The Triumph of Bad Science

Robert Whitaker

July 11, 2012

If we want to understand how our society may end up deluded about the merits of psychiatric medications, we can look at the research published by Robert Gibbons, Director of the Center for Health Statistics at the University of Chicago, on antidepressants and their use in children and adolescents. His latest articles appear in the June issue of the Archives of General Psychiatry, and if we examine his research, and look at how critiques of his research have been treated, we can see how bad science ends up creating a false “evidence base” for the use of the medications.

Let’s follow this story from its start.

In 2004, the FDA concluded that in randomized trials, SSRI antidepressants doubled the risk of suicidal thoughts and behaviors in children and young adults, compared to placebo. That finding led the FDA to issue a  “black-box warning” that these drugs could increase the risk of suicide in children and adolescents.

Gibbons was a member of the FDA panel that voted in favor of the black box warning, fifteen to eight. However, he was one of the dissenting eight, and, as he recently recalled in an interview, he felt that the warning was not warranted. Ever since then, he has published a number of articles that dispute the FDA’s finding that SSRIs increase the risk of suicidal thoughts and behaviors.

As his most recent articles disclose, he has also served as an expert witness for Wyeth and Pfizer Pharmaceuticals in cases related to antidepressants and suicide. His findings, it is fair to say, help make him a valuable witness for the makers of SSRIs.

One of his first such papers, which attracted a great deal of media attention, was published in the American Journal of Psychiatry in 2007. He reported that in the wake of the black box warning (and a similar warning by European regulatory authorities), the prescribing of SSRIs to children and adolescents decreased in the U.S. and Europe, and that when this happened, there was a dramatic increase in suicides in the two countries he studied, the U.S. and the Netherlands. The black box warnings, he concluded, apparently led to an increase in pediatric suicides.

Critics quickly pointed out the dishonest science that Gibbons had employed to make this case. He reported that SSRI prescriptions to youth declined by 22% in the U.S. from 2003 to 2005, and that suicide rates in youth rose 14% between 2003 and 2004. But since he had only the suicide rates for the U.S. through 2004, he should have focused on prescribing rates during that same period of time.

In fact, there had only been a very small decrease in the prescribing of SSRIs to youth between 2003 and 2004, when the number of suicides rose. It was between 2004 and 2005 that the there was a significant decrease in the prescribing of SSRIs to youth, and–as the critics noted–once the suicide data for that period became available, it showed that during that time, the number of suicides for persons ages 5 to 24 declined.

In other words, the data showed that as the number of prescriptions to children and youth declined, the number of suicides in this age group declined too. But Gibbons reported that the opposite was true. He did so by matching the increase in suicides in 2003-2004 to the decline in prescribing in 2004-2005. This is not the sort of error a scientist “accidentally makes.” This is the sort of presentation of data one makes when he or she is trying to deliberately tell a story that fits a preconceived end.

In the Netherlands, Dutch academics were incensed with Gibbons and his statistical antics. In the Dutch Drug Bulletin, they noted that the increase in suicides in the Netherlands was so small that it was “not statistically significant.” They described his conclusions as “astonishing” and “misleading,” and stated that Gibbons and his co-authors had been “reckless” to publish such claims.

But how did the U.S. media treat Gibbons’ article? Newspapers took his conclusion at face value. Gibbons, the Chicago Tribune reported, had “documented a close correlation between declining use of the antidepressants known as SSRIs and rising suicide rates among young people up to age 19.” And given that “fact,” Gibbons told the paper that the FDA’s black box warning had a “horrible and unintended effect” and should be withdrawn.

All told, Gibbons published at least eight papers between 2005 and 2011 challenging the FDA’s black box warning (and it would be possible to critique those papers as well.) Then, in February and March of this year, the Archives of General Psychiatry published in its online edition two more of Gibbons’ articles on this topic. These two articles have now appeared in the journal’s June print edition.

In one article, “Suicidal Thoughts and Behavior With Antidepressant Treatment,”  Gibbons reported that he had done a “reanalysis” of the randomized placebo-controlled studies of fluoxetine and venlafaxine, and found “no evidence of increased suicide risk in youths receiving active medication.” In the second article, “Benefits from Antidepressants,” he reported that these drugs were highly effective in reducing depressive symptoms in youths too.

His reports, starting with their online publication, attracted considerable media attention. In an interview with the LA Times, Gibbons again sounded the theme that the black box warning issued in 2004 was a mistake. “The greatest cause of suicide is untreated or undiagnosed depression,” he said. “It’s very important that this condition be recognized and appropriately treated and not discarded because doctors are afraid to be sued.”

On NPR, it was more of the same. When the FDA issued its black box warning, Gibbons said,  “I worried that what we might end up with was a real epidemic of suicide. And the data suggests that this is exactly what happened. Rather than the black-box warnings leading to decreases in child suicide rates, they were followed by some of the largest increases in child suicide rates both here in America and around the world.”

More recently, with the publication of the two articles in the June print edition of the Archives of General Psychiatry, Medscape reported that his findings indicated there might be a “need to revaluate” the black box warning.

Back in February, when Gibbons’ “Suicidal Thoughts” article first appeared online, David Healy wrote a blog detailing—as he said—the many “tricks” that Gibbons had employed to make the case that fluoxetine and velafaxine didn’t increase suicidal thoughts in youth. In a similar vein, Mickey Nardo, a retired psychoanalyst who writes the blog 1boringoldman, wrote a series of posts on the two articles, describing the “inappropriate data selection,” “opaque methodology,” “obvious arithmetic errors” and “deceitful presentation” to be found in the two studies. Such flaws, he noted, rendered the studies incapable of “supporting any broad conclusions about the safety or efficacy of antidepressants in youth.”

Intent on making his criticisms part of the scientific discussion, Nardo sent a “letter to the editor” of the Archives of General Psychiatry with these criticisms. He did so with the expectation that his letter would be published in the print journal. If so, his criticism would then become part of the scientific record that is archived by PubMed.

The AGP editors neatly kept that from happening. They decided to publish his criticism as a “readers reply,” and only online. As a result, they informed Nardo, “like other online posts, your reply will not be indexed in PubMed.”

As such, his criticism of Gibbons’ report is not part of the “evidence base” on this topic.

More recently, Matthew Miller, an associate professor at the Harvard School of Public Health, whose research focuses on suicide, took a critical look at Gibbons’ newly published suicide article. (Disclosure: Matthew Miller is a friend of mine.)  He and his colleagues who collaborated on this review also concluded that Gibbons’ finding—that fluoxetine and venlafaxine didn’t increase the suicide risk in youth—was unwarranted. Instead, as they detailed in a letter to the editor of the Archives of General Psychiatry, Gibbons had committed methodological errors and misinterpreted data to draw “misleading conclusions.” In fact, Miller and his colleagues concluded that the very data that Gibbons presented in his study, when properly analyzed, “align with the FDA findings,” which is that the effect of antidepressants on suicidality in youth “appears harmful.”

The AGP editors treated their “letter to the editor” in the same way they had treated Nardo’s submission. They published it as a “reader’s reply,” but not as a letter to the editor. Once again, in this way, they kept this criticism from being archived in PubMed, and thus part of the searchable record.

In response, Miller wrote to the journal’s editor, Joseph Coyle, urging that their criticism appear in the print edition. Coyle didn’t respond.

Miller also sent an email to Medscape, protesting its touting of the Gibbons’ article as evidence that the two antidepressants didn’t increase suicidal behavior in youth. Medscape didn’t respond to him either. 

In this brief review of Gibbons’ work—and a review of how critiques of his work were handled by the Archives of General Psychiatry–we can see the triumph of bad science. In randomized trials, SSRIs were shown to double the risk of suicidal thoughts and behavior in children and adolescents. This led the FDA to issue its black box warning. But since then Robert Gibbons has sought to tell a different story, both in the medical journals and in the media, and he has succeeded in doing so.

Critics may have revealed the bad science involved in his reports, but that criticism doesn’t substantially affect the bottom-line conclusion that shows up in PubMed and in the media: Researchers have found that SSRIs do not increase the risk of suicidal thoughts and behaviors in children and adolescents, and the real tragedy is that an unwarranted black box warning may be keeping some depressed youth from getting the drug treatment they need.

As such, this story can help us understand why we, as a society, may end up deluded about the merits of psychiatric medications. The evidence base is massaged in a way that protects the image of the drugs.  Dishonest science gets published in the Archives of General Psychiatry and is archived in PubMed, while in-depth criticisms of that bad science are relegated to the “readers’ reply” corner of the journal’s online website, and thus excluded from the PubMed archives. Meanwhile, the media tells of Gibbons’ “findings,” but omits the part about the scientific dishonesty at the heart of those reports.

