different ways.”⁹
Thomas Insel, director of NIMH from 2002 to 2015, put it most directly in a 2005 address to the American Psychiatric Association: “The DSM-IV has 100 percent reliability and zero percent validity.”¹⁰ Reliability means clinicians using the same manual will arrive at the same diagnosis. Validity means the diagnosis corresponds to a real thing. Insel was telling the assembled profession that its manual sorted patients consistently into categories that did not exist.
The APA response was to convene committees to plan the DSM-5. The committees did not find biological markers. They could not have. The categories were not built to have biological markers. They were built from clinical description alone. The manual reifies its own criteria.
The consequence for the patient is direct. When the doctor says “you have major depressive disorder,” the patient hears a diagnosis in the sense that a diabetes diagnosis is a diagnosis: a measurable biological state with a known mechanism. What the patient has actually received is a checklist tally. Five of nine symptoms present for two weeks. That is the whole test. There is no blood work, no scan, no biomarker. The diagnostic bible of American psychiatry sits on the shelf as an artifact of expert agreement, not a description of nature.
The opening figures bear structural repetition: 3 percent versus 67 percent, admitted by the lead investigator, still not retracted, still cited. Ed Pigott’s reanalysis was published in BMJ Open in 2023.¹¹ The investigators, when confronted, doubled down on the fraud in the American Journal of Psychiatry rather than correct it.¹² The owner of the journal, the American Psychiatric Association, did nothing.
Peter Gøtzsche has documented the specific manipulations. The “remission” threshold was set so low that a patient scoring 7 on the Hamilton depression scale, including endorsement of “feels like life is not worth living,” was counted as symptom-free.¹³ Patients who exited the study were assumed to have remitted at the same rate as those who stayed, a statistical fiction that inflated the numbers by an order of magnitude. Eleven prespecified outcomes were never reported. Suicidal ideation was reported at 0.7 percent in one paper and ten times that in others by the same authors.
The trial that was supposed to establish the effectiveness of antidepressants in real-world practice established the opposite. The profession’s response was to continue citing the announced figure.
The prescription arrives with the phrase “you may notice some side effects.” The phrase does the work of concealment. Three effects, in particular, are not warned about with the seriousness they warrant.
4. Akathisia carries documented suicide risk
Akathisia is a state of extreme inner restlessness produced by antidepressants, antipsychotics, and antiemetics. The Greek term means inability to sit still. The patient may pace, fidget, wring hands, or endlessly walk. The condition may also present without visible motor symptoms, as unbearable internal agitation the observer cannot see.¹⁴
In 1990, Martin Teicher and colleagues at Harvard published five cases of patients who developed intense suicidal preoccupations on fluoxetine, all associated with akathisia, all resolving when the drug was stopped and returning when it was restarted.¹⁵ Rothschild and Locke published the rechallenge study in 1991: three patients who had made serious suicide attempts on fluoxetine, all rechallenged under controlled conditions, all developing akathisia and becoming suicidal again. One patient said in retrospect: “I tried to kill myself because of these anxiety symptoms. It was not so much the depression.”¹⁶
A study of psychiatric inpatients found that 79 percent of those who had attempted suicide were experiencing akathisia at the time.¹⁷ Another found that half of all fights on a psychiatric ward were akathisia-related. Haloperidol at moderate to high doses made half the patients markedly more aggressive, sometimes to the point of wanting to kill their psychiatrists.
The FDA’s 2004 black-box warning on antidepressants describes what Breggin has called the stimulant syndrome: anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, mania.¹⁸ The label warns that these can occur in nonpsychiatric patients, meaning the drug produces the syndrome by itself, not by unmasking a preexisting condition.
Gøtzsche’s team examined manufacturer trial data and found akathisia miscoded as “hyperkinesia” in Zoloft trials. In paroxetine trials they found not a single case of akathisia recorded, which is statistically impossible given the drug class.¹⁹ The miscoding was systematic.
The FDA-approved label for Zyprexa describes akathisia as “extreme inner anxiety and restlessness.” At least one psychiatric textbook labeled it “agitated depression,” folding the drug’s most dangerous effect back into the diagnosis it was prescribed to treat. The patient who reports the akathisia is told the underlying illness has worsened. The dose is increased.
