Psychiatry Is Not Based On Valid Science

Philip Hickey, PhD
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Background

On December 23, I wrote a post called DSM-5 – Dimensional Diagnoses – More Conflicts of Interest?  In the article I sketched out the role of David Kupfer, MD, in promoting the concept of dimensional assessment in DSM-5, and I speculated that at least part of his motivation in this regard might have stemmed from the fact that he is a major shareholder in a company that is developing a computerized assessment instrument.  I ended the piece with a general criticism of psychiatry:

“There is only one agenda item in modern American psychiatry:  the relentless expansion of psychiatric turf and drug sales.  They’ve promoted categorical diagnoses and chemical imbalances strenuously for the past five decades.  Now that these spurious notions are on the point of expiration, psychiatry is developing dimensional diagnoses and neurocircuitry malfunctions as the rallying points of the ‘new and improved’ psychiatry.

But the bottom line is always the same:  turf and money.  Something is truly rotten in the state of psychiatry.”

The article precipitated a fairly lengthy debate in the comments section.  The discussion was wide ranging, and some of the issues addressed were fundamental to the entire psychiatric debate, in particular:  whether or not psychiatry is based on valid science.

My own position is that the foundations of psychiatry are spurious, and the purpose of this post is to set out my position on this matter.

Psychiatry’s Use of the Term “Illness”

Psychiatry’s most fundamental tenet is that virtually all significant problems of thinking, feeling, and/or behaving are illnesses that need to be studied and treated from a medical perspective.  What’s not usually acknowledged, however, is that this is an arbitrary assumption.

In common speech and within the medical profession, the word “illness” indicates the presence of organic pathology: i.e. damage or malfunction in an organ.  Historically, mental illnesses came into being, not because some scientist or group of scientists had recognized and established that problems of thinking, feeling, and/or behaving are caused by an organic malfunction, but rather because the APA had simply decided to extend the concept of illness to embrace these kinds of problems.  For the record, some problems of thinking, feeling, and/or behaving are known to be caused by organic pathology, and I exclude those from the present discussion.

It is not superficially obvious that other problems of thinking, feeling, and/or behaving are actually illnesses, and there is a strong burden of proof on those who adopt this position.  Psychiatry, however, has never proved this assertion, but nevertheless continues to expand its diagnostic net in the same way that it started – by fiat.  A particular pattern of thinking, feeling and/or behaving becomes a mental illness/disorder because the APA says so!

Obviously I can’t dictate to psychiatrists how they should and should not use words.  If they choose to call problems of this sort illnesses, then that’s their business.  But they should also acknowledge that they are using the word illness in a distorted and misleading sense of the term.

They are also deviating from the ordinary standards and procedures of medical science.  In the 1930’s, a German pathologist named Friederich Wegener discovered a “new” disease, which is now called Wegener’s Granulomatosis.  He discovered this disease the old-fashioned way – by years of diligent post-mortem examinations and hundreds (thousands?) of microscope hours.  The history of medical progress is the history of these kinds of discoveries.

By contrast, psychiatry produces their “diagnoses,” (e.g. ADHD, disruptive mood dysregulation disorder, conduct disorder, etc., etc.), simply by voting.  They cling to the unacknowledged extended use of the term illness in these kinds of deliberations and decisions, whilst maintaining the pretense in their practices and promotional literature that the word is being used in its classical sense of organic pathology.

The reason that several psychoactive drugs have become blockbusters in recent years is that psychiatry has the advantage, unique in the medical field, that it can invent illnesses, and relax the criteria for these illnesses, more or less at will.  Psychiatry, unlike other medical specialties, has no natural limits to its growth potential.  They can continue to expand the diagnostic net until everybody in the world has a diagnosis.  But it doesn’t even have to stop there.  They can go for everybody having two, three, four, etc., diagnoses.  If organized psychiatry votes an illness into being, there is no reality that can act as a brake or a check on this activity.

