From the editor: Julie Leonovs (with help from Nick Redman) submitted this letter to the British network ITV regarding comments made by two guest speakers on the actor Stephen Fry’ s bipolar disorder and suicide attempts.
RE: This Morning Programme: 6th of June 2013
On the 6th of June 2013, ITV This Morning hosted their usual show and their early morning feature the News Review. During this particular News Review regular guest speakers were asked to comment on topical news stories of the day. One story, which arose during this particular discussion, was about the actor Stephen Fry and his recent publicity on how he has battled with his ‘bipolar’ condition and suicide attempts. While we don’t have any issue with this and the important message Mr Fry was trying to put across, we do have concerns over the comments made by the two guest speakers. Let us highlight below our grave concerns with what was imparted to This Morning’s vast susceptible viewing audience.
Firstly, one of the issues raised over Mr Fry’s condition ‘bi-polar’ was about how people in emotional distress can become stigmatised by society. Both co-guest speaker then adamantly stated that stigma like this should not happen in society as the likes of Mr Fry with ‘bi-polar’ have a chemical imbalance in their brain. Whilst we do not condone stigma towards anyone and agree with the guest speakers on this, we have to stress that to then go on to categorically state that ‘bi-polar’ is caused by a chemical imbalance is highly misleading to your viewers.
Scientifically, there is no known test to detect and prove a ‘chemical imbalance’ in any mental health condition let alone ‘bi-polar’. This is myth that has been spread for years by the psychiatric system and pharmaceutical industries and to continue to do so does create adverse social, political and psychological implications. Many academics, survivors/service users, psychologists and psychiatrists have campaigned about this controversy within psychiatry for decades and continue to do so. Please note the evidence we provide below.
“When considering possible causes of ‘manic depression’, the prevailing medical view again favours physical causes such as a brain biochemical imbalance or genetic defect, despite the fact that no biochemical or genetic abnormality has been identified regarding what is called ‘manic depression’ or ‘bi-polar disorder.” (Lynch 2004 p.217) (Psychotherapist and General Practitioner)
“People have become willing recipients of the idea that their problems emanate from a chemical imbalance in their brains. The idea has diffused into public consciousness, fundamentally changing the way we view ourselves and the nature of our experience. (Rose 2004 cited in Moncrieff 2008 p.238)
Therefore it concerns us that this misinformation continues to be spread to your viewers (who are already being subjected to this misleading information daily in society). We feel it is wrong to continue to propagate such unproven theories, until a time comes when they may be substantiate by reliable and valid evidence.
Likewise, by saying someone is suffering from a ‘chemical imbalance’ (implying they have a biological mental illness akin to a physical illness) and so cannot help themselves, unintentionally stigmatises those who are assumed not to have a ‘pathological brain illness’ yet are still suffering from acute emotional distress. It implies that a ‘biological brain disorder’ is acceptable and therefore society should not stigmatise, as these people cannot help the way they are. However, by propagating such a myth, this has unwittingly sent the wrong message to your viewers that if you are suffering from severe emotional distress brought about by acute childhood trauma, difficult adult circumstances or other serious external/environmental factors in your life, then it is ok to stigmatise as this person can help themselves. Suggesting an internal ‘biological’ cause for distress immediately isolates and stigmatises many people deemed not to fall into this ‘illness’ group. And yet, as we already reiterate, there is no known evidence for a ‘chemical imbalance’ and ironically stating this causes more stigma than it avoids!
Thirdly, and even more alarming is that by using misleading information of a ‘chemical imbalance’, this creates the assumption of an internal, pathological cause. Consequently, the message your viewers and society learns from this is that the person is ‘ill’, as a result of internal factors they have no control over and therefore can’t help themselves heal. Sadly, many people are told by their mental health professional that they have a pathological disease and will never get better. This is true of ‘bi-polar’ and other emotional conditions where people are informed they will most likely have to take drugs for the rest of their life – even as we know, there is no scientific proof of a ‘chemical imbalance’! Therefore, we consider it more appropriate to spread a message of hope that people can heal from emotional distress and that they are not ‘ill’ according to the disease-centered model. Subsequently, this can enable individuals to become more proactive around their own care, rather than passively accepting and sometimes despairing that they can never change. This notion of taking greater responsibility for their own health and wellbeing can lead to increased positivity about themselves and their abilities.
“Diverse situations from relationship break-ups to job difficulties to sexual abuse and severe trauma have been transformed in to chemical problems. Individual human beings with their unique life histories and personal characteristics are reduced to biochemical entities and in this way the reality of the human experience and suffering is denied. The message that drugs can cure your problems has profound consequences. It encourages people to view themselves as powerless victims of their biology and stores up untold misery for the future when people come to realise that their problems have not gone away but have failed to develop more constructive ways of dealing with them.” (Moncrieff 2007 cited in Moncrieff 2008 p.241) (Psychiatrist)
We have experienced and are aware of many people who have been given this ‘life sentence’ of ‘bi-polar’ by their mental health professional, and yet have refused to accept that they are biologically ill. As a result of this, they have taken charge of their life and healed to reach their true potential. (We can provide evidence of this if required). Informing viewers ‘bi-polar’ is a result of an ongoing ‘chemical imbalance’ concerns us because this sends out a message that a person is dependent on their condition and should just accept their fate. Sadly, many people still believe this. Let’s spread a different message here.
