“Psychiatry Beyond the Current Paradigm”


An article by Pat Bracken, Philip Thomas, Sami Timimi and others (including Duncan Double, Hugh Middleton, and Joanna Moncrieff), published in this month’s British Journal of Psychiatry, argues that “psychiatry needs to move beyond the dominance of the current, technological paradigm. This would be more in keeping with the evidence about how positive outcomes are achieved and could also serve to foster more meaningful collaboration with the growing service user movement.”

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Thanks for posting. This captures so much of what I think about psychiatry and the limits of the neuroscience approach to our work. It does not say we need to give up on the brain or disavow science but rather that these approaches are limited in fundamental ways. The authors say this better. I am just giving a plug to read it!

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  2. REAL science takes into account all of the variables involved. Psychiatry has long since divorced itself from science by arbitrarily limiting their research to neurology, not even honestly looking at that area, and denying that other variables exist. The idea that psychiatry would “disavow science” by taking these social, emotional, and spiritual variables into account highlights the incredible biases that have prevented psychiatry from even looking at the real data in the neurological areas they claim to be scientifically interested in.

    Anyone who is interested in a truly scientific viewpoint would be horrified by the dismal outcome data for psychiatric interventions, much of which has been available for decades but is only now coming to light, due to the intentional SUPPRESSION of this data by the psychiatric establishment.

    To suggest that psychiatry has in any way been seriously involved in a scientific endeavor in the last 30 years is laughable. At least since the DSM-III, psychiatry has insisted that science take a back seat to marketing. Take the serotonin theory of depression, for instance: disproven convincingly in the mid ’80s, propagated for marketing purposes to the present day. That ain’t science, folks!

    The sooner we stop pretending that psychiatry has been focused on neuroscience, or on any science at all, the sooner we can get back to genuinely scientific endeavors that objectively look at all the variables, and that value real patient outcomes over profit margins.

    —- steve

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