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Bipolar Writer Comments on Debate Over “Crisis in Psychiatry”

The views expressed are those of the author and are not necessarily those of Scientific American.


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In 2007, while teaching at George Johnson’s Science Writing Workshop in Santa Fe, I met a talented young writer named Jessica Reed. We’ve stayed in touch over the years and corresponded on many topics, especially on mental health issues. After my recent rant “Crisis in Psychiatry!,” which riffs on the latest debate over the Diagnostic and Statistical Manual of Mental Disorders, Jessica responded with her usual thoughtfulness. I asked her to elaborate for readers of this blog, and she sent me the comments below. –John Horgan

I owe my life to the mental health system, yet as a student of science, I have always been deeply ambivalent about the state of psychiatry. Through years of alternating conviction and doubt, of romanticizing, of stigmatizing and de-stigmatizing, I have been sure of this much: in a less enlightened time, I certainly would have been in worse shape. In the animated series Dr. Katz, comedian Emo Phillips says, “I don’t know if I believe in psychiatry… around 1820 if you were having mental problems they would manacle you inside a well and pour ice-cold water on you until you almost drowned. It’s too bad they didn’t have TV commercials back then, ‘cause, you know: Ask your doctor if being manacled to the inside of a well and almost drowned is right for you.

While I’m grateful that no one has manacled me to the inside of a well, my psychiatrist and I remind each other regularly: the science of treating mental illness is still in its dark ages. Therapy is often ineffective. Medication is rudimentary. Our Bible—the Diagnostic and Statistical Manual of Mental Disorders, or DSM—is a joke. This is what I say regularly, anyway, so I was surprised to feel flushed with panic when I read that the head of the National Institute of Mental Health, Thomas Insel, is moving NIMH research “away from DSM categories.” This is more than just a decision about where to place research dollars. Fundamentally, the NIMH is reconsidering everything. That’s how it feels, anyway. It feels like what little I had to cling to has been ripped away from me. It feels like being abandoned.

I wish I could speak better of our time. Our therapy is all over the place. There are competing schools of thought, ranging from Freudian psychoanalysis to cognitive behavioral therapy. To complicate matters further, there are as many therapeutic personas out there as personalities, so even if you were to choose in advance a school of thought you deemed reasonable or promising, you never know what your therapist will be like.

Our drug treatments are crude. We stumble together, doctor and patient (that’s if you’re lucky enough to be working together), searching for a tolerable combination of meds: one to mitigate each specific core problem and one each to fix the side-effects of the first. Despite advances in neuropharmacology—we know the names of several key neurotransmitters, have an inkling of what they do normally, and we know the mechanisms by which some of these drugs act—we haven’t the foggiest notion why some drugs work for some people and not others. We don’t know why some drugs work for a while in one person and then quit working. We really don’t know why drugs designated for one purpose seem to be effective in completely different arenas—for example, it is historical accident buffered by only a primitive notion of mechanism that anticonvulsants double as mood stabilizers.

The one standard psychiatry had was the DSM. It’s where we stored our collective, agreed-upon (by a few select committee members) definitions and categories of mental illness. “How many weeks have you been unmotivated? More than two? Then you are clearly clinically depressed.” In the past several decades, we’ve seen the politics of homosexuality, transsexuality, and gender identity evolve in this manual. We’ve seen lumpers and splitters get their hands on the definitions. My affliction, manic-depression, comes in many flavors: Cyclothymia, Bipolar I and II, with further codes about the relative severity of the diagnosis. Usually, my doctor officially codes me 296.80, Bipolar Disorder Not Otherwise Specified. I’ve always said that I refuse to become defined by the label. And yet… sign insurance forms with it for over a decade and see how cozy 296.80 starts to feel.

Insel says patients with mental disorders “deserve better” (than the DSM), and I believe his plan to replace it with the new Research Domain Criteria (RDoC) is well-intentioned. RDoC focuses on genetic markers and hard neural and cognitive data. That sounds great. What worries me is that the paucity of such data leaves people like me—at least temporarily—out in the cold. When I was groping for answers in high school and college, I was disappointed every time my thyroid test results came back normal (abnormalities could have confirmed hypo- or hyperthyroidism). In high school they tested my blood hormone levels and found nothing. Each time the hard data came back free of anomalies, I felt more lost. Something was causing my symptoms, and they were not all even arguably “subjective”: surges of sleep deprivation and weight loss cycled with the reverse. There was no question there was a biological basis for my problems, and when doctors shrugged, I wanted to cry. (It was disturbingly easy, on the other hand, a few years later to rattle off a list of symptoms that aligned with the DSM and have doctors hand me the Bipolar diagnosis within twenty minutes.)

I’ve lamented the lack of a test for Bipolar disorder for sixteen years. I should feel relieved about the NIMH announcement, but I’m uneasy about what comes next. When will there be a test? Suppose there is a test, and I fail? How would that explain my life? For over five years, I questioned and resisted my diagnosis. It was three years before I consented to medication. It has taken me a long time to come to terms with it, but I finally have, and like it or not, it is part of my identity.

The whole field of psychiatry is stepping back to regroup. This is what I wanted. So why do I feel more scared than I did a week ago? I’m happy if we admit that our approach thus far has been confused, misguided, ill-advised, sometimes profit-driven, and reckless, but until a wholly changed psychiatry emerges from the RDoC approach, please, please, please let’s not stop trying to figure it out. –Jessica Reed

Photo: Jessica Reed, George Johnson (right) and John Horgan, Santa Fe, 2007.

Postscript from John Horgan: Ms. Reed is my guest here on this blog, so if you respond to her essay, please be respectful. I will delete rude and abusive comments.

Postscript from Jessica Reed: This was a personal, reflective piece. I was not speaking for anyone but myself. I certainly was not speaking for those who have experienced psychiatry by force. While my experience has not been entirely positive—I would need a book to cover the gamut of experiences I’ve had—on the whole it has been more helpful than harmful. I am fortunate to have a doctor who respects my decisions and whose expertise I respect. We consider ourselves a team, and he has never asked me to do anything I wasn’t comfortable with. Probably more importantly, I am fortunate to have a supportive network of family and friends. Since we have found a framework to explain a lifetime of symptoms (the DSM “construct” called bipolar disorder), my family and friends have been better able to help me cope with a host of problems. If NIMH research is successful, this construct might one day be replaced by another explanation or set of explanations that are more physiologically based. I would welcome that. My point in this piece is simply that change can be painful.

About the Author: Every week, hockey-playing science writer John Horgan takes a puckish, provocative look at breaking science. A teacher at Stevens Institute of Technology, Horgan is the author of four books, including The End of Science (Addison Wesley, 1996) and The End of War (McSweeney's, 2012). Follow on Twitter @Horganism.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. Sarahsezz 1:48 pm 05/8/2013

    “and like it or not, it is part of my identity.”

    I was given this label among others. Labels originated from a pseudoscience are not part of my identity. I’m proud to have rejected my labels and I am proud I don’t take toxic psychiatric drugs any longer.

    The mention of 19th century manacles and wells was deeply offensive to me as I know only too well that psychiatry does still use restraints and solitary confinement, and while it may not drown people in iced water, it certainly drowns people’s brains with forced drugging and forced electroshock.

    The fact that you all tacitly admit there is nothing but a veneer of science to psychiatry, makes me resent even more, that so many people are in favor of laws forcing this profession and its drugs on people against their will. I will never forgive this human rights abuse. It is not justified, and it is truly disgusting that you can harbor your doubts and still be in favor of the government forcing this profession on your neighbor.

    I am reminded of how glad I am that I ended my dependence on this ridiculous joke of a profession. How glad I am that I not “clinging” to quackery, brain damaging drugs, and garbage biological determinism.

    “There was no question there was a biological basis for my problems”. There is plenty of question, actually. You have not been provided with a shred of evidence your problems are a biological disease and neither has anybody who has been given any of these labels.

    I support your right to believe in pseudoscience, but I will never accept government forcing it on me. Ever. Every single person with a DSM label will live and die with psychiatry never having produced its biomarker. Psychiatry’s model is patently fallacious and this profession is going to continue to go down in flames. I watch with relish that these human rights abusers have to face the world and admit they’ve got NOTHING.

    Link to this
  2. 2. softwarematters 3:14 pm 05/8/2013

    Sarahsezz

    Thanks for your comment I wrote a similar comment whose content can be summarized as “I support your right to believe in pseudoscience, but I will never accept government forcing it on me” but it was deleted.

    Apparently it was too strongly worded for the author of the blog to digest.

    Link to this
  3. 3. mcortina 3:52 pm 05/8/2013

    I am a psychiatrist who discoverer attachment theory four decades ago . The theory is the brain child of John Bowlby a British psychiatrist and psychoanalyst who turned to studies of animal behavior to understand the nature of the mother-infant bond. a field of study that is known as attachment theory. The theory speaks to one of the issues that Dr. Insel made in termed of re-orienting research toward understanding underlying processes among different psychiatric disorders. This is exactly what attachment research has done. It has identified the attachment bond as a protective factor and risk factor that underlies many psychiatric conditions and personality disorders, such as borderline personality disorder. This hard gained knowledge came about by developing methods that could capture qualitative differences in the parent child attachment bond, focusing particularly in how attachment figures respond to needs for security and protection of their children.
    Hundreds of studies have studied how secure, insecure or disorganized attachment patterns play out through development. It is knowledge of these different developmental pathways that have helped understand underlying processes.
    While we now know a great deal about the neurobiology of attachment (a subject to which Dr. Insel has made contributions), it is the understanding of different development pathways that the attachment bonds can take that has been enormously helpful in helping people with different kinds of attachment vulnerabilities.

    What is missing in Dr Insel proposal are projects that would couple the understanding of the genetics and neurobiology of the brain with well designed develop metal research projects of that are prospective and retrospective in design, such as the ones conducted by attachment researchers all over the world. It is not like we don’t have good models.

