As Confidence in Medical Model Grows, Inclination to Inform Patients Declines

Kermit Cole
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A study of attitudes of 381 medical students attitudes toward medical students’ views of treatments for ‘schizophrenia’ and of patients’ rights to be informed about their condition and their medication, by John Read of the University of Auckland and colleagues at the University of Naples, finds that as students progress through medical school, they “labeling the case as ‘schizophrenia’ and naming heredity among its causes were associated with confidence in psychiatrists and psychiatric drugs. Naming psychological traumas among the causes was associated with confidence in psychologists and greater acknowledgment of users’ right to be informed about drugs.” The authors recommend a greater integration of psychological aspects into medical curricula.

Article →

Magliano, L., Read, J., Sagliocchi, A., Patalano, M., Oliviero, Effect of diagnostic labeling and causal explanations on medical students’ views about treatments for psychosis and the need to share information with service users. Psychiatry Research. Online August 5, 2013

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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]

9 COMMENTS

  1. http://www.psmag.com/magazines/pacific-standard-cover-story/joe-henrich-weird-ultimatum-game-shaking-up-psychology-economics-53135

    The above is an article about the arrogance of western world thinking that we and our societies stand for the best, brightest and greatest of civilization. In reality, we stand for only a small portion of civilization with unique psychological traits that are obviously not genetic or universal when compared to other world societies/groups. Rather, our general traits are those of egotistical, narcissistic, competitive loners that value individual competition and success as opposed to other societies preferring group cohesion and interdependency.

    Once again, I am posting Douglas A. Smith’s superb review of the excellent book, Pseudoscience In Biological Psychiatry: Blaming the Body, that remains all too relevant today since biopsychiatry has continued to fossilize and proselytize its life destroying bogus junk science throughout the world to push its eugenics Nazi like human rights violations agenda. In contrast to this, the above book recommends a trauma model to really help the majority who currently seek help from the so called mental health system. Currently, as Dr. Peter Breggin warns, seeking such help from biopsychiatry is not only the most dangerous thing one can do, but it is also just about guaranteed to destroy one’s life and their relatives as long as biopsychiatry continues to promote its “science of lies” per Dr. Thomas Szasz.

    http://www.antipsychiatry.org/br-pibp.htm

    Book Review:

    Pseudoscience in Biological Psychiatry

    by Colin A. Ross, M.D., & Alvin Pam, Ph.D., et al.
    (John Wiley & Sons, Inc., New York, 1995)

