Stephen Hawking believes there are an infinite number of universes and that alien life exists. Nobel Prize winning physicist Neils Bohr’s interpretation of quantum mechanics shows a cat can be alive and dead simultaneously until we fix it in one state through our observation of it. These are ideas that most people would struggle to see as credible science and yet recent literature reviews reveal that physicists are far more trusted than psychiatrists.
In 2009 the WPA President established a Task Force to examine available evidence about perceptions of psychiatry and psychiatrists. The survey shows that overwhelmingly, other medical professionals, patients and their families and the general public have very contemptuous views of psychiatrists and psychiatry.[1]
The studies reviewed show that psychiatrists are viewed as odd, unsure, ineffective, useless and incomprehensible and as “dangerous and manipulative abusers who exploit their patients and abuse their power.”[1]
The negative effects of psychotropic medications by the groups surveyed are perceived as severe and the use of these medications is perceived as coercive, and compromising patient autonomy. The majority of respondents said they would not be willing to take psychiatric medications.
Research into the attitudes of medical students to psychiatry found they do not view it as an intellectually challenging career choice and see it as lacking a solid, authoritative scientific foundation. Their view is that the majority of diagnostic categories are not validated by biological criteria. Their sense is that psychiatry is not “real medicine’; A perception supported by the families of medical students who consider specializing in psychiatry as being “wasted time. Those who elect to train in psychiatry don’t seem to be the cream of the crop given the fact that around 40% of trainees applying to train in the U.K. currently fail to pass the MRCPsych examination.[2]
By contrast, a similar study looking at public attitudes towards physicists found that they are seen as “patient, conscientious, creative and hard working”, with the majority of respondents believing physics makes a valuable contribution to society.
So how are scientists who believe in aliens, multiple worlds, and cats that are alive and dead simultaneously, more trusted and valued by society than doctors who treat mental illness? What has led to widespread contempt of psychiatry? I think Nietzsche held the key when he said that “The most perfidious way of harming a cause consists of defending it deliberately with faulty arguments.”
I would argue that the most effective single weapon against psychiatry is psychiatry itself, which exhibits all the hallmarks of its own definition of delusional disorder.
The DSM-5 defines delusions as “fixed beliefs that are not amenable to change in light of conflicting evidence.” It notes that
“The distinction between a delusion and a strongly held idea . . . depends in part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence regarding its veracity.”
Surely the following statements are fixed beliefs which represent stubborn adherence to beliefs in the face of reasonable contradictory evidence:
“Antidepressants do not cause violence.” [3]
“[Clinical depression is] an illness that can arise spontaneously due to changes in brain chemistry that are independent of life events.” [4]
“Thinking about suicide and even attempting it are very poor predictors of completed suicide. In fact they are highly accurate predictors of not suiciding.” [5]
“Depression involves changes in brain chemistry and can change the way people respond to their world. Antidepressant medicines can correct the imbalance of chemicals in the brain until such time as the natural balance is restored.” [6]
With significant evidence that the above statements are interpretation, not fact, it is hardly surprising that other medical professionals have a dim view of psychiatry and that medical students are not choosing to practice it.
The vexing question is why, if the public have such a negative view of psychiatry and psychotropic drugs, they are not rejecting them as logic would suggest they would.
I’m of the view that science is the new religion and that the doctrines of normality and happiness have become firmly entrenched in our psyches. We have assimilated messages that in this millennium, medical science can ensure we do not suffer emotional pain and suffering just as it spares us from physical pain and suffering. We believe that different is ‘abnormal’ and that abnormality can be cured. Just as in the past – and for some in the present – rejecting God and church attendance is seen as wantonly choosing to suffer eternal damnation, choosing to reject psychiatry and psychotropic drugs is seen as foolishly choosing to suffer a lifetime of misery and a lack of fulfilled potential.
Despite doubts about the existence of God and the motives and rituals of organized religion, people attend church because it is ‘the right thing to do.’ Interestingly, a significant percentage of athiests attend church.
According to the 2000-2010 cumulative General Social Survey data of those who claim to have no religious affiliation, 26% attend church at least once a year, 12% report going at least several times a year, and 2% say they go weekly.[7] A new study out of Rice University has found that almost one out of five scientists (17% ) who describe themselves as either atheists or agnostics attend church.[8]
Their reasons are interesting. They do so as a way of exposing their children to a range of knowledge to allow them to make informed choices about a religious identity. They go to church because their spouse wants them to and they attend because it gives them a sense of community.
It may be that despite people having serious doubts about psychiatry similar forces channel them down the path of mental health treatment. It is likely that just as the church used to be seen as the only path to God, psychiatry is seen as the only scientific path to mental health. There is perhaps much to be learned from those who promoted and practiced alternative religious pathways.
I think it is a particular form of cruelty to inform people of the risks of psychiatry and psychiatric drugs but fail to offer credible, acceptable, accessible alternatives. For people experiencing emotional distress and suicidal thinking and behavior themselves or in those they love, doing nothing is not an option. Advising people to stay away from mental health providers but giving them nowhere else to go heaps more distress on that that they are already suffering. Evidence of successful outcomes from alternative interventions, including watchful waiting, is critical.
It is easy to state and restate ad nauseum the harms of psychiatry. We all know people who are stuck in this mode. In my view, we need to build on people’s already high levels of suspicion and disdain for psychiatry in the context of providing alternative solutions to the challenge of living happy, fulfilled lives and promoting the notion that human existence cannot and should not be 100% free from pain. We need to tell as many good news stories as we can and let people know that just as there are many paths to God that do not involve hellfire and brimstone, there are paths to relieving suffering and preventing suicide that do not involve forced treatment, brain damaging drugs and engagement with psychiatry.
If Hawking is right, then somewhere in the multiverse, there is a world where intelligent life has rejected psychiatric theory and practice. If, as quantum physics tells us, things are fixed in a particular state by our observation of them, let’s observe the positive and create the world we dream of. And the cat? If it’s the Cheshire one that grins constantly and allows no emotion but perpetual happiness, even this crazy cat lover wishes it dead.
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This blog is dedicated to my son Toran Henry, who loved Quantum Mechanics and taught me to love it too. Wherever you are in the multiverse this new year Toran, mum loves you and hopes Shroedinger’s cat curls up beside you and keeps you warm as you sleep at night.
References:
[1] Norman Sartorius, Wolfgang Gaebel, Helen-Rose Cleveland, Heather Stuart, Tsuyoshi Akiyama, Julio Arboleda-Flórez, Anja E. Baumann, Oye Gureje, Miguel R. Jorge, Marianne Kastrup, Yuriko Suzuki, Allan Tasman 2009 WPA Guidance on How to Combat Stigmatization of Psychiatry and Psychiatrists. World Psychiatry. October 2010; 9(3): 131–144.
[2] Strengthening Academic Psychiatry in the UK. The Academy of Medical Sciences. March 2013
[3] Antidepressant Medication – Clarification by The College of Psychiatry of Ireland 13 May 2010
[4] Sometimes Words Are Not Enough to Lift Depression. Independent IE. January 8, 2010
[5] Letter from Prof Werry to Tony Ryall, Minister of Health, NZ dated 23 March 2009 and presented in evidence at the inquest of Toran Henry. Pdf available on request.
[6] Coping with Depression New Zealand Treatment Guide for Consumers and Carers March 2005 © Royal Australian and New Zealand College of Psychiatrists. New Zealand Treatment Guide for Consumers and Carers. March 2005.
[8] Elaine Howard Ecklund, Ph.D. Some Atheist Scientists With Children Embrace Religious Traditions. Huffington Post. December 11, 2011