    Dr Insel’s proposal just gets us half the way in understanding underlying processes that may (or may not) be shared by different psychiatric and personality disorders. Why stop with genetics and neuroscience ? Why not couple this work with well designed developmental projects ?
    It is very frustrating to see how leaders in the field are limited by a purely biological approach to understanding the human brain/mind

    Mauricio Cortina MD
    Co president of the Latin American attachment network (Red interamericana de apego)
    Director attachment and human development center
    Washington School of Psychiatry

    Link to this
  4. 4. softwarematters 4:04 pm 05/8/2013

    Mauricio Cortina,

    “Dr Insel’s proposal just gets us half the way in understanding underlying processes that may (or may not) be shared by different psychiatric and personality disorders. Why stop with genetics and neuroscience ? Why not couple this work with well designed developmental projects ?
    It is very frustrating to see how leaders in the field are limited by a purely biological approach to understanding the human brain/mind”

    Because anything else makes the DSM something similar to the Mullahs in Iran deciding who is a “heretic” based on behavior of the victims, and the Mullas’ bias, alone. People have had “problems of living” for as long as we have remember.

    The major beef that many like me (such as the first poster) have with psychiatry is its status as a coercive force which manifests itself not only on psychiatry being forced into its victims but also in justice being denied to victims in criminal proceedings under the “insanity defense”.

    People engage regularly in all kinds of pseudoscientific endeavors whose basis is like psychiatry’s: astrology and homeopathy are the most obvious that come to mind. Just as with psychiatry, many people claim to have been “helped” by astrology and psychiatry. And I say, “good for them”. What makes psychiatry different is its status as a legally sanctioned tool of social control.

    Even if all the astrologers of the world were to agree that some person is likely to engage in violence tomorrow morning based on that person’s natal chart and tomorrow’s position of the planets, that would not be enough to legally lock in that person preemptively, at least in the US. However, psychiatry is allowed to make those calls in spite of any evidence that it can predictions about who’s likely to become violent more accurately than astrologers.

    What Tom Insel did was to level the playing field in a way that both the “mind guardians” and their critics can agree that is purely objective: quantitative measurements in bio-markers. And that is a welcome development except of course, for those who make a living out of having their personal biases treated as “science” by the DSM.

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  5. 5. Cataract 9:08 pm 05/8/2013

    “When will there be a test? Suppose there is a test, and I fail? How would that explain my life?” Or suppose there is a test and you pass, but your life is fine? I’m often unsure how to react when someone credits the mental health system with saving their life. I feel incredibly lucky to have escaped the mental “death” system. I credit my luck for over 15 years of a fine, free life. The NIMH’s announcement / admission is incredibly justifying. Either way, thank you for sharing your thoughts and feelings. We’re all in this boat together.

    Link to this
  6. 6. bestofnothing 10:09 pm 05/8/2013

    For those of you who found freedom after feeling trapped within the psychiatric profession–tell us, what led (or forced) you into psychiatric treatment to begin with. You must have had some sort of problem? After leaving psychiatric treatment, did you still have the problem that led you into treatment to begin with? If you figured out how to face your problem, or how to fix your problem on your own after going through psychiatric treatment, then perhaps that psychiatric treatment, no matter how mis-guided or seemingly offensive to you, actually gave you the push you needed to fix yourself.

    The goal of any caring doctor is to get you to a place where you no longer need the doctor. Your old psychiatrists would be pleased that you no longer need them or the field of psychiatry at all.

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  7. 7. Cataract 11:05 pm 05/8/2013

    Hello bestofnothing – It would be fair to say I have had a lot of help from people over the years, but not from the MD system. At age 14, I was told I had a chemical imbalance in my brain, (a “theory” which has since been dismissed as an outright lie,) and would have to take “medication” which caused painful and nightmarish side effects for the rest of my life, or be forced to. What you say about a caring doctor simply does not apply.

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  8. 8. softwarematters 12:34 am 05/9/2013

    bestofnothing,

    In my case I was “forced” into it, so I didn’t ask. Unlike the US, this happened in a country where you can be “forced into it” as long as you have a family member or close associate willing to betray you. There is no need to prove dangerousness, as it is the case in the US. My contact with psychiatry only brought me misery. You can read it here,

    http://www.madinamerica.com/2013/01/ny-times-invites-readers-to-a-dialogue-on-forced-treatment/#comment-19770 .

    I distanced myself from this pseudo science after my marriage fell apart. I have nothing but contempt for the psychiatrists that committed me and for the field of psychiatry as a whole.

    Psychiatrists are not “doctors”, in the way a cardiologist is a “doctor”. They have medical training, but that’s where it all ends. They could have a training in rocket science or in agriculture and they would still be able to do the same job. In fact, that’s where the psychiatric scam begins: people who tell you that just because they have “medical training” they can make decisions about your behavior. Psychiatry and psychiatrists have usurped the role that in the past was reserved to religious institutions and clerics in the West (and in fact, historically speaking psychiatry was born precisely to replace said institutions and mind guardians).

    Tom Insel explicit admission that there is absolutely no science backing DSM labeling is something that every survivor of psychiatry has known for years. Now, as in every fraudulent endeavor, there is no lack of people who are willing to comply with the fraud. If we learned something from Milgram and Zimbardo experiments -they would be considered unethical now, but they provided an invaluable insight into the mind of the average Joe- is that people are willing to do all kind of bad things when told to do so by somebody that they perceived as having “authority”, such as, somebody who tells them “I am a doctor, I know better”.

    Tom Insel’s admission will at least level the playing field in a way that will allow for once and for all to falsify this scam.

    Link to this
  9. 9. Sarahsezz 5:20 am 05/9/2013

    Bestofnothing left the egregiously contemptuous and offensive comment: “If you figured out how to face your problem, or how to fix your problem on your own after going through psychiatric treatment, then perhaps that psychiatric treatment, no matter how mis-guided or seemingly offensive to you, actually gave you the push you needed to fix yourself.”

    Yeah ok pal, brutality and human rights abuses “gave me the push I needed”. Losing my dignity, my basic human and civil rights, having my brain forcibly drugged by guesswork quacks, my reputation and credibility smashed by stigma, all “giving me the push I needed”.

    I don’t tolerate people telling me what I “need” rather well. Especially when they are fundamentally ignorant of the depths of psychiatry’s violence and coercion against the innocent people forced into the system.

    “Your old psychiatrists would be pleased that you no longer need them or the field of psychiatry at all.”

    Ah…. they are not “my” psychiatrists, they are the government forced psychiatrist goon squad, I didn’t consent to any relationship with them whatsoever. They initiated violence and coercion against me. They could not care less what my opinion on what they did to me is, such is the nature of someone willing to use brute force to smash the will of another. That doesn’t make them “my” doctors any more than a chattel slave had “his” employer. And believe me, these people you speak of, they stand ready and able to impose whatever they decide I “need” at a moment’s notice. I am forced to live in fear of their legal powers daily. Like commenter softwarematters above, I too have nothing but contempt for those who all but destroyed my life, and I would like to see them go to prison for what they do. It is an absolute travesty that we live in a world of mindless sheep who would dare tell me that the destruction of my live was “needed”. Based of course, on their ignorant blind deference to psychiatric authority. A false authority, as is being made clearer with each new DSM farce.

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  10. 10. softwarematters 12:23 pm 05/9/2013

    Sarahsezz, again 100% agree. My advise to everyone is to stay as away as you possibly can from shrinks. They will destroy your life under the excuse that it is done “for your own good”. And before taking your child or loved one to these people ask yourself, do I hate my child/loved one so much as to willing to condemn him/her to a life of misery? Once you have been labelled, under the current legal system, the label stays with you for the rest of your life. It has implications beyond the purely psychological and physiological (those drugs will destroy your body). You will be unable to do certain things (such as passing security clearances) and in every legal proceeding you might be involved, such as divorce or probate proceedings, it will be used against you. Believe the survivors: only misery comes from a contact with psychiatry. Ask yourself what would happen if you were to reject an offer you can’t refuse from a psychiatrist. I promise you rather not know the answer to that question.

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  11. 11. jayjonz 12:43 pm 05/9/2013

    Well written article and perspective on living with Bipolar illness, which is real disorder with biological underpinnings. Millions of people around the world derive great benefits from psychiatric medication (perhaps including the author), often provided at their request, and in the vast majority of cases with their consent. “Forced” treatment is relatively uncommon yet understandably horrible for those subjected to it. In the U.S. there are laws that dictate under what circumstances treatment can be imposed. Usually, this happens when an individual is suicidal, threatens someone else’s life, or presents a danger to society due to unpredictable dangerous behavior. Unfortunately, all systems with elements of social control are prone to being misused by those in power. But those who perpetrate such abuses should be blamed, not psychiatry itself.

    There’s no doubt terrible things can happen in the process of psychiatric treatment, but as mentioned those receiving treatment almost always have signficant reasons for encountering the mental health system in the first place. Perhaps this isn’t the forum for such disclosure, but it’s important to note when trying to understand the concerns. Let’s also remember that genetics, developmental delays, parenting problems, violence, drug abuse, poverty, and the negative influences of peers and relatives often contribute to problems that require intervention. We certainly shouldn’t stigmatize or blame those that find themselves in need of mental health care. Nor the people trying to help them.

    Finally, there are a few comments in the article that are imprecise:

    1) We have more than a foggy notion why some people respond to meds and others don’t. There is a wealth of medical literature on liver enzymes, protein binding, drug-drug interactions, and dietary effects. This is not to say the understanding is complete.

    2) Therapy works for many people. The fact that various approaches are required across the population shouldn’t be surprising. Do we really want to apply a one-size-fits-all model to all people/conditions? That’s already available in many cults (and anti-psychiatry movements).

    3) Some medication interventions are not crude, and many people never have any side effects to their medications. Some medications rarely cause any side effects.

    Perhaps the following rather common occurrence isn’t really newsworthy: “Man gets medicine for depression, has no side effects, his symptoms resolve, and he stops taking the medication.”

    Thousands of people have this kind of experience, but they tend not to blog/comment about it.

    Link to this
  12. 12. softwarematters 3:40 pm 05/9/2013

    jayjonz

    “living with Bipolar illness, which is real disorder with biological underpinnings”

    Problem is that there is not the slightest shred of evidence that such is the case. That at least has been agreed by both Tom Insel in his blog and by the APA in its official response. The difference of opinion at this point is not that psychiatric diagnosis lacks biological validity, the difference is what to do with a hundred years + worth of pseudoscience.