5. Benzodiazepine dependence begins at prescribed doses
The FDA-approved label for Xanax states that withdrawal symptoms, including seizures, have been reported after only brief therapy at doses within the recommended range for treating anxiety.²⁰ In the eight-week trials used for FDA approval, patients were worse off at eight weeks than before starting the drug. Between 7 and 29 percent of patients could not withdraw after only six to eight weeks of exposure.²¹
If you are currently taking a benzodiazepine, do not stop it abruptly. Abrupt cessation can produce seizures. Item 12 addresses what safe withdrawal actually requires.
Heather Ashton, the British psychiatrist who ran a benzodiazepine withdrawal clinic at the University of Newcastle for decades, documented that long-term users often required a year or more to taper.²² Some experience withdrawal symptoms lasting years after cessation. Cognitive impairment, depression, and anxiety worse than the original condition are common outcomes of long-term use.²³ Gøtzsche, who has decades of clinical pharmacology experience, has noted that patients report benzodiazepine withdrawal as often worse than heroin. Heroin abstinence symptoms resolve within days. Benzo withdrawal can persist for years.
6. ADHD stimulants produce the symptoms they treat on withdrawal
The DSM has a category for stimulant withdrawal, which lists depression, anxiety, irritability, sleep problems, fatigue, and agitation as the withdrawal syndrome after “several days or longer” of use. Rebound hyperactivity, talkativeness, and inattention are documented after a single dose in a placebo-controlled NIMH study of normal children ages 6 to 12.²⁴ Ten of fourteen children in that study showed marked behavioral rebound; three developed euphoria.
If a child is currently taking a stimulant, do not stop it abruptly. Rebound and withdrawal effects are commonly mistaken for a worsening of the original condition. Item 12 addresses safe withdrawal.
The teacher observes the child on Monday morning after a weekend off the drug, notices the child is more scattered and irritable than usual, and concludes the child needs the medication. The child is in withdrawal. The dose is increased. Peter Breggin’s observation from the early 1990s stands unchanged three decades later: if the child continues on Ritalin because they continue to have problems focusing, the disorder may be the drug’s effect.²⁵ Drug-induced inattention becomes the reason to continue and increase the drug.
The Multimodal Treatment Study of ADHD, the largest NIMH-funded stimulant trial, tracked children through eight years of follow-up. By three years, the medicated children showed no advantage over the non-medicated on any measure. They were, however, 2 cm shorter and 2.7 kg lighter than their unmedicated peers, a growth suppression the FDA eventually required on the label.²⁶
The drugs act on the brain and the brain responds. What the brain does under sustained chemical assault is documented in the profession’s own imaging studies.
7. Antipsychotics shrink brain tissue on MRI
Nancy Andreasen, editor-in-chief of the American Journal of Psychiatry from 1993 to 2005, began a longitudinal MRI study of over 500 first-episode schizophrenia patients in 1989. In 2003, she reported that frontal lobe white matter volume decreased progressively over the years of treatment.²⁷ In 2011, her team published in Archives of General Psychiatry the finding that antipsychotic exposure was directly associated with volume loss.²⁸ In a 2008 interview with the New York Times, Andreasen stated it plainly: “The more drugs you’ve been given, the more brain tissue you lose.”²⁹
Fusar-Poli and colleagues confirmed the pattern in a 2013 meta-analysis of longitudinal MRI studies.³⁰ The 2009 Navari and Dazzan review reported that both older and newer antipsychotics produce gross changes in brain volume in selected regions.³¹ In monkey studies, haloperidol and olanzapine produced substantial reductions in both grey and white matter, and reduced glial cell numbers.³²
Andreasen’s original interpretation was that the shrinkage reflected the disease. The follow-up data forced her to concede the drug was the cause.
Tardive dyskinesia is a drug-induced movement disorder produced by antipsychotics. It can affect any voluntary muscle: face, tongue, neck, torso, extremities, diaphragm, vocal cords. The condition presents as involuntary jerky movements, slower writhing movements, painful spasms, or restlessness the patient cannot control. The mechanism is understood. Antipsychotics block dopamine receptors in a brain region called the basal ganglia. Over time the brain compensates by growing more of those receptors. When the drug dose is reduced, or when the extra receptors eventually outnumber the block, the excess drives the involuntary movements.