And voila, you have a process for creating a societal delusion.

Robert Whitaker

In the News:  A journalist’s review of reports in medical journals and the media on psychiatric disorders and treatments.

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46 thoughts on “The Triumph of Bad Science

  1. As usual, Bob’s analysis of the “bad science” is invaluable, just as “Anatomy of an Epidemic” is.

    But I want to ask, what can we do about this?

    And to answer that question, I have to ask another: what does this really mean?

    It isn’t just mistaken science, or something of only intellectual interest. It is a straight-out lie, designed to accomplish something really sinister, putting millions of children on psychiatric drugs, which as Bob has so ably pointed out, have incredibly destructive effects and ruin these children’s lives. And undoubtedly, the man whose “research” is written about here is being well-paid by the drug corporations who will profit greatly from all this. He is no different from a hired killer. He is paid to carry out actions that he knows will damage and kill hundreds of thousands, even millions, of innocent people.

    Intellectual analyses are fine and worthwhile. But few people read them. And millions of people are affected by what Bob has written about.

    Where is the tone of moral outrage here? What this man has done is not just some intellectually interesting issue about science.

    It is a crime against humanity.

    Why aren’t we saying that? Why aren’t we addressing the general public about this? Why aren’t we raising the alarm here?

    Being “objective” isn’t always a virtue. Sometimes “objectivity” and morality get in the way of each other.

  2. What can we do indeed! I was having a good day until reading this, thanks Bob! ;-)

    I think lots of people are doing lots of different things to bring about change. This website is an obvious example. A change of the size and scope needed will take time I imagine. All the while we’re fighting folks like Gibbons who are desparate to keep the status quo going. The slogan, “I can’t but we can” comes to mind.

    Thanks for another great piece Bob.
    D

    • Great news! The folks at Jannsen Pharmaceuticals are sponsoring a new $50,000 award to ‘reduce stigma’.

      Details of this pointless PR exercise can be found at:

      drguislainaward dot org

      Award judge Pat Kennedy (of the Kennedys of Massachusetts fame)

      said:-

      “This award is inspiring and recognizes the need to change the way people think and feel about brain conditions.”

      Brain conditions huh?

      I don’t remember anybody examining my brain before heaping the stigma on me. Do you?

      Patrick Kennedy is of course just the guy we need in our corner:

      http://en.wikipedia.org/wiki/Patrick_J._Kennedy#Personal_issues_and_incidents

      So, $50 grand from drug company coffers is a couple of seconds in quarterly profit, and a small price to pay for a nice sounding press release that makes it look like the company is the ‘advocate’ for the group of people it profits from lying about and stigmatizing.

  3. Money, Money, Money, Must be funny, in the rich’s man’s world!

    I agree with Ted anger, outrage and stronger reactions are warranted. We need the anger to affect some kind of change.

    We need strong grass roots organizations that band together and use outrage to change things. We need parades, strength, pride and the focus to challenge the money. We need a big and loud enough mouth piece that the media gets interested to hear what we say. We need to challenge not just the medication crap that is going on, but the attitudes that are so prevalent that makes it so darn easy to discredit us when we speak up.

    We need hospitals that are held accountable.
    We need doctors that are held accountable.
    We need therapists that are held accountable.

    Right now what we have is a quiet whisper. A murmur in the ranks. When a few of us get angry enough to sound louder we are easily dismissed by the status quo as too extreme, after all, we are mentally ill, right?

    I think we need to band together more, get more organized, get angry enough to be loud, and start to take massive action.

    • How about standing outside a local psychiatrist’s office and handing out information before people walk in. I see people standing outside abortion clinics with signs all the time. Presenting the information as something the psychiatrist will not tell you. A generic pamphlet that can be easily printed and handed out. Occupy a psychiatrist or mental health clinic for the day. We have to take this to the next phase beyond a comment section.

      • Thank you, Bob. Your article has brought so many things to mind, as have all the insightful comments I have read. Here is my contribution.

        Black box warnings are supposed to be just that: a warning. The black box means that it is “the” sternest warning possible. Doctors prescribe medicines every day that have black box warnings, and most of the time neither we nor they think anything of them. In the case of psychiatric medicines, the big problem occurs when a doctor prescribes a black box psychiatric medication to a child or youth and the patient commits suicide.

        We are all horribly upset when we personally know a child or young adult who commits suicide. I’m sure this guy Gibbons is just as upset about his friend’s child or a neighborhood young adult commits suicide. The big difference is that when we find out that this child or young adult was on an antidepressant with a black box warning for suicide, we are outraged….because we have prior knowledge and understanding that these medications may not have helped this person at all, but may have actually caused or precipitated this death.

        Gibbons, be he Mr. or Dr., is someone who is philosophically FOR psychiatric medication for most or even all individuals who ever had psychiatric symptoms. He, I am fairly sure, believes that this child or young adult who was on antidepressant medication and took his or her own life did so IN SPITE of being medicated. Gibbons, more than likely, believes that this child or young adult was either off his or her meds, mixed meds with drugs or alcohol or was “too far gone” or “would have taken his or her life no matter what was done for him/her.” Perhaps Gibbons believes that the child or young adult couldn’t contact his or her therapist/psychiatrist or that the therapist/psychiatrist was not a good one. Perhaps in some way, this tragic young suicide was not compliant. But Mr./Dr. Gibbons does not believe that psychiatric drugs caused an unnecessary death. If he did, he would be in here agreeing with us!

        The notion that removing the black box will somehow decrease the suicide rate is a very poor exercise in logic. Any doctor who is reputable will not hesitate to prescribe a black box medication if it is the best one to treat the problem, whatever it is. Surely not all psychiatrists are unethical.

        His logic is that, because the black box warning is on these antidepressants, doctors will hesitate to prescribe them to the children and young adults who “so desperately need them.” Poppycock!! With the plethora of antidepressants out there, any psychiatrist with a conscience can correctly prescribe antidepressants to suicidal children and young adults that do not have the black box warning. “When there is a will there’s a way” isn’t just some catchy phrase to put in a fortune cookie.

        As professionals in the mental health community in various capacities, we should all encourage anyone who is suicidal to obtain psychiatric help. However, we should also encourage everyone giving or receiving psychiatric help to give and receive it at its lowest concentration of evil, that is, the lowest dose of the least dangerous drugs and that they should also receive liberal doses of non-pharmacological help: psychotherapy, facilitation of family/friendships, social support webs (such as church/temple)and good old fashioned activities (hobbies, clubs, groups, etc.).

        This is how I survive in this crazy world of mental health. I do my work and the rest I “encourage.” Let’s all make a difference where we can in what way we are able. I’m sure my survival will be a little more tolerable from here on out by learning from you folks.

        Susanna Maklakov, M.S., OT/L

  4. This shows the vital need for this website as a honest journalism and a truly public forum, in contrast to commercial media censorship and propaganda. Exposing the propaganda and disinformation process like this is as important as critiquing the research…

  5. Perhaps it’s the triumph of marketing OVER science. We’re way beyond “misunderstandings” and into the realm of overt corruption.

    No one can really claim they don’t know any better today. He does know better and is trying to refute what he knows to be true, just as tobacco companies knew cigarettes caused cancer but did all they could to prevent this truth from becoming commonly accepted.

    This guy is clearly out to promote a viewpoint, and the truth is simply not relevant as long as he gets paid.

    — Steve

  6. Thank you again Bob for exposing the moral wasteland that too often masquerades as the practice of medicine and science. At what point does bad science no longer qualify to be discussed as science? At what point do we see it as criminal fraud carried out by the same cast of characters who stand behind the recent enormous legal judgements against the drug companies?- the same companies that financially support guys like Gibbons.

    I’d love to see medical journal editors that recklessly legitimize such fraud schemes be identified by the justice departmnet under the RICO statutes as co-conspiratoras- as well as administrators of the tax payer funded university research departments that collude with such research by approving it being done.

    For several years there has been too much evidence that SSRI’s reduce impulse control in some instances of self harm and harm to others. The legendary- “I don’t care” effect of Prozac and other SSRI’s is at play in too many suicides and school shootings by teens who already have marginal impulse control. This well known evidence makes any attempt to remove the black box warninga by Gibbons, a known rep of the drug companies that would profit from it’s removal, part of an organized effort to de-fraud the public in my opinion.
    This kind of fraud endangers young lives everyday. Unfortunately it takes place in the echo chamber of journals and research departmnets that believe their own delusional beliefs about the cause and cures of so-called psychiatric disease.. if you put Gibbons and the psychiatric science guys on a polygraph you would see they are not lying, they believe in what they are doing is true. Is it fraud if zealots believe their own dogmas and go about wreaking havoc for the fervently held belief that it is for the good of others? We used to call that fundamentalism.