    reviewed by Douglas A. Smith

    “Biological psychiatry” is everything in psychiatry that is based on alleged biological abnormality in the body of the “patient” rather than events in the “patient’s” life or the patient’s unfulfilled psychological needs. While Pseudoscience in Biological Psychiatry is far from a comprehensive critique of biological psychiatry – for example, it includes very little about the harm done by psychiatric drugs or electroshock – it is one of the best books I have read attacking the alleged scientific foundations of biological psychiatry. The authors convincingly show that biological psychiatry is pseudoscience, or in other words, nonsense.
    Unlike most books with more than one author, most chapters are written by a single author. The authors of the largest parts of the book are Colin Ross, M.D., who is director of the Dissociative Disorders Unit at Charter Hospital of Dallas, and Clinical Associate Professor of Psychiatry at Southwest Medical Center in Dallas, Texas – and Alvin Pam, Ph.D., Director of Internship Training at the Bronx Psychiatric Center, and Assistant Professor of Psychiatry at Albert Einstein College of Medicine in New York City.
    In the Introduction, Dr. Pam says “The purpose of this book is to show that biological psychiatry – presently the dominant force within the discipline of psychiatry – is dominated by a reductionist ideology that distorts and misrepresents much of its research” (pp. 1-2). In later chapters he says “biological psychiatry cannot fulfill its mission properly because in the current state it has more the accoutrement of a scientific discipline than the substance. … the methodology of biological psychiatry is sufficiently flawed as to call into doubt the preponderance of its accepted findings” (p. 8). Dr. Pam concludes that “The history of biological psychiatry can be depicted as a tale of ‘promising’ leads, closure on slender evidence, hyperbole as initial reception to new work, and ultimately unproductive results. … following about a century of effort, a harsh assessment would be that no substantive results have been tendered for the pathogenesis of any major psychiatric disorder” (p. 42). He says “biological psychiatry does not come close to meeting scientific standards” (p. 69). In chapters he wrote, Dr. Ross, a psychiatrist, says “psychiatry has not acquired even a tiny fraction of the scientific foundation of internal medicine” (p. 88), that “At the present time, there is no proof that biology causes schizophrenia, bipolar mood disorder, or any other functional mental disorder” (p. 90), and “The ideology of bioreductionist psychiatry is that depression, schizophrenia, and other illnesses are biomedically distinct and genetically driven. Decades of fishing for supporting data have yielded nothing of substance, however” (p. 140). Dr. Ross says “Biological psychiatry has not made a single discovery of clinical relevance in the past 10 years, despite hundreds of millions of dollars of research funding” (p. 116)
    Dr. Pam, a psychologist, alleges that virtually all so-called psychiatric disorders are caused by life experience rather than the theoretical biological abnormalities that biologically oriented psychiatrists say are the causes. Dr. Pam says “biological psychiatry tends to ‘blame the body’ for disturbed behavior, rather than the family or society. This perspective lets the social surround escape unscathed from any blame or responsibility, no matter how much psychological disorder is in its midst” that is in fact caused by the so-called patient’s experiences in that family or society (p. 3). He says “Biological factors enter into all behavior, including symptoms, but only rarely are the cause and significance of a patient’s behavior primarily biologically driven” (p. 4). He says “the biomedical model ignores the social conditions that give rise to psychopathology” (p. 6). Dr. Ross, a psychiatrist, expresses a similar view.
    The book includes long, detailed critiques by both Dr. Pam and Dr. Ross of genetic (inheritance) theories of supposed mental illnesses such as schizophrenia and alcoholism. I’ve made the following argument for years: Religion runs in families, but does anyone suspect the existence of Roman Catholic or Baptist genes? No, nobody even suspects religion runs in families because of genetic inheritance. So why does anybody look for genes for so-called mental illnesses that also run in families? Dr. Ross argues: “Scientifically, the only conclusion that can be reached from studying the pattern of occurrence of a disorder in a pedigree [in a family] is an inversion of biological psychiatry’s logical error: If there is no familial pattern, one can rule out an inherited cause. If there is a pattern of family transmission, on the other hand, there may be a purely inherited cause, a purely environmental cause, or a mixture of the two” (p. 89, italics in original). This fact does not however prevent pseudoscientific, biologically oriented, politically correct psychiatrists and others from talking about family patterns of so-called psychiatric “disorders” as evidence of genetic (biological) causation.