The prevalence is not marginal. DSM-IV-TR sets the annual incidence at 3 to 5 percent per year in young adults and 25 to 30 percent per year in older patients.³³ These are cumulative rates. A young adult after three years of exposure has a 9 to 15 percent risk. An older patient after three years has a 75 to 90 percent risk. Prevalence in outpatient clinics runs above 40 percent. In long-term facilities, above 50 percent.³⁴ There is no established treatment. Most cases are permanent.
The condition often extends beyond motor symptoms. Gualtieri and Barnhill observed that “in virtually every clinical survey that has addressed the question, it is found that TD patients, compared to non-TD patients, have more in the way of dementia.”³⁵ Breggin has called this tardive dementia. Tardive akathisia and tardive psychosis have also been documented, representing further permanent damage to the higher brain function of patients whose brains were supposed to be helped.
The condition is frequently masked by the drug that caused it. Increasing the dose suppresses the visible movements while the underlying damage progresses. Reducing the dose brings the movements out, which the prescriber may interpret as evidence that the patient still needs the medication. The patient’s brain, already damaged, is offered more of what damaged it.
The neurological literature has documented tardive dyskinesia for over five decades. It is required disclosure on antipsychotic labels. It is not routinely disclosed at the point of prescription.
Electroconvulsive therapy applies electrical current to the head sufficient to produce a grand mal seizure. In modern practice, the patient is anesthetized and given a muscle relaxant to prevent the visible convulsion. The electrical dose is often increased to compensate for the seizure threshold raised by the anesthesia. Multiple treatments are given, typically 8 to 16 per course, sometimes more.
Autopsy studies dating to the 1940s documented brain necrosis in patients who died following ECT.³⁶ Animal studies documented brain damage. The brain’s response to ECT is an acute organic brain syndrome, medically indistinguishable from severe head injury. In neurological terms, multiple continuous seizures without full recovery of consciousness constitute status epilepticus, a medical emergency defined by its risk of permanent brain damage.
The memory loss is documented in every serious study that has looked for it. Larry Squire and Pamela Slater reported an average of 27 months of retrograde amnesia surrounding treatment.³⁷ Freeman and Kendell, using face-to-face interviews conducted by the treating doctors themselves (a design that biased strongly against reporting), found that 74 percent of patients reported memory impairment and 30 percent said their memory function was permanently affected.³⁸ Squire and Slater’s own longer follow-up found that 55 percent of patients felt they had not regained normal memory function over the years.
Gøtzsche summarizes the current literature: with strict definitions of memory loss, 29 to 55 percent of patients are affected. With looser criteria, 51 to 79 percent.³⁹ Death rates from ECT, according to a systematic review by John Read and colleagues, run at approximately 1 per 1,000 treatment courses, ten times higher than the American Psychiatric Association’s stated figure.⁴⁰
The efficacy evidence is thinner than the harms evidence. The 1985 NIMH Consensus Conference on ECT accepted the finding that no controlled study showed benefit beyond four weeks. The four-week window corresponds to the acute organic brain syndrome, during which severe brain dysfunction produces the euphoria or apathy interpreted as improvement.⁴¹ Once the brain begins to recover, the depression returns. If the patient is given more ECT, the brain damage accumulates. If the patient is not given more ECT, the profession points to the returning depression as evidence the disease was chronic.
The APA’s 1990 task force report on ECT omitted essentially the entire literature documenting memory loss and brain damage.⁴² The literature it omitted included the work of Squire, Slater, Janis, Friedberg, Breggin, and even the APA’s own previous 1978 report, which contained more information on memory loss than the 1990 update. In psychiatry, science sometimes runs backward.
At some point the patient decides they no longer want to be on the drug. The system was not built to help them leave.