  7. Another triumph of “us & them” cause & effect logic Bob?

    “As such, this story can help us understand why we, as a society, may end up deluded about the merits of psychiatric medications. The evidence base is massaged in a way that protects the image of the drugs. Dishonest science gets published in the Archives of General Psychiatry and is archived in PubMed, while in-depth criticisms of that bad science are relegated to the “readers’ reply” corner of the journal’s online website, and thus excluded from the PubMed archives. Meanwhile, the media tells of Gibbons’ “findings,” but omits the part about the scientific dishonesty at the heart of those reports.

    And voila, you have a process for creating a societal delusion.”

    Meanwhile in the reality of LIFE and the need to maintain a consensus reality, the real deluded culprit remains in denial, us and lack of self-awareness?

    Progress happens slowly and we are simply not ready yet to face reality as it really is, beyond the should & should not’s of a consensus reality? Consider;

    “Social aspects of consensus reality:

    Singers,[7] painters, writers, theorists and other individuals employing a number of means of action have attempted to oppose or undermine consensus reality while others have declared that they are “ignoring” it.[8] For example, Salvador Dalí intended by his paranoiac-critical method[9] to “systematize confusion thanks to a paranoia and active process of thought and so assist in discrediting completely the world of reality”.[10]
    [edit]Reality enforcement

    The theory of reality enforcement holds that belief in consensus reality (the “reality”[11] of “reality enforcement” is used in this sense)—on which the apparent persistence of consensus reality’s existence may depend—is “enforced” through various means applied against those who challenge it, including involuntary commitment.[citation needed] Thus, believers in reality enforcement are typically sympathetic to anti-psychiatry. While mental health codes in some United States states specify that a diminished “capacity to recognize reality” (taken from some definitions of psychosis[12]) is part of the standard for mental illness, “there is controversy over what is considered out of touch with reality.”[13]

    Richard Rogers and Daniel W. Shuman, in their book Conducting Insanity Evaluations have, however, said that the standard “refers to the intactness of the individual’s perception of external stimulae” and equated it with “reality testing”,(p. 85) a definition that goes right to the heart of the argument.

    The validity of this as a standard in general has also been questioned. Arthur D. Hlavaty has called the unwillingness of his parents to be overly harsh in breaking down the “walls” of his Asperger syndrome an unwillingness to engage in “reality enforcement.”[14] Some have expressed concerns on computer forums about psychiatric medication being used for “social control” and “reality enforcement.”[15]

    Reality enforcement has also been used to apply to the promotion of consensus reality, such as in education.[16] (The term “reality enforcement” has apparently been also used in looser senses, such as a moment in which one is suddenly “jolted back” to “reality,”[17] negative social sanctions applied to those who transgress gender norms,[18] the correction of factual errors in print or speech[19] or vigilance applied to the “authenticity” of a fictional world.)[20]

    Reality enforcement has been characterised as a possible aspect of psychiatry or approach to or method of psychiatric practice,[21] though its efficacy in promoting realism [disambiguation needed] (in the particular case of genetic counseling) has been questioned.[22]

    The theory of reality enforcement is opposed by those called “reality enforcers” (or, more precisely, “enforcers of consensus reality”)[23] by the supporters of the theory, who have been called “biased” and having a “skewed view of reality;”[24] the term “reality enforcers” has also been used more loosely to describe those who “shore up” a “dominant paradigm” in which general belief is wavering.[25] (Sometimes the term “reality enforcement police” is used interchangeably.)[26] The so-called “reality enforcers” occasionally use the phrase in order to ridicule those who believe in the theory, or, more loosely what they see as farfetched or conspiracy theories generally.[27]

    (It should be noted Alan C. Walter uses the phrase “reality enforcers” in a highly idiosyncratic way having nothing to do with the theory of reality enforcement.) These “reality enforcers” appeal to an objectivist theory of reality, rejecting multiple subjective realities which could diverge considerably, which contradicts the theory of “reality enforcement.”

    In a more general sense, “reality enforcement” is used to mean an (often violent or forceful) ending of a “fantasy” in the person, persons or group on whom it is enacted,[28] or the assertion, using force, of some “reality” to those who are not aware of it, or are in denial about it.” http://en.wikipedia.org/wiki/Consensus_reality

    And what keeps this delusion firmly in place? The unconscious need for homeostasis?

    LIFE AS HOMEOSTASIS

    Living organisms are self-replicating and self-sustaining dynamic chemical systems. They obtain energy from, and information about, their environment – including its chemical, physical, geological, and biological components. A feature that distinguishes living from non-living matter was identified by Claude Bernard. This is homeostasis – the maintenance of a constant internal environment despite changes in the external environment. A second feature of all known life, first proposed explicitly by Schleiden and Schwann, is that living things are composed of spatial compartments, called cells. Cellular homeostasis requires a system of integrated feedback and feedforward, producing adaptive responses to, and anticipation of, ultimately uncontrollable changes in the properties of the outside world. As life evolves, it extends its reach by maintaining its constant internal environment in new external environments, previously inhospitable.

    • A more detailed explanation of my time limited response above.

      Systems thinking vs. our cause & effect reactions of logical reasoning?

      Please consider;
      “Systems thinking, which this research has tried to implement in human relationships, is directed at getting beyond cause-and-effect thinking and into a systems view of the human phenomenon. In the coarse of trying to implement systems theory and systems therapy, we have encountered the intensity and rigidity of cause and effect thinking in the medical sciences and in all our social systems. Man is deeply fixed in cause-and-effect thinking in all areas that have to do with himself and society.

      Systems thinking is not new to man. He first began using it in theories of the Universe. Much later he started thinking systems in the natural sciences, and also in the physical sciences. There was a rapid increase in systems thinking with the beginning of the computer age, until now we hear about efforts to implement systems thinking in many new areas of the applied sciences. Though man may have gained some knowledge about systems thinking from the sciences, he is still a cause and effect thinker on all things that involve his emotional system.” _Murray Bowen.

      The Consensus Reality of “I & Other & Us vs. Them.”

      In our consensus reality have we become so stuck in a cognitive sense of “objectivity” that we literally have lost the ability to sense, the organic nature of a fellow human creature, before our eyes? Are we stuck in a paradigm of pseudo self-awareness, stuck in a socialized denial of our instinct driven, intellect? Consider;

      “I & OTHER:
      So every ego is continuously struggling for survival, trying to protect and enlarge itself. To uphold the I thought, it needs the opposite thought of “the other.” The conceptual “I” cannot survive without the conceptual “other.”
      The others are most other when I see them as my enemies. At one end of this scale of this unconscious egoic pattern lies the egoic compulsive habit of faultfinding and complaining about others. Jesus referred to it when he said, “Why to do you see the speck that is in your brother’s eye, but do not notice the log that is in your own eye?”

      At the other end of the scale, there is physical violence between individuals and warfare
      between nations. In the Bible, Jesus’ question remains unanswered, but the answer is, of course: Because when I criticize or condemn another, it makes me feel bigger, superior.”

      Exerts from “A NEW EARTH” by Eckhart Tolle.

      Why is our current cognitive reasoning capacity so fixated on cause & effect, mechanical thinking? Because we are oriented by instinctual motor reflex, not intelligence or depth of insightful awareness? Our focused attention remains instinctively “out there,” lacking insight into the environment within, where our perception is actually constructed. Constructed, overwhelmingly by nature’s electro-chemical reactivity and not by any parts like mechanisms of an elaborate mechanical construction. Yet in our learned awareness of a consensus reality, we think and speak about ourselves, in this, now out-dated mechanical world view? We simply take it for granted, as a “just so,” of our social environment?

      We remain in socialized denial of our inner world, and the raw power of affect/emotion by which we are deeply embedded in the reality of nature and the wider reaches of the Cosmos. We say the word Evolution, in a dissociated mind state of awareness, which refuses by learned social suppression, to FEEL the inner reality of Evolution. We’re stuck in civilization’s war on the “A” word? We dare not mention it for fear of being ostracized by our social peers, who seek the comfort-zone of civil discourse, and the cool dissociation of the intellect, in its pale imitation of the vitalizing affect, in a real-life NOW?