    It is true that in the US you cannot be forced into psychiatry unless there is dangerousness, but even then there is a dual standard, a “separate but equal” so to speak. If you are considered “normal”, then you have to violate a criminal provision (such as “terrorist threats”) before you can be locked in. And to be able to do that, the government has to prove its case with the standard “beyond reasonable doubt”. If you are labelled “not normal” using the DSM guidelines, suddenly that standard is lowered to “clear and convincing evidence” (higher than “preponderance of evidence” but still lower). Although I would not have been “forced into psychiatry” in the US because I wasn’t eligible for it under either standard -as my American psychiatrist confirmed-, I cannot close my eyes to this injustice perpetrated in the name of a pseudo science that is no better than astrology. Also, people forget that what the DSM says has impact beyond the US. All of the European Union operates under a system of “need for treatment”, which is a vague standard that in practice means “whenever some psychiatrist wants”. Here you have an old reference on the matter that does not include all the EU members but which gives people an idea of what I am talking about http://ec.europa.eu/health/ph_projects/2000/promotion/fp_promotion_2000_frep_08_en.pdf . What it says there is still basically true, and it is true also in all the other EU countries. This is why, the finding that the DSM is not valid, has repercussions beyond the US.

    “1) We have more than a foggy notion why some people respond to meds and others don’t. There is a wealth of medical literature on liver enzymes, protein binding, drug-drug interactions, and dietary effects. This is not to say the understanding is complete.”

    Actually you don’t. The most extensively studied class of psychiatric drugs, antidepressants, have shown to be basically active placebos (studies by Irving Kirsch and similar) when all data available is taken into account. Note that this finding was significant because it used psychiatry’s own measure of efficacy, the Hamilton Rating Scale for Depression‎ -to be fair they should have been willing to test something like a true bio-marker-. Even with that, it was shown that for the overwhelming majority of patients, antidepressants were no better than placebos. And for that small minority of “very depressed” patients for which antidepressants were slightly better, the “active placebo effect” explanation makes more sense.

    “2) Therapy works for many people. The fact that various approaches are required across the population shouldn’t be surprising. Do we really want to apply a one-size-fits-all model to all people/conditions? That’s already available in many cults (and anti-psychiatry movements).”

    But then we are talking about something akin to “religion” not science. Science is all about objective and quantifiable measures of efficacy and predictive value, ie, patient X has depression then we do Y and in the overwhelming majority of cases the result can be predicted. When you have to take into account subjective explanations and hindsight bias, that is not science anymore. It’s something else.

    “3) Some medication interventions are not crude, and many people never have any side effects to their medications. Some medications rarely cause any side effects.”

    They are. As somebody that was under 4 different classes of psychiatric drugs for OCD (stimulants, SSRIs, neuroleptics and benzodiazepines), whose liver and kidneys were almost irreparably damaged (thanks God I stopped the process in time, and the biological markers show very convincingly that the drugs were causing the damage) this is one of the most insidious falsehoods that I hear to justify psychiatry and forced psychiatry: “medications work sometime for some people”. Sure, so does astrology or homeopathy for that matter.

    The members of the psychiatric profession better react in a smarter way than doing “damage control”. Tom Insel statement is unequivocal: DSM psychiatry lacks scientific validity. End of the story. The Emperor Has No Clothes. Repeating discredited old mantras is not going to do you any favors.

    Link to this
  13. 13. bestofnothing 10:25 pm 05/9/2013

    The science, or pseudoscience of psychiatry, is not the problem. The “syndromes” of psychiatry describe patterns of behavior and subjective reports of people who suffer. There is no debate about the existence of these patterns. For instance, some people don’t sleep for days, talk very fast, think they are the smartest person on the planet, become highly distractable, become unable to work, hallucinate voices… Call this pattern whatever you like–it exists. However, there is significant debate about the cause of these patterns–do they reflect “neuro-chemical imbalances”, brain-wiring problems, traumatic history, oedipal complexes, normal genetic variants, toxic exposures, identity issues, drug intoxication, lack of sleep…

    The problems that some of you allege on psychiatrists are just as common with other medical professionals, except with these ‘physical doctors’, most patients collude with the abuse.

    Pediatricians prescribe antibiotics to about 20% of children for common upper-respiratory infections, even though studies show no benefit. Likely parents are partly to blame.

    http://www.chrt.org/publications/price-of-care/issue-brief-2011-02-antibiotic-prescribing-and-use/

    Up to 17% of people get unnecessary and very invasive spinal surgery by neurosurgeons or orthopedic surgeons for back pain. Surgeons want the money, patients want the promise of a quick fix.

    http://www.ncbi.nlm.nih.gov/pubmed/21776403

    Cardiovascular disease can be reduced by about 80% with lifestyle modifications, but your cardiologist and primary care doctor would rather prescribe statins and blood pressure pills for life, and perform cardiac-stenting. Or equally, most people couldn’t be bothered to change their lifestyle choices.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716237/

    For the most part, psychiatrists are trying to pick up the pieces of suffering that individuals, families, societies and governments can’t do themselves or don’t want to. They also pick up the pieces for other doctors. If a patient complains of pain/headache/bowel problems, but all labs/tests are normal, the doctor will often say (to him/herself) “this is just psych”.

    If someone lies to commit you into psychiatric treatment, then that person is a criminal. I’m a psychiatrist. Much of our field is crap, but some of it is not. Psychiatrists exists because of a need–perhaps it is because of the breakdown of religion, or because people suffer in deep emotional ways that will never be revealed by brain-imaging or science proper.

    Link to this
  14. 14. Tzollo 5:43 am 05/10/2013

    Jayjonz says “which is real disorder with biological underpinnings.”

    Every thought has biological correlations. Your profession has not discovered any good reason why we should consider one type of thought pathological, and your profession certainly hasn’t discovered any pathological biology.

    “Millions of people around the world derive great benefits from psychiatric medication (perhaps including the author), often provided at their request, and in the vast majority of cases with their consent.”

    Millions of people around the world love consensual sex, and rape is relatively rare compared to the billions of consensual instances of intercourse that occur yearly. Your minimizing of your profession’s complete contempt for informed consent, your quotation marks as we’ll see here… show your self-interest.

    ‘“Forced” treatment is relatively uncommon yet understandably horrible for those subjected to it.’

    It’s psychiatry that lobbies for this power. It’s psychiatry that refuses to give it up. Millions of people worldwide are forced into psychiatry every year.

    “In the U.S. there are laws that dictate under what circumstances treatment can be imposed.”

    And in the US, jurisprudence academics have found that judges provide only perfunctory rubber stamp kangaroo court hearings and side with psychiatric authority over 90 percent of the time. Nowhere in the constitution does it say you only have the right to own your body at the pleasure of a psychiatrist. Yet that is the reality for many people. Made into psychiatric slaves.

    “Usually, this happens when an individual is suicidal, threatens someone else’s life, or presents a danger to society due to unpredictable dangerous behavior.”

    No jury trial where evidence is tested in open court is provided to the people accused of being “dangerous” by psychiatry. Psychiatry cannot predict risk, cannot predict future behavior. Why should the penalty for being unhappy and wanting to end it all, be to lose more rights than a convicted felon? Criminals in prison only get put in a cage. People forced into the mental patient role get put in a cage AND forcibly drugged and have their brains violated. That is substantially more basic liberties to lose than even the Unabomber has lost. Why is a threat against someone a “medical” problem? The answer: it isn’t.

    “Unfortunately, all systems with elements of social control are prone to being misused by those in power. But those who perpetrate such abuses should be blamed, not psychiatry itself.”

    Psychiatry ITSELF actively defends its widespread use of force all over the world, psychiatric associations lobby government for more invasive laws, and to make it easier to strip law abiding citizens of their right to own their own bodies. And you tell us we shouldn’t blame psychiatry?!!!

    “There’s no doubt terrible things can happen in the process of psychiatric treatment, but as mentioned those receiving treatment almost always have signficant reasons for encountering the mental health system in the first place.”

    So we deserve to have our lives torn apart and to live in constant fear for the rest of our lives do we? Because you say there are “significant reasons” why we garnered the attention of the forced drugging regime?

    “Perhaps this isn’t the forum for such disclosure, but it’s important to note when trying to understand the concerns.”

    Any public forum addressing the state of psychiatry that fails to mention psychiatry’s violence against those it labels its “patients” would be remiss if it didn’t include the voice of those who have had their right to own their own body ripped away by forced psychiatry pitiless enforcers of dehumanization.

    “Let’s also remember that genetics,”

    Bring me the name of just one human being in the history of the world who has had a psychiatric label put on them with the aid of a genetic test.

    “We certainly shouldn’t stigmatize or blame those that find themselves in need of mental health care. Nor the people trying to help them.”

    People who are willing to violate strangers with forced drugging should be stigmatized as the human rights abusers that they are.

    “We have more than a foggy notion why some people respond to meds and others don’t. There is a wealth of medical literature on liver enzymes, protein binding, drug-drug interactions, and dietary effects. This is not to say the understanding is complete.”

    The liver damage I got from the psychoactive drugs that act on no known disease process that you choose to call “meds”, as though they are being used in some kind of legitimate “medical” application, was certainly evident on my liver enzyme tests.

    “Therapy works for many people. The fact that various approaches are required across the population shouldn’t be surprising. Do we really want to apply a one-size-fits-all model to all people/conditions?”

    You’re certainly fine with having laws on the books that violent force a one size fits all model on law-abiding innocent people.

    “That’s already available in many cults (and anti-psychiatry movements)”

    One doesn’t need to be in a cult to see that psychiatry is an ideology, and that it shares many qualities with various cults itself. And many delusions too.

    “Some medication interventions are not crude, and many people never have any side effects to their medications. Some medications rarely cause any side effects.”

    Masters of rhetoric, but empty on facts as usual. All psychiatric drugging acts on no known or provable disease process, and merely disables normal brain function. We must consider the systems psychiatric drugs meddle with normal because we have no evidence to suggest otherwise. No person targeted for drugging has their body tested by a psychiatrist and has disease proven in their biology. I’d call that crude, so would the world.

    “Perhaps the following rather common occurrence isn’t really newsworthy: “Man gets medicine for depression, has no side effects, his symptoms resolve, and he stops taking the medication.”

    Man gets told his despair is a medical problem by a quack. Man meddles with his serotonin neuromechanics after no physician examines his nervous system at all. Man later self reports he is no longer in as much despair.