10. SSRI discontinuation can last years
The FDA-approved labels describe “discontinuation syndrome.” Patients and doctors alike were told the symptoms would last a few weeks and resolve. The systematic review by Davies and Read, published in 2019, established that this was false. Withdrawal symptoms are more common than reported, more severe than reported, and last far longer than reported. In one survey of 580 patients, 16 percent reported withdrawal symptoms lasting over three years.⁴³
If you are currently taking an SSRI or SNRI, do not stop it abruptly. Withdrawal reactions can include severe agitation, akathisia, suicidal ideation, and violence. Item 12 addresses the resources for safe tapering.
The Dutch tapering-strip program run by Peter Groot and Jim van Os has documented the shape of the problem. Of 895 patients on antidepressants, 62 percent had previously tried to withdraw without success. Using hyperbolic dose-reduction strips, 71 percent were able to withdraw within a median of 56 days.⁴⁴ Venlafaxine required 90 percent of patients to start at the lowest available dose and taper over three months. Some patients required more than six months. Dutch insurers refused to reimburse extended tapering because “there is no evidence in the literature” for its necessity, a circular defense against the very treatment the literature was documenting.
The withdrawal is routinely misinterpreted as return of the underlying illness. The patient is told they were unwise to stop and needs to remain on the drug indefinitely. Breggin’s term for this pattern is medication spellbinding. The drug produces effects the patient attributes to the disease.
11. Long-term outcomes are worse with the drugs than without them
The 1997 British study of a large inner-city primary care facility followed 95 never-medicated depressed patients and 53 drug-treated ones. Symptom reduction at six months: 62 percent for the never-medicated, 33 percent for the drug-treated.⁴⁵ A World Health Organization study of 640 depressed patients found that medicated patients had worse general health and were more likely to still be mentally ill at one year.⁴⁶ A Canadian five-year study of 9,508 depressed patients: 19 weeks of depression per year for the medicated, 11 for the unmedicated.⁴⁷ An NIMH study of 547 patients: medicated patients were three times more likely to lose their principal social role and nearly seven times more likely to become incapacitated at six years.⁴⁸
Rif El-Mallakh reported that 40 percent of patients on antidepressants end up in a chronically depressed “treatment resistant” state.⁴⁹ Giovanni Fava documented that drug changes induced by antidepressants “may propel the illness to a more malignant and treatment unresponsive course.”⁵⁰
The pattern extends to antipsychotics. Martin Harrow’s 15-year follow-up of first-episode psychosis patients found that those not on antipsychotics had significantly better outcomes and were far more likely to be in recovery.⁵¹ Lex Wunderink’s 7-year Dutch trial randomized first-episode psychosis patients to maintenance antipsychotics or dose reduction and discontinuation. The reduction group had double the recovery rate.⁵² Bockoven had documented in 1975 that rehospitalization rates rose after the introduction of antipsychotics and that medicated patients were more socially dependent than those treated in the pre-drug era.⁵³
The pattern is consistent across drug classes and across decades. Longer exposure produces worse outcomes. The drugs sensitize the brain and convert episodic distress into chronic dysfunction. The profession’s response has been to rewrite the natural history of the conditions to match the drug-damaged outcomes. The 1999 American Psychiatric Publishing Textbook of Psychiatry declared that older studies showing depression was self-limiting had been “disproved.” Depression became “a highly recurrent and pernicious disorder.”⁵⁴ The drugs had made it so.
12. Tapering protocols do not exist in most medical schools
The prescriber who put the patient on the drug is typically not trained in how to help them come off it. Withdrawal is not covered in the standard psychiatric curriculum. The tapering approach with the strongest evidence base is hyperbolic dose reduction, developed by Mark Horowitz and Joanna Moncrieff and published in Lancet Psychiatry in 2019.⁵⁵ The approach requires micro-dose reductions of a few percent at a time, made possible by liquid formulations or compounded tapering strips. Standard tablets do not come in the small doses required.
Peter Gøtzsche’s team spent two years trying to publish a Cochrane review protocol on antidepressant withdrawal support. The Cochrane depression group, chaired by Rachel Churchill, raised objections through 12,044 words of feedback across 86 numbered points, then rejected the protocol.⁵⁶ Cochrane refused to publish a review on how to help patients safely withdraw from a class of drugs prescribed to hundreds of millions of people worldwide. Gøtzsche’s PhD student Anders Sørensen mentored 30 consecutive patients through withdrawal in his unpaid spare time and documented the results, because it was the only way to do the work.