    Belief that alcoholism is inherited or is biologically caused (is a “disease”) is widespread today. A recovered alcoholic whose father was also alcoholic told me, “I inherited daddy’s disease.” A Connecticut lawyer who told me he as privately retained counsel had successfully prosecuted five civil commitments on behalf of families who wanted to involuntarily commit other family members, loudly told me my not believing alcoholism is a disease proves I am “ignorant.” In a section titled ALCOHOLISM IS A DISEASE, Dr. Ross says “This doctrine [alcoholism is a disease] has been adopted throughout the chemical dependency field including Alcoholics Anonymous (AA), despite the fact that it has no scientific foundation and is logically incorrect. … The idea that alcoholism is genetic is the leading example of the effective marketing of pseudoscience by biological psychiatry. … There cannot be a gene for alcoholism, and alcoholism cannot be a biomedical illness, for logical reasons…” (p. 96.) In Dr. Pam’s discussion of genetic theories of alcoholism, he says “American researchers typically ignore the work of Robin Murray, the leading British expert in the genetics of alcoholism; Murray found no difference in rates of alcoholism for MZ [mono-zygotic, or identical] and DZ [di-zygotic, or non-identical] twins, effectively ruling out a genetic hypothesis if these results are replicated by other researchers” (p. 52).
    In a chapter by Harry Wiener, M.D., he asks “What is the nature of the predisposition to schizophrenia?” (p. 199). He concludes: “The results of these 80 years of research are clear and indisputable: nothing has come of it to date except utter confusion” (p. 200). He mocks biological psychiatry saying: “The belief that schizophrenia is a specific organic disease or a group of organic brain diseases has never been confirmed. We have been on the verge of confirming it since the dawn of modern psychiatry, and we are still on the verge” (pp. 193-194). He makes fun of genetic theories of mental illness by proposing the idea that impoliteness might be genetically transmitted and using the illogic of biological psychiatry to “prove” the hypothesis that impoliteness runs in families for genetic reasons. (pp. 194-197).
    Among the most poignant insights in the book is Dr. Ross’ argument against biological testing for “mental” illnesses. He says: “The dream of biological psychiatrists is that an ‘objective’ laboratory test for one of the major mental illnesses will be discovered. … This dream is logically unsound and can never be realized. Although biological psychiatrists speak of external validation of psychiatric diagnoses by laboratory findings and specific markers, this can never happen. Why?” (p. 101): Suppose psychiatrists decided that people become depressed because of too much or too little of a particular chemical or enzyme in the body as shown by an examination of cerebrospinal fluid or a blood test or urine test or whatever. Suppose further that you tested positive for depression on this test but that you felt perfectly fine, cheerful, and happy? Would you nevertheless start taking (supposedly) anti-depressant drugs or electroshock therapy as treatment for the depression you were not experiencing? Similarly, suppose there were some kind of biological test for schizophrenia – however defined? Despite many other definitions that have been popular in previous decades, today schizophrenia is usually thought of as psychosis, i.e., hallucinations or delusions. Suppose psychiatrists concluded “schizophrenia” is caused by some biological factor the presence of which could be determined by X-ray or MRI or PET scan of the brain. In Dr. Ross’ words: “According to this logic, it would be possible to be diagnosed and treated successfully for schizophrenia without ever having had any psychiatric symptoms” (p. 102). If you were a physician or other therapist and had a patient whose X-ray of the brain or MRI or PET brain scan showed the presence of schizophrenia, but who had no behavioral or perceptual symptoms of schizophrenia – i.e., no abnormal thinking, no hallucinations, and no delusions – would you start treating the patient for schizophrenia? The conclusion is obvious: A mental or behavioral “illness” can not be diagnosed with a biological test. It’s not even theoretically possible.
    Biological psychiatry is criticized from a sociological, political, and human rights standpoint in a chapter by Ellen M. Borges, Ph.D., a sociologist and faculty member at Goddard College in Plainfield, Vermont. In her chapter she examines “the relation of psychiatry to oppression” (p. 231). She says “Biological psychiatry redefines social deviance as a medical problem. By doing so, it transforms social norms, which are subjective and political, into medical norms, presumed to be objective and scientific. … Medicalization of social deviance allows us a pretense of humanitarianism” for coercive measures against people whose behavior “deviates from expectations based on the dominant social class’s ideology and viewpoint” (pp. 213, 217). She says “Psychiatry redefines a great deal of normal human behavior as medically deviant by pathologizing people who are socially marginal in any way” (p. 228). Among those she gives as examples of “socially marginal” people who have been oppressed by psychiatry are (1) homosexuals (when homosexuality was defined by the American Psychiatric Association as a mental disorder, which was prior to 1974), (2) slaves who tried to run away to freedom when there was negro slavery in America (whose