    Woman goes to astrologer, asks for a tarot reading. Astrologer doesn’t have any tool to predict the future. Woman later self reports something the astrologer said would come true has come true.

    “Thousands of people have this kind of experience, but they tend not to blog/comment about it.”

    Sounds like there is a certain kind of experience, a certain kind of take, you’d rather hear in the press and on the internet. Also sounds like there are some voices you’d like to silence and minimize and discredit.

    You won’t be silencing me doc. Psychiatry has silenced millions of people who are now chemically lobotomized or dead. I came very close to being one of them. As long as I have the ability to speak out I will. A self interested shrink dropping by this comment section has actually been an illustrative thing. It tells other victims of psychiatry that if they ever try and tell their story, shrinks will minimize, justify, rationalize, and silence them. Psychiatry is too powerful to need to listen to those pesky people whose lives it has destroyed. Why not push them to the side too? just as the effects of your profession’s toxic drugs are sidelined?

    Link to this
  15. 15. jayjonz 11:57 am 05/10/2013

    Who’s silencing anyone here? The self interest appears to be coming from individuals who have opinions based on personal experience and think everyone else should share their views. Millions of people benefit from psychiatric treatment and their experiences count too. Bad outcomes for some doesn’t mean others should be deprived of help. To suggest so is selfish, misguided, and possibly cruel.

    It is objectively true that lives are improved and sometimes saved by psychiatric medication. Not always, but often enough that most encounters between patients and psychiatrists are initiated by patients and their families, who often demand medication. Psychiatrists routinely resist these demands. Many are conservative with medication and limit their use for only extreme circumstances. Some don’t prescribe medication at all.

    The NIMH seeks to refine our understanding of the biological underpinnings of mental illness, for which there is plenty of evidence. The lack of exact physical markers or objective diagnostic tests doesn’t mean that behavioral illness can’t be measured and treated effectively. Sure, the approach is less precise than say cardiology, but many other medical specialities deal with symptom clusters that lack well defined biological markers, including gastroenterology, neurology, and pulmonology.

    Aberrant, dysfunctional, and destructive human behavior has been described for millenia. Historically, those exhitibing such behavior have been considered alien, demonic, and sub-human (among other things). They were shipped off, imprisoned, and exterminated. Thrown into wells. The idea that they are disabled and in need of help is much more humane. Informed consent is a giant leap forward. Do mistakes, abuses, and atrocities still happen? Yes, and they must be eliminated if we are to continue making progress. The voices of those who have been mistreated need to be heard, and justice served.

    At the same time, let’s not allow specific injustices to disrupt efforts to alleviate pain and suffering for those that want help. To deny or dissuade people from receiving available and effective treatments because of narrowly held personal opinions is wrong.

    Link to this
  16. 16. softwarematters 3:36 pm 05/10/2013

    jayjonz 11:57 am 05/10/2013,

    ” Who’s silencing anyone here? The self interest appears to be coming from individuals who have opinions based on personal experience and think everyone else should share their views. ”

    I am sorry, but we have been silenced in many ways. I cannot say what I am saying here using my real name for several reasons. In the US, while I cannot be, and would have not been, committed, there is still the social stigma associated to being labelled “mentally ill” and having been “forcibly drugged”. It’s like having a criminal record, stigma wise. People just do not believe those like us when we say that we were abused. We are called “delusional”, that “you must have done something to deserve it”, etc. Unlike the victims of rape, our tormentors are lauded on national TV. The issue of labeling, as I said shows up in every aspect where there is extra scrutiny: getting security clearances, divorce/custody proceedings, any responsibility proceeding where “blackmail” is a concern, etc. So please, don’t add insult to injury.

    And then there is what happens in those countries that have oppressive legal psychiatric regimes along the lines that the propagandists of American psychiatry demand every time there is a Standard Gravure, Columbine, Virginia Tech, Aurora or Newtown massacre: more power to preemptively lock in and forcibly drug anybody of their choice. Here is the poster example of psychiatric nonsense; instead of asking themselves how is that each and every single one of these mass killers was under (or had been recently under) psychiatric drugs (and use of mind altering drugs/alcohol has been more reliably linked to propensity to violence than psychiatric labelling http://www.ox.ac.uk/media/news_releases_for_journalists/090520.html) when they committed their crimes, they ask for more power to forcibly drug even more people!!!! In those countries where psychiatrists enjoy such power (basically all of Western Europe and the US prior to O’Connor v. Donaldson), victims of psychiatry are silenced because opposing the “official labeling” is considered “lack of insight into mental illness” and thus a valid reason for being civilly committed and forcibly drugged (several of the people I shared my experience with had been civilly committed for that reason alone: refusing to “accept the diagnosis” and “take the appropriate drugs”).

    So please, don’t make us more cynic than we actually are.

    “Millions of people benefit from psychiatric treatment and their experiences count too. Bad outcomes for some doesn’t mean others should be deprived of help. To suggest so is selfish, misguided, and possibly cruel.”

    Actually, the studies on the most widely studied class of drugs (antidepressants) show that the average so called “patient” on drugs does not get any more benefit from psychiatric treatment than from placebos. That is a scientifically established fact (by Irving Kirsch and EH Turner). The only discussion between Irving Kirsch and EH Turner was about the meaning/cause of the small difference placebo/antidepressants.

    While that is the case, there is also the established fact that antidepressants cause significant side effects on a significant percentage of those who take them. Just as they have been reliably linked to an increase in violent thoughts of those taking them.

    So the scientifically accurate statement is: psychiatric treatment is not better than placebo for the overwhelming majority of people and it causes important side effects on a significant portion of those following it. Psychiatry has been masterful in twisting this for propagandist purposes, but the science is the science.

    ” It is objectively true that lives are improved and sometimes saved by psychiatric medication. ”

    Actually, it is objectively true that placebos do just as well and that antidepressants increase propensity to violence. Just this or last week the CDC showed that despite a record number of people on antidepressants, the number of suicides has increased in the last 20 years. Maybe it is time to reconsider that mantra.

    “Not always, but often enough that most encounters between patients and psychiatrists are initiated by patients and their families, who often demand medication. Psychiatrists routinely resist these demands.”

    “Many are conservative with medication and limit their use for only extreme circumstances. Some don’t prescribe medication at all.”

    My anecdotal evidence is that psychiatrists are very willing to submit to these demands. An I have many like me in the survivor movement to attest to it.

    ” The NIMH seeks to refine our understanding of the biological underpinnings of mental illness, for which there is plenty of evidence. The lack of exact physical markers or objective diagnostic tests doesn’t mean that behavioral illness can’t be measured and treated effectively. Sure, the approach is less precise than say cardiology, but many other medical specialities deal with symptom clusters that lack well defined biological markers, including gastroenterology, neurology, and pulmonology.”

    Actually, it will take psychiatry a long time to recover from this damning statement by Tom Insel,

    “The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”

    It cannot get any more explicit than that. It seems taken from Thomas Szasz’s “The Myth of Mental Illness”. I think that Szasz’s heirs have a pretty good “plagiarism” case against Insel :D . The official APA response does not disagree with that, it is only saying something like “a scam is better than nothing”. Sorry, I am one of those who thinks that “nothing is better than a scam”.

    ” Aberrant, dysfunctional, and destructive human behavior has been described for millenia. Historically, those exhitibing such behavior have been considered alien, demonic, and sub-human (among other things). They were shipped off, imprisoned, and exterminated. Thrown into wells. The idea that they are disabled and in need of help is much more humane.”

    Note that you are implicitly acknowledging that psychiatry has usurped the role of the Inquisition. It’s great to hear. The end result of some cleric labeling “abnormal” vs some doctor labeling you “abnormal” using equally unscientific criteria is pretty much the same. In fact, a very strong case can be made that more people have killed (either because of suicide or violence against others) as a result of taking antidepressants than the Inquisition killed in its entire history (the latter number has been historically computed to be around 5000 thousand through several centuries).

    ” Informed consent is a giant leap forward. Do mistakes, abuses, and atrocities still happen? Yes, and they must be eliminated if we are to continue making progress. The voices of those who have been mistreated need to be heard, and justice served.”

    I would love to see the psychiatrists that committed me in jail. But alas, in that country that shall remain nameless what they did to me was legal even though they almost destroyed my kidneys and liver. So, no, there will be no justice up until psychiatry is stripped of all of its coercive powers. ALL.

    ” At the same time, let’s not allow specific injustices to disrupt efforts to alleviate pain and suffering for those that want help. To deny or dissuade people from receiving available and effective treatments because of narrowly held personal opinions is wrong.”

    As somebody said above, these Stockholm syndrome sufferers are the worst enemies of those of us in the survivor movement. They are like those Jews who were glad to comply with their captors in Nazi Germany. If we learned something from the Milgram and Zimbardo experiments is that in every single situation where authority perpetrates human rights abuses, there is always a group of people that are too happy to have been abused and that are used by the propagandists to justify themselves to other victims. For instance, up until last week, it was perfectly normal for shrinks to declare as evidence for “madness” the fact of saying,

    “The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”

    Now that we have Tom Insel on record backing that, I wonder what will psychiatry’s next trick to subdue its victims.

    Link to this
  17. 17. softwarematters 3:46 pm 05/10/2013

    bestofnothing,

    The problem is that at least in those other fields there is an objective measure of what is wrong. You can declare “normal” cholesterol levels by just collecting these levels from a large and representative sample of the general population and measure where they are for 90% of the people. The lack of quantifiable and objective measures to decide “normality” alone (let’s forget about validity for a second now) it is what makes psychiatry such a perpetrator of human rights abuses. And then, to compound matters there is the fact that even when psychiatrists agree to what is “normal”, they have absolutely no clue as to what causes that “normality” (vs in other fields of medicine where that causality has been established; whether you lower your cholesterol levels by making life changes or taking medications, the causality is well established).

    And then there is the irony: those fields of medicine for which both validity and causality have been scientifically established in quantitative ways, CANNOT BE imposed into people. You don’t want to go through chemotherapy, fine.

    But the only field in medicine (to me it is not a legitimate field, I am just accepting the fact that legally it is considered to be one) whose reliability has not been established on anything that could be considered scientific and quantitative (that is what Tom Insel said) and for which both the NIMH and the APA acknowledge that there is NO scientific validity to speak of, that field….; it can be imposed into people against their will.