      What I believe is missing in Robert’s cause & effect analysis of a societal delusion about the efficiency of drug therapy, is the emotional transaction between Doctor & patient, in the real-life anxiety of that lived moment. A moment of NOW, which begs a constant question of us all? Can I cope? Psychiatry clings to the illusion of drug efficiency because it currently sees no other way to cope with the demands of unconscious stress reactions, in that moment of consultation, when the individual or those close to him/her are seeking immediate relief. So we sedate. Problem resolved in our usual modus-operandi of crisis management.

      In a socialized consensus reality, we remain in denial of this hard-wired response-ability, to LIFE. What is also missing from the cause & effect analysis of a societal problem, are the hidden stress responses, which bring the identified patient before the good Doctor, for the very first time? In our cognitive consensus fashion, the problem is analyzed as some, thing, “out there,” a story of “not me” otherness describing power broker’s, who somehow force a delusion on helpless others? An analysis, I believe, is lacking a subtle sensitivity to inner sensation, and its construction of perception?
      An unconscious, autonomic, “I & Other,” response, of limited self-awareness? Supported by this cradle of denial, a socialized, consensus reality. A fearful suppression of nature’s powerful sense of vitality, our innate affect/emotion? Consider;

      “INNATE AFFECT/EMOTION & SOCIETY:
      Because the free expression of innate affect is extremely contagious and because these are very powerful phenomena, all societies, in varying degrees, exercise substantial control over the free expression of the cry of affect. No societies encourage or permit each individual to cry out i.e, rage or excitement, or distress or terror wherever and whenever they wish. Very early on, strict control over affect expression is instituted and such control is exerted particularly over the voice, whether used in speech or in direct affect expression. (p, 93)

      With anger the matter is further confused, because of the danger represented by this affect and enormous societal concern about the socialization of anger, what is typically seen and thought to be innate is actually backed-up. The appearance of the backed-up, the simulated, and the innate is by no means the same. (p, 94)

      Details of the difference in socialization concern, differences in tolerance or intolerance of the several primary human affects – excitement, enjoyment, surprise, distress, contempt, shame, fear and anger – which in turn determine how positively or how negatively a human being learns to feel about themselves and about other human beings. Such learning will also determine their general posture towards the entire ideological domain. (p, 168)”

      Exerts from “Exploring Affect,” (1995) by Sylvan Tomkins.

      Hence a societal delusion is created and maintained by our need to suppress our own nature, in this process of societal evolution, we call civilization?

      • Dear David Bates,

        I have read your two posts here, and a few of your other comments on previous blogs. I don’t understand what you are saying. Would you please describe, in a few paragraphs, in as concrete and non-conceptual terms as possible, what you believe Bob should have said? How do you think he should have described the events, and how should he have interpreted what he described? If you believe other events are relevant, what are they and how should he have described and interpreted them?

        Thank you.

        Pete Dwyer

        • Pete,

          Not speaking for David, but to what his posts evoke from my spiritual aspirations, as they pertain to the Buddhism of Nichiren Daishonin (1222-1282, Japan- (his practice, established in 1253, is based on the historical Buddha, Shakyamuni’s highest teaching, the Lotus Sutra). I have engaged in practice and study of Nichiren Buddhism for the past 24 years. David has written commentary that describes, in part, the Buddhist doctrine “Dependent Origination”, that explains the coming into existence of all life entities and phenomena as the effects causal relationships. This very difficult to comprehend story of creation, literally defines our existence as one of ongoing interconnectedness. Buddhism is unique amongst religious and life philosophies in that it claims no superior or transcendental being as a creator, and it completely removes the concept of dualism; ie; self and other, self and environment, mind and body… ,even good and evil… as ALL share a common essence- the Ultimate Law of Life—-given concrete expression as the title of all chapters and volumes of the Lotus Sutra:” Myoho-Renge- Kyo” Because of this shared essence, all entities and phenomena are subject to transformation and cannot be defined as *fixed* descriptions… all things being in a state of flux, the transformation is dependent on consciousness as an influence.( The practice of chanting Nam-myoho-renge-kyo awakens one to this powerful innate influence— )

          Realizing I have already delved further into the basis for my own thinking, I will just cut to the chase of what I understand from David’s 2 posts here–as they relate to this blog post by Robert Whitaker. David describes a *shared delusion* as the basis for all misunderstandings between patients, psychiatrists, scientists and journalists who weigh in on the status of the conflict. This delusion is based on *difference* to the exclusion of all potentially beneficial *commonalities*.

          Brief example: Science based thinking is cause and effect analysis. An event can be explained and understood in this construct–we can know WHY something happened, but can never fully explain why it effected a select person or group and not another—and therefore can never accurately predict who else is at risk–This is the limit for science! It is based on concrete separations and dualism.

          IF the philosophy I described briefly were the accepted norm, then, there is no exclusion of contributing factors— a psychiatrist, for example, could not view a patient’s experience as separate from his existence— or rather what is happening to the patient is more like a bit of micro data about ALL of us. IF the psychiatrist believed this, then he/she would immediately engage in a process of analyzing info and problem solving for his own safety and well being— invested and involved to a degree none of us can easily imagine!

          David, is writing from a perspective that is based on *reality* that correlates with spirituality— and carries the message that we are literally all in this together— He makes many references to this type of thinking that removes all validity from “us” and “them”— or solutions that are predicated on blame assignment to individuals or groups as being mutually exclusive entities.

          The dialogue that I am certain is a major focus of Bob’s work; that psychiatry engage with the public and all people with a vested interest, in a dialogue regarding the dichotomy that exists between scientific evidence and psychiatric practice CAN only really occur when the commonalities of all participants are discovered and shared—- otherwise it is a tedious debate, at best. THIS accords with spiritual beliefs regarding concepts like, Ultimate Reality.

          I find David’s writing very enriching and cutting edge… I think he both provokes deeper thought and provides an ideal that is beyond the comprehension of most of us… unless we pause to consider WHAT IF… he is right?

          • Sinead,

            Thanks – that helps. It is somewhat clearer, and if I understand what you’re saying, there’s some common ground here with what I’ve been thinking. For starters, your example of the psychiatrist and the patient seems connected with my view that we should throw out the word “intervention” and replace it with “interaction; and on the deepest level, I don’t think anyone “treats” anyone else. We are indeed all in this together, and the best way to be useful to someone else is to work full tilt on our own issues and do everything we can to bring about a world in which we don’t hurt or exploit each other.

            But I’m going on scant information, considering I don’t understand that much about what you’re saying, and as you say, you can’t speak for David.

            I would still very much like to know – again, in concrete terms – how David would describe and interpret the situation Bob wrote about.

            Thanks
            Pete

          • “I find David’s writing very enriching and cutting edge… I think he both provokes deeper thought and provides an ideal that is beyond the comprehension of most of us… unless we pause to consider WHAT IF… he is right?”

            Thank you, from the bottom of my heart Sinead!

            You are the only adult in this community with the courage, grace and dignity to seek real perception, beyond personal dependency needs.

            I can’t thank you enough for your kind words of support, as I try to give from my heart & soul, what the reality of my nature dictates.

            I do stand by an earlier statement that there will be no paradigm shift until we begin to be more honest with ourselves, about the reality of our functioning?

            Until then, we will continue this merry dance of “us vs them,” going round and round in circles with the same old arguments”

            The same old “the more things change, the more…..” path to oblivion?

            Its an evolutionary maypole which we march around, in our constant “acting out” of our blind instinctual nature.

            The spinal column and the brain stem reality of the serpent, the rod, the staff, or any other metaphor interpretation of our hidden, internal motor-vation, we can think of. Consider:

            “The motor act is the cradle of the mind – The capacity to anticipate and predict movement, is the basis of what consciousness is all about” _Sir Charles Sherington.

            In the Beginning, before the Word, was Consciousness.
            The primal consciousness in man is pre-mental, and has nothing to do with cognition. It is the same as in the animals. And this pre-mental consciousness remains as long as we live the powerful root and body of our consciousness. The mind is but the last flower, the cul-de-sac. _D. H. Lawrence.

            “Most people think of trauma as a ‘mental’ problem, even as a ‘brain disorder’ However, trauma is something that also happens in the body” _Peter Levine “In an Unspoken Voice”

            And the “existential crisis” so eloquently described by Paris Williams?

            “Ultimately, we have only one fear, the fear of not being able to cope.” _Peter Levine.

            Or the Tyranny of Self-Doubt, imposed by a lack of sensitive, Self-Awareness?

            Again, I thank you from the bottom of my heart Sinead:))

        • Dear Peter,

          What Bob should have said?

          “Being as honest as I can be with myself and my readers., I’m a trained journalist, taught to present a story that captures attention in simple concrete and non conceptual terms. To do this I look for an angle, a hook, on which to predicate my story and capture the readers immediate attention, and feeds their need for simple black & white answers. I do this because I understand that this is what my readers really want, just as psychiatrists understand that their patients want the quick fix answer to the “existential distress,” from which they are suffering.”