desire for freedom was supposedly caused by a mental illness called drapetomania; see also Drapetomania – A Disease Called Freedom), and (3) political dissidents (such as those in the Soviet Union who were defined as schizophrenic because they opposed Communism). She says “Whereas discrimination and censorship are illegal methods of containing and controlling diversity, in this country [the U.S.A.] ‘inappropriate behaviors,’ including speech, can be attributed to biological misfortune and treated with drugs [involuntarily, of course – or with involuntary commitment]” (p. 228). Like Doctors Ross and Pam, Dr. Borges accuses biological psychiatry of ignoring the real causes of the supposed illnesses it is called upon to treat. In a discussion of racism she says: “A treatment bias in psychiatry is the tendency to assume a biological basis for symptoms that are caused by social-racial factors” (p. 225).
    Among the gems in this book are the following observations by two psychiatrists. Dr. Ross says during his training to become a psychiatrist, when the “cognitive errors pervading clinical psychiatry [were] unwittingly demonstrated to me by my residency supervisors” he learned that not only medical students but even “psychiatrists rarely do the critical reading” that would make the nonsense they learn in their psychiatric training apparent for what it is (pp. 85, 87 – emphasis added). In a chapter by Susan S. Kemker, M.D., staff psychiatrist at North Central Bronx Hospital in New York City, she says “most of us [psychiatrists] have been taught to believe [that] biology is the science of psychiatry. That fact that I believed this dogma made Pam’s (1990) critique of biological psychiatry especially unsettling. When I read his work, I felt that my entire education as a psychiatrist was subject to question” (p. 241). Speaking of herself and other psychiatrists, she says “our understanding of our own field remains naive” (p. 242 – italics in original). Statements like these from board-certified psychiatrists make me wonder if just by reading a book like Pseudoscience in Biological Psychiatry – or even just this book review – you know more about the “cognitive errors” that pervade modern biological psychiatry than many or even most psychiatrists.
    Although Dr. Ross’s criticisms of biological psychiatry are excellent and perceptive, he makes a completely erroneous statement in support of the so-called selective serotonin reuptake inhibitor or “serotonin blocker” drugs, the first and most popular of which is Prozac but which also includes Paxil, Zoloft, Luvox and Celexa. He says: “The new serotonin reuptake blockers are a major and highly beneficial development for psychiatric patients, and I prescribe them regularly – for dissociative identity disorder patients, among others. There is no disputing the fact that these medications are more effective than placebo” (p. 118). In his book Talking Back to Prozac, psychiatrist Peter Breggin, M.D., says: “Despite the current enthusiasm for Prozac, the FDA studies underscored the drug’s lack of effectiveness, and recent analyses of literature indicate that antidepressants in general are no better than placebo” (St. Martin’s Press, New York, 1994, p. 57). In the 1999 updates to Psychiatric Drugs: Cure or Quackery?, found on this web site, you will find a link to an article by journalist Thomas J. Moore, author of outstanding books such as Heart Failure and Prescription for Disaster, titled No prescription for happiness. In that article Mr. Moore reviews the studies the FDA required for approval of Prozac: “Lilly [manufacturer of Prozac] had conducted 10 such clinical trials for Prozac, according to FDA records. However, in six of these trials no measurable overall difference could be detected between those treated with Prozac and those who got the placebo. … Failure to produce a measurable effect is a routine event in the testing of drugs for depression.” It is also interesting to note that Dr. Ross says he prescribes serotonin reuptake blockers for dissociative identity disorder, because drugs in this group are approved as and advertised as anti-depressants. Like almost every psychiatric drug, Prozac and other “serotonin blockers” are used for almost every supposed psychiatric “illness.” This should make any thoughtful person doubt the assertion that psychiatric drugs are specific treatments for any supposed psychiatric “illness.”
    This review would not be complete without mentioning something about this book that is truly amazing, and that is the price I paid for it: $95.00 (ninety five dollars). That is an unusual and very high price for a book of 294 pages (including the indexes). With sales tax I paid $102.84 for this book. Thinking the price tag had to be a mistake, before I made the purchase I asked a book store clerk to verify the price for me. After a few minutes she returned and told me that not only was the price of $95 correct, but that in the time since the store had purchased the book, the price had risen to $115.00 (not including sales tax). To me the book was worth $102.84 because I can afford it and have a vital interest in the subject and wanted to write this review of the book for this web site. You’ll have to decide for yourself if it’s worth that much to you. If you don’t mind the price or can find the book in a library, I highly recommend it.