    Something is very rotten here.

    Link to this
  18. 18. katana 4:06 pm 05/10/2013

    I’m a unipolar major depressive and I felt compelled to comment on this. I don’t need “therapy.” Why am I depressed? The sun came up this morning. I don’t know, okay? I don’t have unresolved issues with my parents, my life doesn’t suck any more or less on average than most people’s. I just don’t experience joy in day-to-day living. It’s more like dreaded drudgery just to go through the motions for one more day, and for what? The promise that it’s going to get better?

    I take antidepressants. They DO help some, and I am more functional with them. I’ve read the DSM III, III-R, and IV from cover to cover, and I can’t say I’m sorry to see it go. Pigeonholing mental disequilibrium is unkind at best.

    However, I also echo the sentiments of the author in that it causes some concern. These diagnoses are the only means by which insurance companies are willing to assist with whatever forms of help we are seeking. Sans those codes and clear pigeonholes, will be able to continue care for those of us who opt to? I fully back an overhaul of the mental health care system, but we need corresponding flexibility to appear in the insurance system–which I don’t think is likely.

    Link to this
  19. 19. softwarematters 4:19 pm 05/10/2013

    18. katana 4:06 pm 05/10/2013

    Echoing 1. Sarahsezz 1:48 pm 05/8/2013 above,

    “I support your right to believe in pseudoscience, but I will never accept government forcing it on me. Ever. Every single person with a DSM label will live and die with psychiatry never having produced its biomarker. Psychiatry’s model is patently fallacious and this profession is going to continue to go down in flames. I watch with relish that these human rights abusers have to face the world and admit they’ve got NOTHING.”

    Link to this
  20. 20. jayjonz 4:37 pm 05/10/2013

    Agree with some of what you’re saying. Confronting injustice is an ongoing need. Indeed, psychiatry was historically abused by militaries and establishment powers to oppress dissent. And yes that still happens.

    But not exclusively. I’m not making this up: people get better with psychiatric treatment. I’m repeating myself because this simple point seems to be overlooked. There are lots of patients (millions!) who appreciate their mental health treatment and are not suffering from Stockholm Syndrome. If you can’t/don’t believe this, then you’re missing an important point and will not be taken seriously by those who’s minds you wish to change.
    Most everyone knows someone who has benefitted from some kind of mental health care.

    Also, it seems your experiences and concerns are related to coerced treatment, institutional control, and overlap with the legal system. I hope you’re aware tha the vast majority of psychiatric care is done on a voluntary basis in outpatient settings, driven by consumers not providers.

    Painting an entire discipline and it’s multitude of manifestations as a monolithic evil is a leap of logic, and (pardon the repetition again) potentially damaging to those that need help and would benefit from it. Throwing the baby out with the bathwater.

    Complaining about the DSM and its lack of validity goes way back, far before Tom Insel. The lack of objective tests in psychiatry is not a new discovery. Repeating myself again: there are many areas of medicine in which diagnosis and treatment is based upon symptoms clusters without well defined biological markers. You’ll note Tom Insel’s references to medical illnesses do not include anything from the specialties I mentioned. Talk to non-psychiatrist doctors and ask them how much of their practice is based upon verifiable objective evidence. Some, but not most. Good doctors will tell you that for the most part the practice of medicine is still more art than science. Even surgery.

    We can both fight injustice and provide compassionate care for those in need. These aren’t mutually exclusive goals.

    Link to this
  21. 21. jayjonz 4:48 pm 05/10/2013

    softwarematters, to enhance my point about the often subjective and ever-changing nature of physical medicine, I’d like to point out that cholesterol is not as well established as you suggest. There’s recent evidence that total cholesterol levels do not correlate with cardiovascular risk, despite the last few decades of cholesterol-lowering obsession. It appears lipid subtypes and the interplay between other specific risk factors in an individual are more important in understanding risk. Lots of mysteries in medicine.

    Also, not to burst your bubbles, but psychiatry is not going down in flames. Awareness is increasing, research is proceeding, interventions are developing (magnets!). Our world is also increasingly stressful and unjust, which leads more people to seek support. As as long as psychiatry keeps working for so many, it will only grow. Even moreso if the hero Tom Insel is successful in redefining and validating mental illnesses with objective markers.

    Link to this
  22. 22. softwarematters 7:48 pm 05/10/2013

    jayjonz

    ” If you can’t/don’t believe this, then you’re missing an important point and will not be taken seriously by those who’s minds you wish to change.”

    Where is the rigorous study that proves that? I already provided two citations that speak of antidepressants being not better than placebos. I am going to give another one http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6217a1.htm?s_cid=mm6217a1_w “From 1999 to 2010, the age-adjusted suicide rate for adults aged 35–64 years in the United States increased significantly by 28.4%, from 13.7 per 100,000 population to 17.6” . Americans are taking more antidepressants and other psychiatric drugs than ever, yet the increase in suicides seems unstoppable. If psychiatry is of any help, the science not only doesn’t show it but, on the contrary, is consistent with the statement that psychiatry does more harm than good.

    “Painting an entire discipline and it’s multitude of manifestations as a monolithic evil is a leap of logic, and (pardon the repetition again) potentially damaging to those that need help and would benefit from it. Throwing the baby out with the bathwater.”

    I don’t know who came up with the mantra of “throwing the baby out with the bathwater” but it is interesting that my anecdotal evidence is that every defender of psychiatry resorts to the same mantra when faced with the facts of the damage psychiatry causes. Again, the science about the lack of efficacy of antidepressants, its side effects and the increase in suicide rates backs my position that indeed, society should “throw the baby out with the bathwater”, and make psychiatry the same type of endeavor that astrology and homeopathy are. Both also can appeal to users of their services that have been “greatly helped”. To which I say, fine, but they don’t have the coercive status that psychiatry has.

    “Complaining about the DSM and its lack of validity goes way back, far before Tom Insel”

    Sure, it’s in fact a copy/paste of what Thomas Szasz have been saying for years, except that now it has been given the “authority” (ironic how these things go), of having been uttered by the US Government’s top institute in psychiatric research.

    “Also, not to burst your bubbles, but psychiatry is not going down in flames.”

    That is where you are headed for a bitter surprise. It is one thing to have Thomas Szasz’s points despised as “nonsense”, quite another to have the chief of the NIMH officially endorsing those points. It will have all sorts of legal implications. Now the contents of the blog entry can be brought into legal proceedings to challenge forensic psychiatrists, something that was previously not possible (even if the content, as you say has been known for years). Whether psychiatry will go down in flames will depend on psychiatry’s reaction. If they insist on a bitter fight until the end, they will end up like homeopathy (or even astrology). Their only chance at surviving is to embrace reform (and the first reactions by the APA are not encouraging by those who think along your lines). If they don’t I can perfectly see psychiatry losing its status as a legitimate branch of medicine in my lifetime.

    Link to this
  23. 23. Chryses 8:31 pm 05/10/2013

    softwarematters (10),

    “… My advise to everyone is to stay as away as you possibly can from shrinks …”

    If you’re sick, you seek help where you can find it.

    “… They will destroy your life under the excuse that it is done “for your own good” …”

    They also save many lives.

    Link to this
  24. 24. softwarematters 8:46 pm 05/10/2013

    23. Chryses 8:31 pm 05/10/2013

    “If you’re sick, you seek help where you can find it.”

    Only there isn’t the slightest shred of evidence that DSM disorders are real, biological diseases. That point has been agreed by both the NIMH and the APA in its official response to Tom Insel’s blog.

    “They also save many lives.”

    Again, I keep asking, where are the scientific studies that prove that? Irving Kirsch and EH Turner (2008): antidepressants are no better than placebos. CDC: suicide rate increased more than 28% from 1999 to 2009 (time during which record number of Americans were taking psychiatric drugs). Standard Gravure (Prozac), Columbine (Prozac), Virginia Tech (neuroleptics), Aurora (neuroleptics) and Newtown (unknown which one but known that he was taking psychiatric drugs), all these massacres were perpetrated by people who were at the time of the massacres (or had been previously) on psychiatric drugs.

    Anecdotal evidence, such as that provided by the bipolar writer that wrote this blog, is not scientific evidence. I can tell you that for every person you bring that claims to have been helped by psychiatry, I can bring you at least 5 who claim to have been helped by astrology or homeopathy. And yet, what the scientific studies say about these two is that they are no better than random chance (astrology) or placebos (homeopathy). Psychiatry, same story. Actually, psychiatry is WORSE story since psychiatry has to account for the people who took their own lives or committed massacres under the influence of psychiatric drugs.

    Link to this
  25. 25. Chryses 9:06 pm 05/10/2013

    softwarematters (24),

    “… there isn’t the slightest shred of evidence that DSM disorders are real, biological diseases …”

    Even if that is true, even if you feel that others should take your advice, if one is sick, one seeks help where one can find it. What do you offer instead?

    “… Anecdotal evidence, such as that provided by the bipolar writer that wrote this blog, is not scientific evidence …”

    She finds it persuasive, as do many others who have responded to the treatments you revile.

    Link to this
  26. 26. softwarematters 9:18 pm 05/10/2013

    “Even if that is true, even if you feel that others should take your advice, if one is sick, one seeks help where one can find it. What do you offer instead?”

    Before the era of 28% increase in suicide rates from 1999 to 2009 and mass shootings like Standard Gravure, Columbine, Virginia Tech, Aurora and Newtown people already experienced “problems of living”. And people got support VOLUNTARILY from support networks (family, friends, pastors, etc). The “chemical imbalance”/”take a pill that will solve your problems” era has brought only increase in suicide rates and massive killings. You pick your choice.

    “She finds it persuasive, as do many others who have responded to the treatments you revile.”

    To which I respond what 1. Sarahsezz 1:48 pm 05/8/2013 said above,

    “I support your right to believe in pseudoscience, but I will never accept government forcing it on me. Ever. Every single person with a DSM label will live and die with psychiatry never having produced its biomarker. Psychiatry’s model is patently fallacious and this profession is going to continue to go down in flames. I watch with relish that these human rights abusers have to face the world and admit they’ve got NOTHING.”