          So as a good journalist I begin with;
          “If we want to understand how our society may end up deluded about the merits of psychiatric medications, we can look at the research published by Robert Gibbons, Director of the Center for Health Statistics at the University of Chicago, on antidepressants and their use in children and adolescents. His latest articles appear in the June issue of the Archives of General Psychiatry, and if we examine his research, and look at how critiques of his research have been treated, we can see how bad science ends up creating a false “evidence base” for the use of the medications.

          Let’s follow this story from its start.”

          My concrete simplistic reply to Peter’s need for such a mind-based sense certainty/security is;

          This is not the start Bob?

          The starting point, of how “our society may end up deluded about the merits of psychiatric medications” is as I wrote above?

          “What is also missing from the cause & effect analysis of a societal problem, are the hidden stress responses, which bring the identified patient before the good Doctor, for the very first time?”

          As Sinead points out with reference to Buddhism’s deeper awareness, beneath our “at first glance Western educated objectivity,” “Dependent Origination” is first cause and its the socialized denial of our innate dependency, as the cause of existential distress in so-called mental illness, which is the deeply rooted factor NOT addressed in Roberts black & white, cause & effect, intellectual reasoning.

          A basic and fundamental denial of the “instinct” stimulation of of our so-called intellect.

          And yes I’m fully aware of just how much resistance there is to this fundamental truth, about our human/animal nature. Yet I stand by every single word I’ve written on this webzine since early June when the metamorphosis of another six week long psychosis, began to complete its personal transformation work, as mother nature and the REALITY of evolution has always intended.

          In a recent comment about Robert’s seeking dialogue with leading figure in psychiatry, the recoil reaction that Bob received was “I don’t like your attitude.”

          In a private email to Robert I asked him to consider that I was trying to show people their “unconscious” reactions towards me, and asked him to be more transparent about the nature of our tendency to cover-up truth and reality.

          As a maverick outsider, to use an American term, and as a non-member of the educated priesthood, I am predictably ignored on this webzine, in a perfect real-life example of all the information I’ve provided, from brilliant and non-sycophantic truth seekers like Murray Bowen and Silvan Tomkins.

          Please watch this video about our false sense of spirituality in the Western World?

          A sense of reality born from denial of our own nature, as we cling to a childish dependency?

          Watch a wonderful Catholic priest tell his flock to grow up and face reality as it is?

          http://www.youtube.com/watch?v=mOHFCTnuWnw

          On the Mad America webzine, this IS the great avoidance issue, and as Sinead rightly points out;

          “Realizing I have already delved further into the basis for my own thinking, I will just cut to the chase of what I understand from David’s 2 posts here–as they relate to this blog post by Robert Whitaker. David describes a *shared delusion* as the basis for all misunderstandings between patients, psychiatrists, scientists and journalists who weigh in on the status of the conflict. This delusion is based on *difference* to the exclusion of all potentially beneficial *commonalities*.”

          Further more Peter, you join the real debate, after your initial “reaction” to my posts?

          “there’s some common ground here with what I’ve been thinking. For starters, your example of the psychiatrist and the patient seems connected with my view that we should throw out the word “intervention” and replace it with “interaction; and on the deepest level, I don’t think anyone “treats” anyone else. We are indeed all in this together, and the best way to be useful to someone else is to work full tilt on our own issues and do everything we can to bring about a world in which we don’t hurt or exploit each other.”

          Search your heart Peter, and be honest about your fundamental needs. In your response to my comments on Robert’s essay, were you seeking an honest perception, or a sycophantic connection with the webzine’s community?

          Harsh words, which in our consensus reality I’m not supposed to utter, “I don’t like your attitude,” the predictable reaction. Exactly the same response the psychiatrist had to Robert, and exactly the same response Robert has to me?

          Are we fully conscious, intelligent and reasoned human beings? Not yet! Me thinks?

          Here’s a qoute that child like, black & white hero worshiper’s will react to with predictable disdain, for my “obvisuously,” Crazy attitde?

          “Myth is much more important and true than history. History is just journalism and you know how reliable that is.” _Joseph Campbell.

          In Buddhist terminology. Try to catch the gap, between the spark and the flame, which IS your mind?

          Or in Western terminology, Moses Burning Bush?

          • David,

            I think I understand more of what you are saying. We do seem to have some common ground:

            Dependent Generation resonates with how I see things, for instance. I also agree many/most of our thoughts are influenced – often driven and distorted – by very gut level emotions. Even so, I do believe we can think clearly, without simplistic reductionism. That usually happens when we’ve had the chance to heal from traumatic experiences that create defensive and distressing gut level emotions.

            In my experience, healing can take place in many ways, but it’s almost always best in the presence of another person who assumes you have something important to say, and accepts you without demanding that you first be rid of all your gut-level feelings. It’s good to have people welcome you, what you have to say, and what you feel.

            You mention “… the metamorphosis of another six week long psychosis … ” I know people who have used such experiences to greatly increase their ability to live the lives they want to have. I hope that is so for you. You are obviously very smart and passionate about what you are doing. I encourage you to cultivate direct contact with people you feel safe with, and to process your experience with as much support from others as you can. I’ve found that sometimes even unlikely people can come through for me when I give them the opportunity.

            Thank you for your thoughts and obvious caring about what goes on with people. And all the best on your journey.

            Sincerely,
            Pete Dwyer

  8. I agree that there is rampant publication bias, I agree that medical journal editors are bought and paid for by pharma.

    I agree that most RCTs pharma puts out cannot be trusted. I don’t trust shrinks who get paid to be drug blaming expert witnesses in court either. Especially the ‘stealth ECT psychiatrist in the reform movement’.

    I don’t believe in straight out saying a drug ’caused’ a suicide.

    What kind of person volunteers to be paid to be in a study?

    http://neuroskeptic.blogspot.com/2012/01/antidepressants-bad-drugs-or-bad.html

    How common is ‘suicidality’ in everybody?

    http://abcnews.go.com/Health/DepressionNews/50-college-students-felt-suicidal/story?id=5603837#.T_6Hz_X6icI

    http://news.xinhuanet.com/english/health/2012-05/02/c_131563140.htm

    I believe it is demeaning to paint people as automatons with no free will on psychiatric drugs.

    People who are psychiatrized, that is, indoctrinated into the tenets of the medical model, are made to feel they are the passive victim of an active brain disease, and therefore that they are at the mercy of this brain disease (that they believe is real), and I just hate to see a simple just so story told about drugs.

    Some kid on SSRIs, who is crying himself to sleep at night believing he is doomed to a life of ‘chemical imbalance’ despair and a drug carousel, who impulsively decides to rig up noose in his closet and hang himself, is still a human being with intentionality, an actor, instead of the endless grinding debate about the garbage drugs put into his body, what about garbage ideology put into his MIND?

    Say this kid does kill himself, he’s ‘on’ two things, the drug, AND the ideology of helplessness and hopelessness instilled in him by the shrink his mother carted him off to see and get a label and a prescription.

    The kid has been led to think he is defective, that his most important organ, his thinking organ, is defective. A pervasive feeling of ‘there is no way out’, ‘there is no point’, can be brought about by such a belief.

    If he kills himself, the mother buries him, and as his casket descends into the ground, people are blaming SSRIs. Does anybody see what is wrong with this picture? Even IF, someone from the drug company gets put in prison, and millions in restitution is paid, who is going to be held accountable for allowing that young person to lay in bed ruminating on his falsely ‘hopeless’ situation? Who is going to be held accountable for allowing the kid to believe he is a diseased brain? That he has no active part to play in the solution to his problem other than to be at the mercy of fraudulent neurochemistry technicians?

    Maybe, ANY psychoactive drug, can increase impulsivity. That doesn’t obviate the fact that it would demean the memory of any dead kid, to simply make a blanket statement blaming SSRIs for his decision making, which still remain acts of human intentionality.

    Garbage in/garbage out with BOTH neurotoxic pharmacological crap AND psychiatric ideology.

    To read some of the unbelievable conspiratorial musing on this site about the Columbine massacre, or Mary Kennedy’s final solution to her life of dysfunction and despair, is something I find demeaning. It sometimes, many times, comes across as if there is a suite of people who believe fervently that if these drugs were never invented, these complex human events would never have occurred.