“While bi-polar is portrayed as a life-long condition to be managed rather than recovered from, people can and do make a full recovery.” (Lynch 2004 p.228)
Fourthly, in society generally we are witnessing an over-reliance on prescription drugs for what are actually problems of living not ‘chemical imbalances’ in the physical brain. It concerns us that individuals are being routinely prescribed mind-altering drugs for ‘illnesses’ that have no scientific proof. Continuing to propagate this myth can potentially hinder what is known as ‘holistic recovery’. We would never deny an individual’s emotional suffering or pain but rather feel that if a person can find healthier alternatives to toxic drugs then this will allow them to experience authentic thoughts and emotions (which can be worked through with the right help), rather than have these masked by a ‘chemical cosh’. The theory of a ‘chemical imbalance’ again sends out a wrong message, as it unwittingly diverts a person from looking towards other ways of healing rather than reliance on these drugs. Even more alarming, is that credible research and evidence is showing the physical damage of using prescription drugs over the long term, and the notion of treating a ‘chemical imbalance’ only increases this harm.
Lastly, we also question the use of the term ‘bi-polar’. Whilst many individuals prefer to identify themselves from a psychiatric label (which is their choice); labelling can actually cause harm too. Psychiatric diagnosis often creates a self-fulfilling prophecy whereby an individual becomes their label, identifies with it and sadly loses sight of who they really are. A person again believes they have an internal ‘disease’ or ‘illness’ from which they may never heal. Likewise diagnosis can detract from the underlying cause/s of a person’s real distress (such as traumatic external events). When considering stigma, diagnosis can unwittingly imply that the person ‘diagnosed’ is the one with the problems, the one who needs help. They therefore become the scapegoat within their own surroundings and so many serious external issues are left unaddressed. The individual never gets a chance to move towards true healing.
“‘Diagnosing’ someone with a devastating label such as ‘schizophrenia’ or ‘personality disorder’ is one of the most damaging things one human being can do to another. Re-defining someone’s reality for them is the most insidious and the most devastating form of power we can use. It may be done with the best of intentions, but it is wrong – scientifically, professionally, and ethically.” (Johnstone 2013)
Even more tragic and alarmingly, which we would like you to take note of here, is that psychiatric labels themselves are not based on scientific fact. Psychiatric diagnosis is based on a checklist of symptoms that have being taken from either the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) or the International Classification of Mental and Behavioural Disorders (ICD-10). You may be surprised to know that such manuals are not based on objective fact (as people have been led to believe) but rather subjective opinions made by psychiatrists. You may be aware that the new version of the DSM-5 is causing great controversy presently since it was introduced last month. Even the British Psychological Society’s Division of Clinical Psychology (DCP) issued a Position Statement on Classification highlighting their concerns about the lack of scientific objectivity involved in diagnosing an individual, and therefore too much reliance on drugs for what are in fact ‘problems of living’, not pathological/mental illnesses.
“…it should be noted that functional psychiatric diagnosis such as schizophrenia, bipolar disorder, personality disorder, attention deficit hyperactivity disorder, conduct disorder and so on, due to their limited reliability and questionable validity, provide a flawed basis for evidence-based practice, research, intervention guidelines and the various administrative and non-clinical uses of diagnosis…” (DCP 2013).
“I stated that ‘The DSM is wrong in principle, based as it is on re-defining a whole range of understandable reactions to life circumstances as “illnesses”, which then become a target for toxic medications heavily promoted by the pharmaceutical industry….The DSM project cannot be justified, in principle or in practice. It must be abandoned so that we can find more humane and effective ways of responding to mental distress.” (Johnstone 2013) (Clinical Psychologist)
Therefore we support entirely the concerns issued by the DCP and other professional bodies who draw attention to these vital points. Such points cannot continue to be ignored.
Consequently, we feel that it was irresponsible of both ITV and This Morning to spread misinformation about ‘bi-polar’, allow talk of a ‘chemical imbalance’ and ‘illness’ to your wide viewing audience without conducting greater research on this subject matter beforehand. For that reason, we believe this admission or oversight made the show unbalanced and biased in how it presented ‘bi-polar’ and thus avoided discussing the range of factors that can cause it. We feel it is quite easy to continue to spread misinformation (or myth) that is deeply engrained within society and often goes unchallenged.
Yet, this information as highlighted above is based on very little scientific evidence and is therefore unreliable. By presenting only the disease-centred perspective gives a one-sided view. As a result, the alternative viewpoint that emotional distress is often caused by problems of living and that the answers towards healing do not have to be chemical or biological based, sadly goes unrecognised. Therefore we would appreciate in the future that programmes from ITV provide viewers correct factual information on mental health so that they can make up their own minds, rather than seeing despair and missing the opportunity to see the potential for personal growth and hope.
We trust that as a responsible television company that you will take our concerns onboard and move towards addressing these issues in future televised programmes. We would also appreciate any response to this letter to be in writing.
Julie Leonovs and Nick Redman
Division of Clinical Psychology (2013) DCP Position Statement on the Classification of Behaviour and Experience in Relation to Functional Diagnosis: Time for a Paradigm Shift. British Psychological Society. London
Johnstone, L (2013) Time to Abolish Psychiatric Diagnosis? Mad in America: science, psychiatry and community. [Online] Accessed July 2013
Lynch, T (2004) Beyond Prozac: healing mental suffering without drugs, Ross-on-Wye, PCCS Books.
Moncrieff, J (2008) The myth of the chemical cure. Basingstoke. Palgrave MacMillan.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.