    You can keep repeating your mantras that psychiatry “helps some people some time” but that repetition will not make psychiatry more scientific. In fact, after the pronouncements of Tom Insel (NIMH director) and David Kupfer (Chair of the DSM-5 Task Force, speaking for the APA) the lack of scientific validity of DSM psychiatry is not even a controversial point anymore. The controversy is what to do with 100 + years worth of pseudoscience. And this is where honest psychiatrists have a role to play: either admit that their pseudoscience is no better than other pseudosciences (homeopathy, astrology, etc) and aspire for it to have a similar status in society as these two (last time I checked, astrologers and practitioners of homeopathy make pretty good money and they also claim to help people) or engage in a bitter fight until the end. It they choose the second, it is not going to be pretty now that the official gatekeepers of so called “mental health science” have embraced talking points that were easily dismissed earlier as “anti psychiatry nonsense”.

    Link to this
  27. 27. CarefulReview 9:39 pm 05/10/2013

    softwarematters (26),

    “… people got support VOLUNTARILY from support networks (family, friends, pastors, etc) …”

    Reminder: “It’s too bad they didn’t have TV commercials back then, ‘cause, you know: Ask your doctor if being manacled to the inside of a well and almost drowned is right for you.

    “…The “chemical imbalance”/”take a pill that will solve your problems” era has brought only increase in suicide rates and massive killings …”

    A classic example of the post hoc ergo propter hoc logical fallacy (http://tinyurl.com/22yzwf ).

    “… You pick your choice. …”

    Many have, and have been satisfied with the results.

    I know you’re convinced you are absolutely correct. What you need to come to terms with is the fact that you’re not as convincing as you think you are.

    Link to this
  28. 28. Chryses 9:46 pm 05/10/2013

    softwarematters (24),

    “… You can keep repeating your mantras that psychiatry “helps some people some time” but that repetition will not make psychiatry more scientific …”

    Medicine remains an art based on science. Get over it.

    Link to this
  29. 29. softwarematters 10:17 pm 05/10/2013

    CarefulReview,

    “A classic example of the post hoc ergo propter hoc logical fallacy (http://tinyurl.com/22yzwf ).”

    Actually, it is not. While what I said only establishes correlation in time -ie the increase in suicide rates and violent shootings is coincident in time with increased used of psychotropic drugs-, the cumulative case against psychiatry is much stronger. I encourage you to read http://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing/dp/0307452425 that elaborates more. John Horgan gave great reviews to the book.

    “Many have, and have been satisfied with the results.”

    Does this apply to psychiatry, astrology or homeopathy? I am confused now.

    “I know you’re convinced you are absolutely correct. What you need to come to terms with is the fact that you’re not as convincing as you think you are.”

    Actually, your opinion about how convincing I am at this point is irrelevant. As ironic as it might sound now both the NIMH and the APA are on my same page (actually on Thomas Szasz’s page). The only disagreement is about what to do with 100 + years worth of pseudoscience. In the case of astrology and homeopathy society decided to keep both 100 % legal and voluntary. When it came to health, insurance companies never considered paying for astrology services, but some pay for homeopathic medicine while others don’t. I would be perfectly fine if psychiatry ended up like homeopathy: stripped of all of its coercive powers, and 100% voluntary. 2 weeks ago I was pessimist that this would ever happen. After the NIMH/DSM fallout, while I am not under any illusions as to how hard it is going to be, I am optimistic that I might see psychiatry fall as a coercive force in my life time :D .

    Chryses,

    “Medicine remains an art based on science. Get over it.”

    Actually the whole point of Tom Insel’s blog entry is that while that is true in psychiatry it is not anymore the case in other areas of medicine. Other areas of medicine are now fundamentally bio-marker based, with clear and quantitative definitions of what it means to be “diabetic” or having “high cholesterol levels” (as well as scientifically validated theories that support the treatment of choice for either condition). To pick the most obvious equivalent equivalent in psychiatry: the serotonin deficit theory of depression. There is no biological test to measure what is the serotonin level in the brain, let alone “what is the right range of serotonin”. That doesn’t prevent psychiatry from prescribing drugs that increase the level of serotonin in the brain to treat depression (SSRIs). Problem? Selective Serotonin Reuptake Enhancers (SSREs) that do the exact opposite (ie, they decrease the level of serotonin in the brain), seem to be as effective as SSRIs for treatment of depression (and both are as effective as placebo), that tells you how much of a joke psychiatry is with respect to other areas of medicine.

    Link to this
  30. 30. American Muse 4:38 am 05/11/2013

    The conceit and hubris of APA in authorizing DSM manuals is astonishing. Why do we need a special “American” diagnostic manual for psychiatry alone? Why not use the ICD manual (International Classification of Disease) for psychiatric disorders as well, like all other medical specialties do for their illnesses?

    Link to this
  31. 31. jayjonz 1:02 pm 05/11/2013

    Softwarematters,

    It’s not a mantra, just an old saying. “Baby with bathwater” goes back centuries, the equivalent of saying “cutting off your nose to spite your face” or “shooting yourself in the foot,” all of which concisely point out the basic logical fallacy of your argument.

    “Psychiatry helps people” is an objective statement of fact. It is evident on a personal/anecdotal level, in hundreds of research articles, and in the health care marketplace at large.

    To deny this is to ignore mountains of evidence. It must be exhausting. Are you suggesting that all the major psychiatry/psychology journals are fraudulent? That every single study is biased and wrong? One could easily offer dozens of citations that you would be hard pressed to refute. Since this is a Scientific American blog, however, we can presume readers are scientifically literate enough to decide for themselves.

    You’re obviously aware of some literature, as you glorify Irving Kirsch’s work. Hopefully you also know it’s been roundly criticized (with direct logical argument) and remains scientifically controversial:

    http://www.psychologytoday.com/blog/the-skeptical-sleuth/201203/irving-kirsch-d-j-vu-all-over-again
    (Subheadline: “Irving Kirsch’s refusal to address critics reveals his argument’s weakness”)

    Perhaps you’ll argue all these academic critics are part of the conspiracy theory. In that case, look at Kirsch’s work itself, which showed some benefit from antidepressants for people that are severely depressed. And since severe depression confers a significant risk for suicide, his own findings logically translate to “antidepressants can save lives.”

    Astrologers are not required to provide empirical evidence nor subjected to peer review, both of which are ongoing in psychiatry research. Like it or not, empirical evidence of the effectiveness of psychiatric treatment continues to mount, and the field will only be further validated if/when the NIMH confirms disease concepts with biomarkers (the idea that prompted this entire discussion).

    There are important battles for patient rights and justice that should be fought, but not by trying to destroy the medical speciality of psychiatry. To borrow another centuries-old phrase, that effort is the equivalent of “tilting at windmills.”

    Link to this
  32. 32. softwarematters 3:17 pm 05/11/2013

    jayjonz,

    ” It’s not a mantra,”

    It’s a mantra not in the sense that it’s a catchy phrase (your dissertation about being an centuries old phrase is just another red herring), but in the sense that it is used by those who have to argue your position once the scientific facts have debunked it. The excuse goes something like “yeah, but it helps some people some time”. And then you don’t know anymore if they are referring to psychiatry or astrology :D .

    ” “Psychiatry helps people” is an objective statement of fact. It is evident on a personal/anecdotal level, in hundreds of research articles, and in the health care marketplace at large.”

    Again, I am hoping you can provide the actual citation where an objective survey has been done on users of psychiatry not subject to being captive to their psychiatrists (ie, testimony that somebody like me telling a psychiatrist what he wanted to hear in order to get out of civil commitment, as I did, doesn’t count). Absent that, your anecdotal evidence is as valid as mine. Mine is obtained form having shared experiences both while I was civilly committed as well as from my work in the psychiatry survivor networks. While there is disagreement on everything else (politics, who is to blame, what to do with the psychiatric pseudoscience), the overwhelming majority agree that psychiatry ruins lives.

    Absent any such survey, we have to go by medical outcomes: antidepressants are no better than placebos (more below), antidepressants increase violence risk both on those taking the drugs as well as on those that could be at the receiving end of a Standard Gravure type of massacre (caused by Prozac). The CDC shows that in an era where antidepressants and other psychotropic drugs are more prescribed than ever, suicide rates have increased by 28%. From the medical outcome numbers alone, psychiatry does more damage than good.

    “Are you suggesting that all the major psychiatry/psychology journals are fraudulent? That every single study is biased and wrong? One could easily offer dozens of citations that you would be hard pressed to refute. Since this is a Scientific American blog, however, we can presume readers are scientifically literate enough to decide for themselves.”

    Basically. And up until 2 weeks ago, it was too easy to dismiss the concerns of us in the psychiatry survivor movement as “anti psychiatry nonsense”. Now we have the director of the NIMH on record saying,

    ” While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”

    “The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories. Imagine deciding that EKGs were not useful because many patients with chest pain did not have EKG changes. That is what we have been doing for decades when we reject a biomarker because it does not detect a DSM category. ”

    So sure, psychiatry is a fraudulent endeavor from a pure scientific point of view. It uses the language of medicine to give itself credibility, but at its core it doesn’t have any science to back it up. That has been agreed now by both the NIMH and the APA in its official response days later.

    The presence of scholar journals recognized by peers is irrelevant. Astrology and Homeopathy also have theirs: http://www.journalofastrology.com/ , http://www.journals.elsevier.com/homeopathy/ .

    ” You’re obviously aware of some literature, as you glorify Irving Kirsch’s work. Hopefully you also know it’s been roundly criticized (with direct logical argument) and remains scientifically controversial:

    http://www.psychologytoday.com/blog/the-skeptical-sleuth/201203/irving-kirsch-d-j-vu-all-over-again
    (Subheadline: “Irving Kirsch’s refusal to address critics reveals his argument’s weakness”)”

    Psychology Today is not a scholar journal. It seems you haven’t been following the latest on the matter,

    http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8653836

    ” Perhaps you’ll argue all these academic critics are part of the conspiracy theory. ”

    NOT AT ALL. See, speaking of tricks and mantras, now you are trying to pull off another one: ad hominem attack. I don’t think that there is a conspiracy, it’s plain old self interest: that of the psychiatrists who make a living out of the scam, that of Big Pharma which also makes a living of a scam that promises “medications for life” as its treatment of choice, and that of governments that have a “scientific” (again, I put scientific in quotes, because that is its legal status not because I think it is the case) of exerting social control. There is no conspiracy in the sense that all the information that backs the assertion that psychiatry is a scam and that it does more damage than good is publicly available (for it to be a conspiracy it should be hidden) and there is no evidence that the aforementioned stakeholders are doing anything other than following their own interest. Actually, the lack of conspiracy is what allows Tom Insel to make an statement so at odds with the canards of the APA.