The insurance system compounds the problem. Dutch national health insurance refuses to reimburse extended tapering on the grounds of insufficient evidence, though the evidence exists and the insurers know it does. American insurers do not cover compounded formulations. The tapering strips developed at the Amsterdam pharmacy (taperingstrip.org) are available to prescribers in any country, but the patient must find a prescriber willing to order them, which many will not.
The knowledge exists. The Ashton Manual for benzodiazepine withdrawal has been public since 2002.⁵⁷ The Horowitz-Moncrieff hyperbolic tapering literature is in peer-reviewed journals. Mad in America hosts a withdrawal community with thousands of patients’ documented experiences. Breggin’s Psychiatric Drug Withdrawal was published in 2013.
None of it is on the psychiatric residency reading list. The doctor who wrote the prescription is, in most cases, not the doctor who can help the patient stop taking it. The patient is on their own.
The most common defense of the current prescribing paradigm is that the drugs help some patients, and that essays like this one endanger those patients by encouraging them to stop.
Some patients do report subjective benefit on these drugs. That is not disputed. What is not established is that this benefit exceeds placebo by a clinically meaningful margin, or that it survives the long-term outcomes documented in Item 11.
The safety caveats throughout this essay, and the resources listed below, exist precisely because abrupt cessation is dangerous. Nothing here recommends abrupt cessation. What is recommended is informed choice, which requires the twelve findings to be visible before the prescription is written or renewed. A patient who wishes to continue after seeing the twelve findings has made a different decision from a patient who was never shown them.
Resources
For patients currently on psychiatric drugs who wish to withdraw, resources exist outside the mainstream medical system. The Ashton Manual (benzo.org.uk/manual/) remains the standard reference for benzodiazepine tapering. The Horowitz-Moncrieff papers on hyperbolic tapering in Lancet Psychiatry (2019) provide the scientific basis for SSRI withdrawal. Mad in America (madinamerica.com) hosts an active community of patients who have withdrawn or are withdrawing. The Amsterdam tapering strip program (taperingstrip.org) makes hyperbolic dose reduction physically possible for antidepressants that do not come in the required small doses. Breggin’s Psychiatric Drug Withdrawal (2013) provides detailed clinical protocols. None of the above require permission from the prescribing physician. All require time and typically a support person. None should be attempted abruptly.
Closing
The twelve findings above are documented. They are not concealed by conspiracy. They sit in FDA labels, peer-reviewed journals, systematic reviews, and the admissions of senior figures within the profession. What conceals them is training.
Psychiatric residency does not require reading Whitaker or Breggin or Gøtzsche. It does not require examining the primary trial data on the drugs the resident will spend a career prescribing. It requires reading the textbooks the profession publishes about itself, the same textbooks that praised electroconvulsive therapy while omitting the memory-loss literature and that continue to cite the STAR*D 67 percent figure. The continuing medical education the practicing psychiatrist attends is funded largely by the pharmaceutical industry, whose interest in the twelve findings is that they should not surface. The drug representatives who visit the office once a month are the primary source of pharmacological information for many prescribers.
The doctor across from the patient in the fifteen-minute consultation is often not withholding information out of malice. The doctor does not have it. What was left out of the training reproduces itself in every consultation the doctor conducts for the rest of the career.
The training explains the local silence. It does not explain how the whole enterprise reached the point where twelve findings of this severity could accumulate without institutional response. That answer comes from someone who ran the enterprise.
Thomas Insel directed the National Institute of Mental Health from 2002 to 2015. He controlled the American federal research budget for psychiatry for thirteen years. He was, in that period, the single most powerful figure in American psychiatric science.
Reflecting on his tenure after leaving the position, he made the following observation, widely reported and repeated in the years since:
I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders. And when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs, I think $20 billion, I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.⁵⁸
Twenty billion dollars over thirteen years, and the head of the enterprise said it moved nothing on suicide, hospitalization, or recovery.