    On the FDA, there is no reason to trust any institution. Trust in public institutions is at an all time low, and set to plummet even more in the coming years. The FDA is a big government institution no more trustworthy than the CIA. If you were filmed by an unmanned drone unloading a truck in Pakistan, the President of the United States can order your summary execution from a missile strike operated by a 23 year old with a joystick thousands of miles away.

    The government doesn’t care about us. Big business doesn’t care about us. Big science and the closed shop of Big Academic Journals don’t care about us. Big psychiatry is out for their own prestige and they don’t take prisoners.

    The most worthwhile activity on the internet in relation to so called mental health is to provide resources that people who’ve been misled can come across to make their own responsible decisions to stop believing the lies. When this site does that, it is among the best resources around.

    Questionnaires filled out in some room somewhere by a disparate bunch of people who believe in psychiatry enough to step into that room and get paid 40 bucks, are never going to lead to ‘good’ science on an event as complex as human self-killing.

    • Anonymous,
      RE: your frequently posted beliefs focused on linking SSRIs to suicide, I must point out how efficiently you have proven that one’s beliefs can override even the most compelling factual basis for dispelling them! And as such, your comments demonstrate, in part, the force of opposition to reforming the practice of the leading, most highly esteemed American psychiatrists. If you had the status, respect and clout of these psychiatrists, you would be well on your way to commanding a formidable audience who would protect and propagate YOUR BELIEFS about the gross errors involved in citing SSRIs as a cause for suicide.

      With all due respect for the validity of the emotions that are filtering your views of any issue around psychiatry reform, I would like to point out that there is a significant emotional filter employed by psychiatrists with regard to their being unable to accept actual, factual scientific evidence. While you protect and nurture your own *self* concepts of your very real and pure identity as a human being with both knowledge and experience, the vast majority of psychiatrists in our country are protecting their mutually established identity— and claim to a rather high standard of living! Though we are all loathe to acknowledge it, we share something in common— even with our designated arch enemies. IT’s about human nature… evil or good, we are all in possession of self preservation traits.

      So, as you continue to rail against the SSRI issues and anything other than :

      “The most worthwhile activity on the internet in relation to so called mental health is to provide resources that people who’ve been misled can come across to make their own responsible decisions to stop believing the lies. When this site does that, it is among the best resources around.”

      I am going to politely and respectfully share that we do, after all is said and done, live in the U.S.— and though poorly educated in the process of redressing grievances to “our government” , actually do have a means for gaining the attention of our law and policy makers and become the focus of their attention. If WE abdicate this right, we really cannot describe our plight as innocent victims who need to band together for protection from the”government”. You can believe that this is a worthless use of time and energy… so long as you discount the factual evidence that this is the only proven method for initiating change and fail to realize that this is the ONLY avenue that remains uncharted and untapped by credible, valuable resources, such as this site. THE “WE THE PEOPLE” , organized movement for political and social change is the next frontier. WHAT is the major obstacle to this, the next and most crucial level? I think it is our culturally conditioned preference for “Individualism”— self preservation for personal comfort and gain is the epitome of the current American culture.

      We are not even oriented to the meaning of community as it relates to our benefit being intricately linked to bringing benefit to* others* (others, as in even those to whom we have no personal connection, but share a neighborhood, community, society, country–replete with the full gamut of good and evil inherent in the governing bodies that impact us all)) with equal emphasis for our own dedication to personal well being. I would link this to “depression” on a large scale— that exclusive focus on the self leads to this condition— which as we are told by the experts, has reached epidemic proportions in the U.S.!

      Connecting and networking on this site is definitely a gratifying and empowering experience. It also has the potential for igniting a movement that empowers WE THE PEOPLE as the force of change and benefit for ALL. As such, madinamerica could be called the best first line treatment for depression… a “mental illness” that has paralyzed our PEOPLE for a little over 100 years!

      So, the next time you post from the core of your beliefs, I hope you will consider that you are demonstrating your full indoctrination to individualism, which deserves the highest respect, but may not reflect either the truth of a matter, or the best interests of others… which, of course is the foundation of the practice of psychiatry as we criticize it …. and probable cause for depression ! The flip side is that this site is a good first line treatment.. as are the myriad of expensive hobbies and leisure activities currently treating the same malady suffered by our arch enemies! BOTH treatments are short term, with ensuing equal suffering for the loss of these symptomatic treatments.

      So, what’s the CURE? Humanistic driven tasks that open our minds and hearts to ALL others and tap our unique, individual talents for the common goal of the highest good for ALL— there will be (already are) psychiatrists engaged in this movement– I can guarantee everyone has a part to play in the CURE!

    • Robert Gibbons shares your belief, Anonymous, and has done everything he can to disprove a causal link between antidepressants and suicide. His latest efforts involve dishonest statistics, so I guess he hasn’t had much luck finding real evidence to support his intuition.

      You are fortunate if you have not had such severe adverse effects from psychiatric drugs that you have not considered suicide. The physical, psychological, and cognitive effects can be so awful that suicide can seem a reasonable solution to torment for which there seems no medical cure.

      Akathisia, a relentless inner agitation that allows no sleep or rest, is an example of such an adverse effect. It exists only as an adverse effect of medication. People suffering it often think they have literally lost their minds.

      Having no apparent recourse, out of free will, someone may reasonably choose to suicide because of the effect of psychiatric drugs. People experience intense sensations they would not have felt without the drugs. The drugs induce such anguish, therefore the drugs are the trigger for suicide.

      I’ve looked into the abyss myself, and for no reason but unrelenting torment from an antidepressant. If it weren’t for a very lucky meeting with a doctor who identified my adverse reaction, I wouldn’t be here today, I would have carried out my plan.

      I can understand entirely the link between antidepressants and suicide which, if anything, is under-reported.

      • When I consider driving, or killing myself, while on alcohol, I don’t blame the alcohol.

        Or on nicotine, or on caffeine.

        Did you know 20% of this week’s suicides were smokers?

        Time to update the warning labels on the cigs?

          • Anonymous,

            The point is, PhARMA and mainstream psychiatry promote their financial interests and the medical model by citing the “results” of clinical trials. As such, it is fair to point out that, using the same measures they claim show SSRI’s relieve “depression” and prevent suicide, the studied’ “results” actually show SSRI’s are more likely to “cause” suicide. It’s just showing that their own argument defeats them – not that all of us believe SSRI’s “cause” suicide in a vacuum, although it appears that does happen sometimes.(See the cases Breggin reports of people with no indication of violence going on wild sprees within a week or so of starting on SSRI’s).

            You are right that the medical model influences people to feel helpless and to wrongly assume they are powerless over their own lives. But this is not an argument against many who post on this site – we are critical of the medical model for that reason, among others. And this learned helplessness is intimately connected with PhARMA/psychiatry’s use of SSRI trials – the trials are used to convince us that we are in fact helpless without the drugs.

        • Anonymous, you might read some of the research about this, particularly by David Healy, who’s been campaigning about the antidepressant-suicide connection for 12 years, see http://www.guardian.co.uk/education/2001/may/07/medicalscience.highereducation.

          1boringoldman.com has exhaustively critiqued Gibbons’s work.

          Of course, your beliefs about personal responsibility, as Ayn Rand might call it, may be impervious to any incoming information.

          Insistently, you have presented such beliefs to an audience among whom are those who have lost loved ones after watching them deteriorate and kill themselves under the influence of antidepressants.

          If denial from the medical establishment has not caused them pain enough, explaining the justness of their cause — exposing the dangers of psychiatric drugs — to someone holding opinions like yours might be simply too much to bear.

          I urge those people to ignore your further posts on this site, as I am going to.

          • Altostrata, I know that you believe that drugs that the unhappiest people in the world take ’cause’ the decision to end one’s life to enter the human mind and for those deeply unhappy people to execute this decision.

            I know you believe this. Great. By all means.

            I don’t share the bulk of your beliefs about the issue. I don’t agree with your simple narrative about an issue that I consider to be vastly more complex than you or Healy seem to paint it as. Just deal with it. Let us agree to disagree.

            Just because I don’t believe your simple story about drugs and human decisions, it doesn’t mean you should be making personal attack posts, labeling me some Ayn Rand fan (I’m not), insensitive to the relatives of the dead (I’m not), and you also ‘encourage’ everyone to ignore me (childish).

  9. Thanks for all the information about the role of Gibbons in the controversy about suicide and antidepressants.

    I agree Gibbons is influencing many people with his bad (or possibly fraudulent) science, and that is sad. Being of a optimistic nature, I think it is equally important to point that Gibbons is not necessarily representative of any majority in the medical field:

    - Gibbons advice/vote did not sway the FDA. Eventually the FDA did a useful thing, decided on the black-box warning, and maintained it. In spite of all its flaws, we would probably be much worse off without the FDA (and equivalent foreign institutions).