    To give you an analogy, I don’t think that there is a conspiracy of American consumers and American companies to slave Chinese workers so that they work on pretty inhumane conditions. There is just the interest of the American consumer in having cheap electronics in cooperation with the interest of American corporations in making money and the interest of the Chinese government in growing its economy at any cost. There is even the “self professed” interest of many of these Chinese workers that make more money despite working in conditions that would be considered inhumane in the US.

    “In that case, look at Kirsch’s work itself, which showed some benefit from antidepressants for people that are severely depressed. And since severe depression confers a significant risk for suicide, his own findings logically translate to “antidepressants can save lives.””

    This is a complete leap of logic of the kind that passes as “normal” in psychiatry but that would have you expelled from the ranks of any discipline with sound scientific foundations.

    - “Kirsch’s work itself, which showed some benefit from antidepressants for people that are severely depressed” It was statistical significance no clinical significance. The theory of “active placebo” makes sense.

    - “And since severe depression confers a significant risk for suicide” So does usage of antidepressants. The FDA is willing to admit that much in the case of young people but Eli Lilli’s own data shows the same to be the case on adults (as it was known through the Standard Gravure court proceedings).

    - “his own findings logically translate to “antidepressants can save lives.” ” Actually, when you compound the fact that antidepressants DO increase suicide risk and that antidepressants are no better than placebos -even in the case of severely depressed people-, only an evil mind would ever think about prescribing antidepressants to depressed patients. Nor should be people surprised that in the era when antidepressants have been more prescribed than ever, the rate of suicide has increased by 28%.

    ” Astrologers are not required to provide empirical evidence nor subjected to peer review, both of which are ongoing in psychiatry research.”

    When you “peers” are corrupted, it doesn’t make the slightest difference. And, as I said below, there are peer reviewed astrology and homeopathy journals as well.

    “Like it or not, empirical evidence of the effectiveness of psychiatric treatment continues to mount,”

    Please give me the studies. Again repeating a mantra “empirical evidence of the effectiveness of psychiatric treatment continues to mount” is not the same as providing a scientific study.

    “and the field will only be further validated if/when the NIMH confirms disease concepts with biomarkers (the idea that prompted this entire discussion).”

    The field will be completely falsified in the new regime. It will become as economics, but at least it levels the playing field in a way that allows psychiatry to be falsified (unlike the Inquisition-type regime of the APA/DSM).

    ” There are important battles for patient rights and justice that should be fought, but not by trying to destroy the medical speciality of psychiatry. To borrow another centuries-old phrase, that effort is the equivalent of “tilting at windmills.””

    If you are truly convinced of this, I hope you write your representatives to strip psychiatry of all its coercive powers: no more civil commitments, no more insanity defenses and making forensic psychiatry entirely voluntary in all court proceedings. Until then, you are just a psychiatrist fighting for your livelihood. In that regard you are no better than astrologers or practitioners of homeopathy (many of whom also have MD degrees) when they make similar statements about their own fields (“some people are helped”).

    Link to this
  33. 33. softwarematters 5:03 pm 05/11/2013

    jayjonz,

    ” Astrologers are not required to provide empirical evidence nor subjected to peer review, both of which are ongoing in psychiatry research.”

    As a scientist that makes a living out of the type of science that makes planes fly or computers work, I want to elaborate on this.

    Science is a profoundly totalitarian endeavor. We are not government by “peer review” but by the laws of nature and the laws of mathematical deduction. The reason people take legitimate areas of medicine (such as oncology) or physics seriously is because they produce astonishing results. Cancers that otherwise killed people 40 years ago, are now cured. And the “falsifiability” test of oncology is clear: without cancer treatments, people would die of a metastatic tumor. That is the same way that the HIV-AIDS theory has been established. The test for the average AIDS denialist is simple: get infected with HIV (as measured by an HIV test), then don’t take any drugs. There is a high probability (like above 90%) that you’ll be dead in 10 years unless you take antiretrovirals. You have two choices: either bet that you are going to be part of the elite club of “long term non progressors” or take the drugs that will keep you alive. Here is how AIDS denialism is confronted : http://www.aidstruth.org/denialism/dead_denialists .

    When it comes to the science behind planes that fly (ie, Newtonian mechanics), same story: the falsifiability of the theory is tested in the US alone 30000 times a day (that’s the estimated number of domestic flights carrying passengers that happen every day).

    When it comes to quantum mechanics, the computers that handle all your bank transactions are built on silicon chips that are designed on quantum principles. I bet you are very happy that the science behind the design of those computers is more sound than psychiatry. You want to count on the fact that the money in your bank account will not disappear unless legitimate business transactions (that you have approved) happen on the account.

    So this is what we are talking about here. I don’t need to appeal to “peer review consensus” to make the case that the science out of which I make a living works. With legitimate branches of medicine, same thing. People are free to risk their lives not following scientific medicine. The biggest irony is that it is the only scientifically unsound branch (psychiatry) that cannot be opposed :D .

    Link to this
  34. 34. softwarematters 8:58 pm 05/11/2013

    jayjonz,

    Things are about to get even more interesting,

    http://www.guardian.co.uk/society/2013/may/12/psychiatrists-under-fire-mental-health

    “British Psychological Society to launch attack on rival profession, casting doubt on biomedical model of mental illness”

    It’s the British equivalent of the American Psychological Association (the other APA) launching an institutional attack against psychiatry. Even in my wildest dreams, I never thought I would see things precipitating this quickly :D .

    Link to this
  35. 35. jayjonz 3:40 pm 05/12/2013

    Softwarematters,

    Yep, the science of engineering is more rigorously empirical than the science of medicine. As mentioned, all medical specialties are best described as art based on science, some more than others.

    Keep dreaming. Sounds like your mind is made up and your goals remain unchanged. That’s unfortunate as you seem intelligent and passionate, and there were many issues raised in this discussion that could use your dedicated advocacy. You’d have many more people on your side if you narrowed your focus to fighting for patients’ rights and justice.

    As far as the question “Is there empirical evidence of the efficacy of psychiatric treatment?”–we’ll leave it up to readers to decide.

    Good luck

    Link to this
  36. 36. softwarematters 5:09 pm 05/12/2013

    jayjonz,

    “Yep, the science of engineering is more rigorously empirical than the science of medicine. As mentioned, all medical specialties are best described as art based on science, some more than others.”

    Again, that statement is only right if you consider “psychiatry” medicine. If you take away “psychiatry” from medicine then medicine is on par with other sciences (at an epsilon/delta distance, but on par). This is what falsifies the HIV/AIDS theory http://www.aidstruth.org/denialism/dead_denialists . Same can be said of other legitimate branches of medicine.

    Do you realize that psychiatry is corrupting medicine with practices such as disease mongering (what was earlier something that was restricted to psychiatry, in recent years, other areas of medicine have tried to pull off similar scams, such as with hormone replacement therapy for menopausal women).

    “Keep dreaming. Sounds like your mind is made up and your goals remain unchanged. That’s unfortunate as you seem intelligent and passionate, and there were many issues raised in this discussion that could use your dedicated advocacy. You’d have many more people on your side if you narrowed your focus to fighting for patients’ rights and justice.”

    Keep dreaming? This is how the greatest injustices of our time have been defeated. In the late 1960s, not in their wildest dreams gay rights activists would think that homosexuality would be removed from the DSM, let alone that gay marriage would be legal in several US states and that a discussion about gay marriage would arrive to the US Supreme Court.

    What you seem unable to understand is that the status quo has been fundamentally altered during the last two weeks. That old “shrink/psychologist” tricks do not work anymore.

    Let’s see where everybody (the NIMH, the APA, British Psychological Society , me, Thomas Szasz, you???) agrees upon:

    1- DSM disorders lack scientific validity, ie, there is not a single bio marker that has been reliably linked to presence or absence of any of the so called “mental disorders”

    2- The DSM is just a “consensus”

    Now, the status-quo has been altered in the sense that even if 1- and 2- were “well known” among professionals, never before their institutional representatives had been on record admitting it. You just cannot pretend to go by as if nothing happened. A lot has changed since April 29th. The chain of events has been pretty dramatic.

    Let me tell you why adopting your approach of “sticking to a known evil” is very evil.

    - First: the most obvious one, all of those DSM disorders have no better basis than homosexuality. I don’t think I have to work very hard to convince you of the untold suffering that was created by labeling homosexuals “mentally ill”. Why is that don’t you get that the same misery comes from any other label, such as “OCD”. Ie, that having a label attached to you, that makes you “less human” can only ruin your life?

    - Second: even for those willing to entertain the notion of being helped by shrinks/psychologists (not me), the DSM approach is not the one with the best outcomes. There are countless cases of people who have fully recovered from their altered mind states only after they rejected the “system”. The most prominent of them is of course John Nash, who has been on record several times that the movie “A Beautiful Mind” (not the book) distorts what happened to him; he didn’t recover because of drugs but only after he rejected the drugs, he blames the distortion on the script writer having a family member worried that so called “patients” would decide to go out of meds. The survivor networks are full of people like him. In fact, the only thing that keeps us together is our contempt for the current system that has ruined our lives; we disagree on everything else.

    People like you could be part of the solution, yet you insist on being part of the problem.

    “As far as the question “Is there empirical evidence of the efficacy of psychiatric treatment?”–we’ll leave it up to readers to decide.”

    This is not how science is settled, by an opinion poll among the readers of a blog. Science is settled by the ability of making accurate falsifiable accurate predictions. I take this as an implicit admission that you have lost the debate.

    As I said, the only question you need to address at this point is whether you want to continue to be part of the problem or you want to be part of the solution.

    Link to this
  37. 37. jayjonz 6:48 pm 05/12/2013

    This isn’t about you, or me, or this “debate.” It’s about science. Psychiatry will remain a medical specialty as long as it continues to be demonstrably effective, a well established reality for most of us. Perhaps you would agree if you had a better appreciation for the science underlying the practice of most medicine.