That is not the assessment of a critic. That is the man who ran the enterprise, describing the enterprise, from inside it. Insel went on to write a book defending psychiatric drugs, so the admission cannot be attributed to conversion or apostasy. He continues to believe in the paradigm. He just concedes it produced nothing.
The twelve items above sit inside that enterprise. What the psychiatrist was trained not to tell the patient is what the man who ran it for thirteen years, on his own accounting, could not deny.
How to Explain It to a Six-Year-Old
Imagine a garage that has been fixing cars for many years. Every car that leaves the garage has a bumper sticker that says FIXED.
One day someone counts. Out of every hundred cars leaving the garage, only three actually work. Ninety-seven do not.
The garage keeps operating. The mechanics keep putting on the FIXED stickers. The owner keeps telling everyone the garage fixes seven cars out of every ten.
When someone points out that the real number is three out of a hundred, the owner says yes, he knows the real number is three. He does not correct the seven-out-of-ten claim. He does not put up a new sign. He keeps the stickers.
The people bringing in their cars do not know about the three. They see the FIXED sticker and they drive off. Some of the cars catch fire on the highway. Some of the brakes fail. Some of the cars will not start again once they are turned off.
When people bring the broken cars back, the garage says the problem is not with the fix. The problem is with the car.
That is the garage. The cars are patients. The stickers are prescriptions. The garage is a whole profession.
In Print
The Unbekoming library is available in paperback, printed to order through Lulu and shipped worldwide. The shelf begins with the paradigm question underneath everything else — No Virus, the isolation problem, the collapse of virology’s foundational claims, and a disease-by-disease reappraisal — and moves through the suppressed compounds mainstream medicine set aside: The DMSO Book, Chlorine Dioxide: The Forbidden Remedy, The Iodine Book, and The Hydrogen Peroxide Book. Two more recover what’s still on the kitchen shelf: Baking Soda and The Castor Oil Book. Two more recover the minerals modern soil, water, and processing quietly stripped from the diet: The Magnesium Handbook and The Boron Book. Sitting alongside these is No Contagion, co-authored with Jamie Andrews — the case against germ theory itself, catalogued through 258 failed contagion experiments.
The critique books cover what medicine, dentistry, psychiatry, and veterinary practice have become. The Unvaccinated treats the completely unvaccinated as a comparison group across twenty chapters and five appendices. Medicalized Motherhood follows a woman through 123 documented interventions from teenage pill to postpartum discharge. Drilling for Profit treats cavities, gum disease, and crooked teeth as the dietary problem they are. What Your Vet Can’t Tell You applies the same critique to pets. Escape from Psychiatry documents the fabrication of the DSM and the specific damage of every major psychiatric drug class. The Vitamin K Injection covers what happens in the first hours of a newborn’s life.
The full shelf is at lulu.com/spotlight/unbekoming. A physical book reaches the person a Substack post never will — the skeptical relative, the friend who won’t click a link but might open a book, the visitor whose eye lands on a coffee table. Buy one to keep, and one to give away.
New Biology Clinic
For those of you looking for practitioners who actually understand terrain medicine and the principles we explore here, I want to share something valuable. Dr. Tom Cowan—whose books and podcasts have shaped much of my own thinking about health—has created the New Biology Clinic, a virtual practice staffed by wellness specialists who operate from the same foundational understanding. This isn’t about symptom suppression or the conventional model. It’s about personalized guidance rooted in how living systems actually work. The clinic offers individual and family memberships that include not just private consults, but group sessions covering movement, nutrition, breathwork, biofield tuning, and more. Everything is virtual, making it accessible wherever you are. If you’ve been searching for practitioners who won’t look at you blankly when you mention structured water or the importance of the extracellular matrix, this is worth exploring. Use discount code “Unbekoming” to get $100 off the member activation fee. You can learn more and sign up at newbiologyclinic.com
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Ilias Kasidiaris, a former MP of the neo-Nazi Golden Dawn party, who was released from prison last week, announced on Monday, his support for a new far-right party called the Alliance of Greeks. As KTG reported last week HERE, Kassidiaris is eager to return to politics, however, legislation makes it impossible for convicts for crimimal […]
Former MP of neo-Nazi Golden Dawn party, Ilias Kasidiaris was released from Domokos Prison at noon on Tuesday after serving the lengthy sentence imposed on him for his actions as the ‘first lieutenant’ within the criminal organisation Golden Dawn, a neo-Nazi group that had entered Parliament at the height of the Greek crisis. Kasidiaris supporters […]
The White House ballroom project is wildly unpopular. Donald Trump doesn’t care. Ben Terris reports on Trump’s obsessive bid for architectural immortality, which is now barreling toward completion, and captures the breathtaking sycophancy required to work for this president:
“We had asphalt going into here,” Trump says, standing on the pathway leading to the residence of the White House. “Now you have the best stone.” He points at a pile of square-cut granite—the type being used to replace the asphalt walkway—and looks to his communications director, Steven Cheung, who is accompanying us on this impromptu tour of the White House grounds en route to the construction site.