    - In the funny (or sad) back and forth between Pies and Jonathan Leo about chemical imbalance, Dr Ron Pies said something that seems very true and quite significant:
    “[Leaving aside] the dubious notion that there is a ‘psychiatric community’-I see it more as a balkanized collection of competing fiefdoms!-”.

    So for most purposes, the “psychiatric community” does not exists, which makes it clear there is no conspiracy or general delusion affecting all psychiatrists.

    - The following blog provides a powerful argument about why clinical trial data is generally irrelevant to reach a conclusion (either way) about SSRI and suicide:
    http://neuroskeptic.blogspot.com/2010/05/ssris-and-suicide.html

    I will add that if being suicidal were considered a distinctive “diagnosis” category, it is one for which nobody could recommend any science-based drug treatment, because suicidal people are specifically excluded from any drug trials (that looks to me as if we were excluding diabetic people from tests about diabetic drugs, that would make the testing safe and useless).

    - Delusions often feed on either the absence or the weaknesses of competing thought/beliefs systems. I can see how MIA contributes to the emergence or promotion of new proposals for the treatment of madness, but I hope “MIA-approved” approaches are internally subjected to the same level of scrutiny than competing approaches. In many ways, right now, MIA is already one of the competing fiefdom in the psychiatry field (I hope it grows while maintaining high internal standards, rather than any specific direction).

  10. This is just another example of how money corrupts science. The scientific method is sound IF it is used and acted upon. The problem is that Gibbons probably has told himself enough times that his defence is the correct one, will help kids etc so that he believes it. Most people I know do not knowingly do bad things. The process of assessing these studies needs to be free from political and financial influence. That is the hard task ahead.

  11. AD drugs can most definitely cause you to “freak out”, loose control and do things without thought or intent. I’ve experienced this as a child on those drugs and can tell you that there is most definitely no “free will” involved. And now as an adult when I hear about a woman committing suicide by STABBING HERSELF 200 TIMES, I can understand exactly how that happened. People who doubt the ability of AD’s to CAUSE suicide really need to study more on HOW they cause suicide. They can cause you to go manic psychotic with extreme levels of energy and rage with no rational thought or regard.

  12. Most people don’t do bad things knowingly, but unfortunately, a small minority of people knowingly do bad things on purpose, usually because they can make money or gain power by doing so, sometimes just because they seem to get satisfaction from being deceptive. I would term these people criminals, but many of them never go to jail, because their crimes are actually legal.

    We should not assume that Gibbon or anybody else has good intentions. He may, in fact, know all the facts and be strategically working to keep them a secret. There are written memos from drug company personnel that have been released, clearly stating that their objective is to “manage the drug’s image” by minimizing the dangers or presenting alternative explanations they know to be untrue. This is very different from believing in a false theory because of insufficient or incorrect information being provided. This comes down to intentionally providing false or misleading information in order to promote a believe known to be false and potentially very dangerous.

    Evil intentions do exist, and they exist, in my opinion, in much larger than average numbers in the psychiatric profession, as well as in the pharmaceutical corporations who supply them with their products. One reason the psycho-pharmaceutical industry has been able to succeed so thoroughly is because no one wants to believe doctors will knowingly act in ways that will hurt their own patients. While in most cases this is true, and the doctors are acting on what they’ve been told by someone they consider a “higher authority,” a goodly percentage of those “higher authorities” know very well that they are advocating for harmful interventions in order to maintain control of their market share. Unless we understand and accept this reality, and make it well known, I believe it’s going to be very difficult to move forward with real alternative thinking.

    Some people ARE evilly motivated.

    • I cannot disagree with you, Steve but in the end teh solution is going to be how we can change the systemic corruption from developing. I think the only way to do that meaningfully is to address the checks and balances and make them effective, make them hurt if those like Gibbon cross the line. One example would be to ensure that opposing points of view and data are heard on an equal basis as Bob points out in this article…simple but necessary.

  13. I totally agree! Real science not only allows but insists on alternative viewpoints and explanations – it’s part of the process of sifting out the truth. And even greedy and ill-intended people change their behavior when the incentives are changed, because after all, they’re out for their own benefit. So make sure they don’t benefit from doing wrong, and we’ll see a lot less people doing the wrong things.

    —- Steve

  14. Hey, Bob,
    Update on *public outrage*— without sound knowledge and complete understanding of the science, or lack thereof, as well as the expertise to interpret statistics and data analysis, the *public* tends to seek elements of human drama to guide their response—- who is the most trustworthy authority? Who is a disgruntled back stabbing *wanna be*?

    I think that perhaps experts like, Matthew Miller and Mickey Nardo should go to the next level as whistleblowesr, taking this case to the U.S. Attorney General. It will require the abilities and the integrity of guys like these to provide persuasive evidence for criminal indictments. It is not just the facts of the case that matter, unfortunately, BUT who is credible enough to present the evidence that is needed to prosecute *criminal psychiatrists*.
    I am learning this on the state level— so wanted to pass on my dedication to getting the full impact of this issue before the public in the manner required to incite full outrage— that which is appropriate to the degree of threat and harm to the public.

    It stands to reason that one must continue to climb up the chain of command until the requisite attention is obtained… small time concerned citizens can only holler and protect those within their reach…

    • Duane,

      Without even the slightest intention of minimizing the meritorious impact of Bob Whitaker’s work and this site, I must day that there is a very crucial element on which we must remain focused; that is, BAD SCIENCE fueling the destructive practices in our mental health system has NOT been trumped! I say this from current experience orientating, as a newly-hired professional, to an acute inpatient psychiatric unit in the Boston area. While I accept that I have a mission to teach and share vital factual scientific information with colleagues, and acknowledge my debt of gratitude to Bob and and a handful of dedicated psychiatrists who have both integrity and tenacity, the fact remains that the big picture that looms over us all, remains —in full force! What is the *big picture*? Well, for starters, not only has the basic myth of mental illnesses, as diseases of the brain, continued, but the basic view of the so-called, mentally ill is as dismal as it has ever been—possibly worse as it has become most dangerous challenge to the healthy development and well being of our nation’s children!

      My perspective on the *big picture* is that it is solely due to the fact that psychiatrists have not been persuaded to re-think their erroneous model of care and cease and desist with prescribing and promoting the use of dangerous drugs as treatment for non-existent disorders; that psychiatrists have not been persuaded to announce the good news, that RECOVERY from severe so-called, “mental illness” is INDEED possible— its not a life long, debilitating illness, does NOT require life long treatment with drugs AND THEN, begin the work of ending the numerous *treatment guidelines* that currently insure that a young person (or any age, for that matter) person who makes contact with the mental health system–through whatever means– because he/she is experiencing extreme mental states, will not receive DRUGS as first line treatment. much less a bogus diagnosis! There is ample work for psychiatrists in the current system— the work of preventing more damage and the work of repairing current damage…THE GREATEST damage, I will add it : THE MYTH that there are millions of Americans suffering from treatable mental illness!

      For the past 4 years, there have been various aspects of both bad science and corporate greed/corruption exposed in the media, connected to the very top of this food chain. There have been numerous forums, across the spectrum of mental health professionals and psychiatric survivors that have initiated a strong grassroots movement aimed at alleviating suffering and educating the public to become proactive in, for lack of a better word, SAVING our children and loved ones! Once again, Bob Whitaker and this site are a major force for that movement.BUT, there has been no significant impact on the system itself.

      In various posts on this site, I have been suggesting that it is crucial to focus on the next level, or at least fully identify the obstacle to advancement of this urgent cause. I have a great deal of personal experience as a professional in the system with one aspect of this obstacle. I also have painfully confronted the limitations that my like minded colleagues face regarding forcing the criminality issue with psychiatrists. It turns out to be an unfortunate consequence of our culturally influenced bias towards status and possibly Fame*. It’s not so much what you know, or how well you cite the references for what you know, but WHO you are that is the key to gaining both the attention and the cooperation of key players,; like; the attorney general- state or federal level.

      There is a bit of irony in my ongoing struggle to advance the cause. The most prestigious academic medical centers have established themselves as MAGNET hospitals, which advertises their commitment and dedication to establishing and promoting excellence in nursing care. Magnet status hospitals claim to be encouraging and supporting improvements in patient care based on the experience and the research done by nurses *at the bedside*. Magnet status hospitals claim that nurses who provide direct care for patients receive support and respect for their contributions to improve clinical practice, through recognition of a nurse’s own evidence based practice presentations for better patient outcomes or practice based on current scientific literature. However, in the area of inpatient psychiatry, nurses who endeavor to access this avenue for reforming many ineffective and/or unsafe practices, will embark on a learning curve that leads first to their loss of employment with the facility and further to a tragic realization of the corruption collision amongst state mental health regulatory agencies– and even further, toward bias of media (and reputable law firms) in favor of protecting the reputations of both academic medical centers and state mental health regulatory agencies! Or— maybe attorneys and professional journalists have their own self preservation issues… doesn’t matter— same result.