    The increased media attention on these topics over the last few weeks is due to the impending publication of DSM-V. History will decide if it’s anything more.

    Conspiracy theories stem from fear and hate.

    Peace and love are more powerful.

    Take care

    Link to this
  38. 38. softwarematters 7:02 pm 05/12/2013

    jayjonz,

    “This isn’t about you, or me, or this “debate.” ”

    It’s certainly not about me anymore, since in the US I am legally protected against psychiatric abuse unless I become dangerous, something I don’t have the slightest intention of doing :D . It’s a little bit about you, because you make a living out of a pseudo science, so you have a vested interest in keeping the status quo.

    “It’s about science. Psychiatry will remain a medical specialty as long as it continues to be demonstrably effective, a well established reality for most of us.”

    Are you kidding me? The last two weeks didn’t happen in your mind? You now, people have been labelled “paranoid schizophrenic” from less than that. Let me repeat it for you. In the span of two weeks we have had the NIMH, the APA and British DCP all agreeing that,

    1- DSM disorders lack scientific validity, ie, there is not a single bio marker that has been reliably linked to presence or absence of any of the so called “mental disorders”

    2- The DSM is just a “consensus”

    It is impossible that things are going to continue as if nothing ever happened. Of course, shrinks and Big Pharma making a living out of the status quo will fight back (and they are in full damage control mode as we speak) but the change in unstoppable. It might take long, but it will happen. Let me give you an example about how things might turn out. It’s only a question of time that a legal case that was decided on the assumption that psychiatry has scientific validity is challenged under the explicit admission by those three bodies that the opposite is the case. If the legal case is carefully chose, it could go all the way up to the US Supreme Court, paving the way for a legal battle that could strip psychiatry of its status as a coercive force. That is how other landmark cases in the context of so called “mental health”, such as O’Connor v. Donaldson (1975), have happened.

    ” Perhaps you would agree if you had a better appreciation for the science underlying the practice of most medicine.”

    Actually, I could turn this around and say that if you had appreciation to who real science works, vs the reasoning that passes as “scientific” in psychiatry, you’d be ashamed as having tried to justify your positions with such fallacious arguments as “appealing to popularity” or “appealing to authority”. In science, the only authority are the laws of nature and the laws of mathematical logic. And science is tested via accurate falsifiable propositions.

    “The increased media attention on these topics over the last few weeks is due to the impending publication of DSM-V. History will decide if it’s anything more.
    Conspiracy theories stem from fear and hate.”

    Again, who has talked about a conspiracy ? Certainly not me.

    What you don’t seem to understand is that this is not the typical media frenzy that happens when a new DSM is published. Never before you had three such powerful organizations so publicly agreeing that the DSM lacks scientific validity. Their disagreement is about what to do with 100 years + worth of pseudoscience. It is very unlikely things will be the same.

    As I said, your only problem now is whether you want to be short sighted, and continue to be part of the problem, or open your mind to being part of the solution.

    Link to this
  39. 39. Chryses 5:56 am 05/13/2013

    Softwarematters (34),

    “… if you consider “psychiatry” medicine …”

    Medicine is the applied science or practice of the diagnosis, treatment, and prevention of disease.
    http://tinyurl.com/rdjcv

    An internal state of mind that predisposes an individual to find, in the absence of external or independant justification, suicide an attractive activity may reasonably be described as an illness

    Psychiatry routinely successfully treats such conditions. Psychiatry is therefore Medicine – at least among those who employ these terms as they are commonly used and who think rationally.

    Good luck.

    Link to this
  40. 40. softwarematters 10:20 pm 05/13/2013

    Chryses,

    “An internal state of mind that predisposes an individual to find, in the absence of external or independant justification, suicide an attractive activity may reasonably be described as an illness”

    Repeating a lie many times, doesn’t make it true. This description is only appropriate as a “metaphor”. Unless you come up with a biological test that proves that the brain is diseased when goes though these issues (such as what happens with Alzheimer’s), what you describe is not a true “illness”.

    “Psychiatry routinely successfully treats such conditions. Psychiatry is therefore Medicine – at least among those who employ these terms as they are commonly used and who think rationally.”

    First, I hope that you can come up with some scientific study that backs up the statement “psychiatry routinely successfully treats such conditions”. Because so far none of the defenders of psychiatry has been able to bring a single one.

    If you are speaking anecdotally, I hope you don’t mind I mention astrology and homeopathy as two other disciplines for which your definition of “medicine” can be applied. In fact, there was a time, not so long ago, when homeopathy was also considered a legitimate branch of medicine until it finally was relegated to the scam it is. The same is coming for psychiatry, no matter how many shrinks show up defending their livelihoods here.

    Link to this
  41. 41. Chryses 10:09 pm 05/14/2013

    softwarematters (38),

    “Chryses,
    “An internal state of mind that predisposes an individual to find, in the absence of external or independant justification, suicide an attractive activity may reasonably be described as an illness”
    Repeating a lie many times, doesn’t make it true …”

    As my statement was not and is not a lie, it does not need to be repeated to be true.
    QED

    Link to this
  42. 42. softwarematters 11:34 pm 05/14/2013

    Chryses,

    “As my statement was not and is not a lie, it does not need to be repeated to be true.
    QED”

    Your statement is a lie as in,

    http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

    “The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.”

    So you can keep repeating your lie as many times as you want, it will not become true. As a metaphor, sure. But not as real disease as in “diabetes”. Psychiatric diagnosis does not have scientific validity, end of the story.

    Link to this
  43. 43. Chryses 4:57 pm 05/19/2013

    softwarematters (40),

    “Your statement is a lie as in,
    http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml

    If you feel better redefining words to suit your purpose, then by all means do so, however a lie is willfully misrepresenting the truth or falsehood of a statement. The facts remain.

    1. Internal states of mind which predispose an individual to find, in the absence of external or independent justification, suicide to be an attractive activity may reasonably be described as a mental illness, or a diseased mind.

    2. Medicine is the applied science or practice of the diagnosis, treatment, and prevention of disease.
    http://tinyurl.com/rdjcv

    3. Psychiatry routinely successfully treats such conditions.

    4. Psychiatry is therefore Medicine – at least among those who employ these terms as they are commonly used and who think rationally.

    Link to this
  44. 44. ssenerch 2:11 am 06/8/2013

    Softwarematters, Sarahsezz, Tzollo, your comments are fantastic.

    Softwarematters, I think anyone with a brain would say you won that debate. The opposing arguments appear to be third-grade level in comparison. Well-done. Repeating over and over that psychiatry is a legitimate branch of medicine does not make it so. I am so surprised, time and again, that people who have had the smarts to get through medical school would not have the smarts to question fundamentally unscientific assumptions and methods in their chosen profession. It does astound me.

    In time this pseudoscience will be exposed for the joke/lie that it is. People may still opt to take psychoactive drugs just as many opt for alcohol or other substances/behaviors to deal with their emotions, but it will no longer be pretended that a biological disease is being treated with absolutely no evidence of same. What we are demanding is *honesty* and *legitimacy* in your profession, or its loss of status, respect, and power. Is that so much to ask?

    Link to this
  45. 45. LipService 2:11 am 11/11/2013

    I have always known there was something wrong with me. I wasn’t like the people around me. I tried to commit suicide a few times. I know when I do it again, it HAS to be permanent or I will suffer the consequences of losing my rights as a citizen of this country. I was hospitalized last year. the psychiatrist threatened if I didn’t sign myself in, he would get a court order. So I voluntarily signed myself in. I didn’t know I had voluntarily signed myself to jail. Some days we weren’t allowed to go outside. On the days we were allowed, the time was limited to an hour a day, on lucky days we would get 2 hours. I talked to the therapist once, while I was there. He yawned in the middle of our conversation as he sat there with a bored look on his face, I ended the conversation immediately and did not go back to see him. The psychiatrist came in every couple of days to tell me he was working on my case, trust him, everything will be okay. By week three nothing was any different, than day 1. What a waste of taxpayer money and what a waste of time for the patient. They brought students in from the local college and took away any right to privacy by discussing our cases in front of the whole floor. Anyone could walk by and listen in on our conversations, anyone sitting close by could listen to our private medical details. But that was ok, we were crazy people, we didn’t have any right to privacy, dignity or respect.
    Mental health in the US is a tag word people use but don’t take serious, unless someone murders another. Everyone is concerned until someone actually has to do something. I moved to a different state. Since I have been here, I have had 3 psychiatrists ( in 8 months), that I saw once each. The turnover alone is unbelievable. Each time, I have to start over to help them understand what I have been through, they don’t care. They collect their paycheck, then go home. They tell me I’m getting better, despite the fact, I know I am still the miserable person I was when I started going to their facility. The first doctor gave me meds to help me. I said I would take the meds IF a doctor was going to monitor me on those stupid pills. The doc assured me I would be monitored. The doctor was gone/replaced by the time I got to the next appt. Monitored means: are you taking your meds? I stopped taking the meds. Everyone has a pill to cure you, despite the fact that it isn’t a cure, it just masks the disease and does not get to the underlying cause.
    I have reached out over and over to the mental health people and get slapped in the face over and over. I have been 100% truthful with my feelings so you understand what I am experiencing. Stop telling me I’m getting better when you can’t remember the last session we have had.
    I have explained I think about suicide but I won’t expound on these thoughts, because you are “obligated” by law to report me to the police, only to lock me away. I’m not allowed to express those feelings, even though it might help you understand what I’m feeling and help me get past those thoughts and feelings.
    Everyone gives lip service to mental health, but no one wants to seriously help those of us that are screaming for help. Don’t be shocked when you see those that act out and hurt others and don’t be shocked when we successfully commit suicide. We reached out and you didn’t want to hear us. I no longer trust that you are here for me, it’s just lip service to lull me into a false sense of hope.

    Link to this
  46. 46. JennStephan 12:31 am 06/7/2014

    I am wondering if anyone has had any experience with Truehope EMPowerplus? I ran across this article tonight (I am on my 12th day of the supplement and off all meds) and thought it portrayed a nice third party view. I have been feeling great and level but want to try it longer before I say for sure.

    http://bipolar.about.com/cs/altercomp/a/truehope2.htm

    Link to this

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