“That’s some stone, huh, Steven?” he says.
“It’s incredible,” Cheung concurs.
“Look at the thickness of it,” Trump says. “Normally, you use one inch, as thin as you can. It’s the White House—I said, ‘Fuck it, what’s the best you have?’ They said, ‘We have one that’s four inches.’”
“You’re restoring glory to the White House,” Cheung says, shaking his head in apparent awe.
BioTexCom, a Ukrainian firm, has announced a September conference in Warsaw promoting surrogacy and offering the “purchase” of a child for 65,000 euros; the case is now with prosecutors
Since 2023, Ordo Iuris has submitted opinions to UN and EU bodies arguing that surrogacy constitutes human trafficking and the sale of children under international law.
The Ordo Iuris Institute cooperates with UN Special Rapporteur Reem Alsalem, whose report on violence against mothers cited its position; Alsalem was a guest at a conference organized in June 2026.
Ordo Iuris advocates a new Optional Protocol to the Convention on the Rights of the Child banning surrogacy and has prepared Polish translations of two UN reports on the issue.
The Ordo Iuris Institute is petitioning Poland’s Minister of Justice, Waldemar Żurek, to block the event organized in Warsaw by BioTexCom as a promotion of human trafficking; the appeal is available at niedlasurogacji.pl.
On September 12–13, the Ukrainian company BioTexCom plans to hold a conference in Warsaw aimed at promoting programs offering surrogate motherhood and in vitro fertilization. The company is inviting interested parties to individual meetings with its representatives, offering surrogacy packages worth nearly 65,000 euros. Under Polish law—unlike Ukrainian law—surrogacy may be classified as a criminal offense. The matter of the Warsaw conference has already been referred to the prosecutor’s office.
This event is not an isolated episode but another manifestation of a broader phenomenon: Poland, alongside other Western and Central European countries that lack their own surrogacy regulations, has for years been becoming a market for foreign so-called reproductive companies. In this context, it is worth recalling that the issue of surrogacy has for years been a central concern of the Ordo Iuris Center for International Law—both at the domestic level and in the most important international forums.
Opinions and positions at the UN and the European Union
Since 2023, the Institute has regularly submitted opinions and positions to bodies of the United Nations (UN) and institutions of the European Union (EU), consistently arguing that surrogacy meets the definition of human trafficking and the sale of children under international law. In February 2023, Ordo Iuris experts published an analysis showing that European Union law does not require member states to legalize surrogacy. When, in December 2024, the Third Committee of the UN General Assembly adopted a resolution on trafficking in women and girls that for the first time explicitly addressed the phenomenon of surrogacy, the Ordo Iuris Institute described it as a significant precedent.
A special place in these efforts is occupied by the cooperation with Reem Alsalem, the UN Special Rapporteur on violence against women and girls, who consistently defends the biological understanding of sex and motherhood in her reports. Ordo Iuris took part in informal expert consultations conducted by Alsalem for both of her key documents—the report on violence against women in the context of surrogacy, submitted to the UN General Assembly in October 2025, and the report on violence against mothers, presented to the Human Rights Council in July 2026. Importantly, the Ordo Iuris Institute’s position was explicitly cited in the latter document, in the section addressing the devaluation of motherhood in contemporary public and institutional discourse.