      Schooled well in the chain of command protocol for resolving conflict, I have been aware for almost a year now that the next step is criminal indictment of psychiatrists and their benefactors, leaders of academic medical centers, editors of medical journals, leaders of their professional organizations, and specific federal regulatory agencies. This amounts to a simple statement of fact, which I am reading more frequently on this site and a few other: Willful deceit of the public for profit that causes harm is a criminal offense— in the U.S.A.

      What can the public do? I am drafting letters to individuals of professional, social and political prominence to enlist their support in speaking publicly on the issues we all know well. For example, Bill Clinton, who played a major role in the kick off of a national campaign to diagnose, label and medicate kids, in his landmark White House conference on Mental Health, June 1999–less than 2 months after the Columbine tragedy, needs to address the egregious harm done by this –viewed as a gallant effort to *save our troubled youth* and protect the rest of us from them… Bill Clinton & Hillary Clinton committed the same error as so many of our trusted leaders in terms of trusting the experts and backing a corrupt enterprise— using the defense–”all good intentions”. Likewise, Al & Tipper Gore have the opportunity to join together and produce another “Inconvenient Truth” documentary for their fans. I say this with all due respect and seriousness that ANYONE can step up to the plate and demonstrate what true leadership FOR the people looks like.

      Petitions and/or letters to all levels of political –”public servants”— is another grassroots activity that can be inspired —- even organized and directed through the venues we are all familiar with. Guidance on this process and support for the task is a learning curve venture. Educating ourselves to gain access to our bottom line government protection is …. in my opinion, the next logical step up the chain of command.

      Having been schooled in advocacy for impacting on public policies that effects the health and welfare of children, I still have my resource— the instructional manual from this course ( an offering from a leading academic medical center’s institution!) – this education tool takes into account that the average person needs to learn appropriate and effective means for gaining the attention of their political representatives! While we wait for the heavy hitters to knock on our attorney general’s door with the air tight case I hand, I can offer a tip from education I did not receive in public 12 years of public schooling: practice by, filling out this “Fill-in-the-Blanks Rap sheet”

      1. ____________________________ are in crisis because _____________________________________________________ 2. You should care because ______________________________________________________________________________________________________________________________________________________________________3. We know that ______________________________________________________________________________________ would begin to fix it. 4. You can help by ____________________________________________________________________________________________________________________________________________________________________________.

      Then: If you can come up with brief answers to these five questions, you are well on your way to coming up with a message that is succinct, clear and compelling:

      1) WHO ARE YOU–name, do you live in the legislator’s district? Are you a constituent? Are you affiliated with an organization? How many members? State wide? Nation wide?

      2) WHAT IS YOUR ISSUE —Be prepared to discuss your issue and don’t be surprised if your legislator is unfamiliar with it. Use no more than two or three sentences–DON’T bombard them initially with the details!

      3) WHY DO YOU CARE ?— Why should your listener care? What’s happening in their district, their community?

      4) WHAT SPECIFICALLY DO YOU WANT ME TO DO ABOUT IT?– ALWAYS have a clear call to action- a “to-do” ALWAYS ask for an outcome, follow up. BE SPECIFIC– don’t ask for “support” as support is a vague thing. Sometimes the best action you can hope for is keeping the dialogue open– ask if they would be willing to read some supporting materials—follow up with a phone call from you…

      Media attention may ensue as a consequence of a large volume of seeking political support… if you have practice the communication skills outlined from my *resource*, you will be well prepared to make the best use of media attention!

      If you are wondering how beneficial this strategy may prove to be, I’ll reiterate it’s claim to fame. This is an introduction to the very *tool kit* that has been employed successfully to achieve many of the policies and practices in the mental health system that we are trying to eliminate and/or reform. IT’S claim to fame thus far : “Building real l clout for children and Famiies” , has successfully pulled in the required support for the wealth and prominence of the *leaders* we are trying to reorient to reality! In other words, I have shared just a page from their *play/game book*.

      I hope to inspire a channeling course for the energy that is inspired by any and all victories of our cause… as we have so much more work ahead before we can truly celebrate…

      • “I say this from current experience orientating, as a newly-hired professional, to an acute inpatient psychiatric unit in the Boston area. ”

        I am not clear on this.

        Do you make a living ‘working with’ involuntary ‘patients’, as in people who do not wish to be ‘worked with’?

        If not, thank you.

        • Anonymous,

          Currently there are approximately 14 facilities in the Boston area that have inpatient/locked psychiatric units–over half have adolescent/child units. Roughly 700 beds – 200 of which are adolescent/child.

          I am working in a facility that is in the process of changing the philosophy of care– focused on *Trauma Informed Care* model, and recovery. Primarily I am an *educator*, but in this role I am also on the units role modeling humanistic care for staff.

          My personal decisions regarding professional affiliations are based upon confronting reality. Inpatient/involuntary psychiatric *treatment* is by far the most egregious evidence of the failure of all psychiatric reform movements to date. I took my resume to the scene of tremendous suffering, invited by a colleague who shares my goal of eliminating these units.

          Better to light one candle, then to simply curse the darkness!

          Thanks for asking!

          xo,
          Sinead

  15. OK Anonymous- I should know better—right? Your want me to answer “yes” or “No” to your question :

    “Do you make a living ‘working with’ involuntary ‘patients’, as in people who do not wish to be ‘worked with’?”

    Not that simple, though— if I am to be accurate— YES, I do work with “some” involuntary patients, but they do not ALL fall into the category of “people who do not wish to be worked with”— but ALL are in the same category as far as sharing the goal of leaving the locked unit ASAP– which is my goal as well! Additionally, I will continue to gravitate toward anyone who is having a *gruesome* experience—my nature– my duty– my quest … to be where I can do the most for those who need HELP — regaining their rights and FREEDOM!

    I am NOT *making a living* adhering to ANY of the standards or practices you are familiar with on locked units– those that reflect biomedical model , relying on intimidation and
    /or coercion/force to *accept* a bogus diagnosis. I was invited to join a former colleague working with a few other *educators*, clinicians who have defined the philosophy on these 3 units as :”Trauma Informed, as in :What has happened to you? NOT what is WRONG with you?” AND RECOVERY, which as I pointed out during my interview means:”First and foremost acknowledging that biomedical psych, drugs– the REASON for admission IS a false, damaging paradigm … staff need to be de-programmed and so called *patients* need education, and profuse apologies”> I was hired telling the truth… and will work so long as the premise of my work is respected and upheld!

    THIS job found ME— I was not seeking IT… but, I have prayed for a very long time that somehow what I have learned on those units and on this site will create value for the people– young and old who are unjustly locked up , demeaned, abused and ignored. The majority of locked units in Boston are NOT reforming in the true sense— using rhetoric to cover same old same old… I know this due to another way I have been making a living, as an advocate, case manager—getting young adults discharged from locked units by request of loved ones— and helping them get off “meds”, mostly via acupuncture and Chinese herbs.. and *social* activities- attending concerts, supporting New England’s ONLY gay Rugby team, shopping, coffee, book stores..(not as a paid companion, but usually have to insist on paying my own check )- SO I have been painfully aware of the ongoing injustice that is virtually unaffected by FACTS, SCIENCE, or the latest PHARMA scandal.

    I was adamant in my interview regarding the seriousness of the WORK that needs to be done. My colleague and I agree that Psychiatry as we know it is like the Titanic… it is going down… When presented with that analogy, I responded, “Well, then let’s get to rescuing people—” the last thing I want to do is be a part of the unscrupulous so-called “professionals” who also perceive” their ” beautiful cruise ship is sinking BUT decide to busy themselves rearranging the furniture … on the Titanic… how absurd is THAT?

    Writing here and working in the *big house* feels a bit like being a double agent— except that I am committed to the truth ALL the time… but still don’t want to blow my cover… if you catch my drift…because IF this job turns out to be a sham, and I am being exploited AGAIN by psychiatry… I want YOU to be the first to know!

    xo,
    Sinead
    ;-)

  16. Sinead said above “YES, I do work with “some” involuntary patients, but they do not ALL fall into the category of ‘people who do not wish to be worked with’”.

    I don’t understand. Isn’t that the very definition of involuntary patients?

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