    Obviously, anyone just reading this simple, brief review can immediately see the logical fallacies of the Italian students/doctors in the main article above. Thus, by acting like such blind parrots bullying their victim “patients” with their fascist, bogus ideology, ignorance, blind spots and lack of informed consent, with people so much better informed with access to so many more resources via the Internet and others, these so called doctors will quickly lose all respect and credibility even if they can force their deadly stupidity and arrogance on their victims. The cat is out of the bag on the bogus eugenics theories of biopsychiatry, so I question how long such dictators will survive or thrive with impunity not to mention how ignorant and fascist they appear. Mussolini incarnated?

          • “Do you bookmark things and collect links Hermes?”

            Actually, this is a thing I’ve been struggling for ages. I kept bookmarking links I thought I might need later and kept creating increasingly complex folder structures, but the result was so huge and complex that I never bothered to use it, usually Google found what I was looking for much faster. And the pages could also go away. Right now I have only services I visit quite regularly but are too hard to find with Google in my bookmarks. For instance, to get to this site I write “mad in america” in Google search bar or just the address bar, but to go to my work email, I use a bookmark.

            I’m bit of a geek too, so what I describe here is maybe not useful for everyone. When I find a scientific article (usually PDF) that I think is important, I save it to a scientific article management program called Mendeley. It has programs or apps at least for Windows, OS X, iPhone and iPad. The idea is that you download the PDF files to yourself in that program. Then you can do searches through the files, star them, tag them, organize them in groups (psychiatry, mathematics, etc), add other meta-information such as what was the original link, your own comments, etc. You can also sync all of this between, say, iPhone and computer. It’s free up to a limit.

            With just web pages and other stuff, not strict scientific PDF articles, I use Evernote for a similar purpose. I’m not totally satisfied with its user interface, but it works in a similar way to Mendeley for those things. You can take a “snapshot” of a web page to that program, create folders and tag files, etc. You can do searches through the pages you’ve saved, and if a page goes away from internet, you still have a copy of it.

            I have similar systems at least for my own plain text notes, images, etc. I also use Dropbox. There are many other programs or systems like Mendeley or Evernote as well. But yeah, I stopped bookmarking pages which I thought might be important later on. That system didn’t work very well for me personally, I just collected a huge number of links that I never used in practice.

  2. ‘A Connecticut lawyer who told me he as privately retained counsel had successfully prosecuted five civil commitments on behalf of families who wanted to involuntarily commit other family members, loudly told me my not believing alcoholism is a disease proves I am “ignorant.” ‘

    This lawyer… my god… what a piece of work.

  3. http://www.ncbi.nlm.nih.gov/pubmed/23643756

    Has the above study and studies like it been discussed on this site yet? What about in the medical schools? This corroborates other studies finding a “neuroleptic induced defecit disorder,” as well as my subjective experience on, and coming off of the drugs. I am still only 1/3 down (though still with remarkable positive changes) but shortly will reduce to 1/2. So far the only side-effects of neuroleptics that have been reported in the mainstream as significant are the metabolic ones, and “sedation.” And sedation is characterized as little more than sleepiness, when, as we know, this effect is far more pernicious. Where is the reporting in mainstream media of studies like this? We know what the problem is, but how do we get the attention of the public and medical academia?

    “For 30 out of 49 items a clear response pattern emerged, which was similar for patients with psychotic disorders and patients with other diagnoses. Factor analysis of these items revealed three main effects of antipsychotic medication related to doubt and self-doubt, cognitive and emotional numbing, and social withdrawal. Antipsychotic treatment appears to be connected to a number of negative subjective effects on cognition and emotion. Further studies are warranted to assess how these effects impact on the patients’ subjective well-being and quality of life, as well as their association with antipsychotic efficacy on one hand, and adherence rates on the other. Induction of doubt and dampening of emotion may be one reason why antipsychotics work and at the same time offer an explanation why they are experienced as rather unpleasant and are eventually discontinued by many patients.”

  4. Anonymous,

    I just saw your message, so I’m sorry I didn’t respond sooner.

    I just accessed the article and here’s the link:

    http://www.antipsychiatry.org/br-pibp.htm

    Here is the link to all the articles on this great web site that includes the book review of Pseudoscience in Biological Psychiatry in its contents. Maybe you can access the page this way:

    http://www.antipsychiatry.org/index.htm

    I’m honored that you like this book review so much Anonymous because I love it myself. I can see why you’d like it so much because like you, the authors show with great intelligence and wit that they don’t suffer the fools promoting biopsychiatry pseudoscience gladly. I also appreciate this article updated by the recent articles at MIA debunking the bogus eugenics claims of biopsychiatry to validate our reality. Dr. Jay Joseph has done an excellent job on this as well as you and others have noted.

    You may also want to check out the description of this book and reviews on Amazon:

    http://www.amazon.com/gp/product/B000W0UVUC/ref=pd_lpo_k2_dp_sr_1?pf_rd_p=1535523722&pf_rd_s=lpo-top-stripe-1&pf_rd_t=201&pf_rd_i=0471007765&pf_rd_m=ATVPDKIKX0DER&pf_rd_r=1KZ28PNP5GKVW6DA7DG4

    You may also be able to access the article via this google page:

    http://www.google.com/search?sourceid=navclient&aq=&oq=mad+in+america&ie=UTF-8&rlz=1T4GUEA_enUS504US504&q=pseudoscience+in+biological+psychiatry+blaming+the+body&gs_l=hp..0.41l606.0.0.1.376202………..0.

    Finally, you can probably just copy the book review like I did for this post because I wanted everyone to have access to what I think is a critical challenge to biopsychiatry’s junk science and fraud.

    Hope this helps.