This cooperation also took a direct form: on June 3, 2026, Reem Alsalem personally took part—as a special guest—in the international academic conference “Motherhood in the 21st Century” organized by Ordo Iuris at Cardinal Stefan Wyszyński University. During the panel devoted to surrogacy, she presented the findings of her report, outlining the profile of women who become surrogates—almost exclusively poor women, often single mothers or immigrants—and calling for a model of surrogacy abolition modeled on the abolition of prostitution. She was accompanied by Olivia Maurel, spokeswoman for the international Casablanca Declaration—a coalition of more than 150 experts from 75 countries advocating a universal ban on surrogacy—who was herself born through the procedure and shared a moving personal testimony.
Cooperation with the initiators of the Casablanca Declaration
This is not the first time the paths of Ordo Iuris and the circle surrounding the Casablanca Declaration have crossed. As early as April 2024, the Ordo Iuris Institute took part in an international conference in Rome organized by the Declaration’s initiators, devoted entirely to the issue of surrogacy, and addressed its findings in the commentary “The Right to a Child, or the Rights of the Child?” The participation of the Declaration’s spokeswoman in the Warsaw conference in June 2026 is thus a continuation of many years of ongoing cooperation with this coalition, not an isolated episode.
A call for a new Optional Protocol to the Convention on the Rights of the Child
In its opinions submitted to the UN, the Ordo Iuris Institute consistently puts forward a specific legislative proposal: the adoption of a new Optional Protocol to the Convention on the Rights of the Child that would explicitly prohibit surrogacy. The legal argumentation, developed in particular in the November opinion for the Special Rapporteur, invokes Article 35 of the Convention on the Rights of the Child and Article 2(a) of the existing 2000 Optional Protocol on the Sale of Children, whose definition of “the sale of children”—in the assessment of Ordo Iuris experts—also covers surrogacy agreements under which a child is transferred in exchange for remuneration or another benefit.
Polish translations of UN reports
The latest element of this activity is a publication that took place just a few days ago. On August 25, 2026, the Office of the UN High Commissioner for Human Rights published on its official website Polish translations of both of Reem Alsalem’s reports mentioned above—on violence against women in the context of surrogacy and on violence against mothers. Both translations were prepared by the Ordo Iuris Institute. Thanks to this, Polish-speaking lawyers, journalists, public administration officials, and NGOs have gained direct access to the full content of both documents—without relying on the fragmentary quotations and secondary media coverage through which UN reports had until now been known in Polish public discourse.
The actions outlined above—more than a dozen opinions and positions submitted to the UN and the EU, participation in the UN Special Rapporteur’s expert consultations, its own international academic conference in Warsaw, cooperation with the initiators of the Casablanca Declaration, the call for a new international treaty, and the preparation of official translations of UN reports—together form a picture of Ordo Iuris’s systematic, years-long engagement in the fight against surrogacy at both the domestic and international levels. It is against this backdrop that the Ordo Iuris Institute’s opposition to the BioTexCom conference planned for September 12–13 in Warsaw should be understood. The Ordo Iuris Institute has prepared a petition to Poland’s Minister of Justice, Waldemar Żurek, calling for the event to be blocked.
“The conference that the Ukrainian company is planning for September in Warsaw is not a neutral informational event, but a promotional campaign for a commercial reproductive business that treats a woman’s body as a means of production and a child as a product tailored to the client’s expectations.
Polish law does not explicitly criminalize surrogacy, but that does not mean a legal vacuum. An agreement under which a child is handed over in exchange for payment may meet the definition of human trafficking, and organizing and promoting such practices on the territory of the Republic of Poland should meet with a response from the relevant authorities. Ordo Iuris has for years documented the mechanisms of exploitation built into commercial surrogacy: from Colombia, through Ukraine, to the United States—and consistently works to ensure that this problem is no longer treated as the private affair of ‘commissioning parents,’ but is recognized for what it truly is: a form of economic exploitation of women in difficult life circumstances and a violation of a child’s fundamental right to identity and to a bond with the mother who gave birth to them,” notes Julia Książek of the Ordo Iuris Center for International Law.
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