Psychiatry and Science

Despite this confusion in terminology, psychiatry routinely contends that its diagnoses are based on science.  In the Introduction to DSM-IV, the APA wrote:

“More than any other nomenclature of mental disorders, DSM-IV is grounded in empirical evidence.” (p xvi)

And, of course, an enormous number of studies had been done.  But, to the best of my knowledge, there wasn’t a single study on any “diagnosis” that addressed the fundamental question:  is there any logical reason why this particular problem of thinking, feeling, and/or behaving should be conceptualized as an illness?  This, in every case, was simply assumed, despite the fact that there are better, more productive, more parsimonious, and more logically sound ways to conceptualize these problems.

As a companion to DSM-IV, the APA published a five-volume sourcebook of references.  There were prevalence studies, correlation studies, data re-analyses, field trials, etc… All of which was wonderful.  But on the fundamental question:  is there any rational reason for conceptualizing these conditions as illnesses? –  there was nothing.  Which was not surprising, because there had been nothing along those lines in the earlier manuals.

The Change From DSM-I to DSM-II

And speaking of the earlier manuals, it needs to be noted that a major shift in underlying theory occurred between DSM-I and DSM-II.  In DSM-I, most of the diagnostic terms contained the word “reaction” (e.g. schizophrenic reaction), the implication being that the problem in question was to be conceptualized as a reaction to something.  In DSM-II, the word reaction was dropped.  In the Foreword to DSM-II the drafting committee stated that the purpose of this change was to avoid terms that implied any particular causal theory.  This notion was repeated in the Introduction to DSM-III-R:

“The use of the term reaction throughout the classification [in DSM-I] reflected the influence of Adolf Meyer’s psychobiologic view that mental disorders represented reactions of the personality to psychological, social, and biological factors.”  (Adolf Meyer was an eminent Swiss-American psychiatrist, 1866-1950)

And

“The DSM-II classification did not use the term reaction, and except for the use of the term neuroses, used the diagnostic terms that, by and large, did not imply a particular theoretical framework for understanding the nonorganic mental disorders.” (p xviii)

All of this sounds fairly reasonable, but ignores the fact that the omission of the term “reaction” inevitably conveys the impression that the categories listed are to be conceptualized as primary illness entities.  Despite their proffered justification for the claim, it is more plausible that the term was dropped in a deliberate attempt to oust Adolf Meyer’s notion of mental disorders as reactions to biopsychosocial stressors, especially his reformulation of schizophrenia as a cluster of maladaptive habits acquired in response to such stressors.  It is also plausible that it was an attempt to return psychiatry to a Kraepelinian nosology of biologically-specifiable illnesses.  In any event, that is exactly what has happened.

Psychiatry’s “Nosology”

Many eminent psychiatrists today refer to the DSM as a psychiatric nosology.  These include:

The word nosology (from the Greek word nosos, meaning disease) means classification of illnesses, and by using this term in this context, psychiatrists are implying, without valid reason, that all significant problems of thinking, feeling, and/or behaving are illnesses, even though there is no evidence that this is a valid or helpful stance.  In fact, as we’ve seen above, an alternative perspective (Adolf Meyer’s “reactions”) actually constituted psychiatric orthodoxy from 1952 to 1968.  What is also clear and noteworthy in this matter is that Adolf Meyer’s theoretical/explanatory concepts were not abandoned on the grounds that they had been scientifically discredited or disproven.  They were abandoned as part of an arbitrary decision by the DSM-II committee  to medicalize problems of thinking, feeling, and/or behaving.

DSM-II’s decision to drop the word “reaction” was not, as claimed, a move to an atheoretical classification.  Rather, it replaced a genuinely biopsychosocial causal framework with one that was purely biological:  i.e. that all problems of thinking, feeling, and/or behaving are by definition primary disease entities.  Under the present DSM system, psychiatry doesn’t have to prove that a problem is an illness, because that assertion is built into their definitions.  If the DSM is a nosology, then every item listed must be an illness.  This is not science.  It is intellectual chicanery.

Having demonstrated that they could do this without much opposition in DSM-II, the APA solidified the arrangement in DSM-III, and expanded it to the point of travesty in DSM-IV and 5.  In fact, in DSM-5, the disease notion is injected even more explicitly and more clearly than in the earlier manuals.  In the Introduction chapter, following a discussion on the value of dimensional assessment, the APA states:

“These findings mean that DSM, like other medical disease-classifications, should accommodate ways to introduce dimensional approaches…” (p 5) [emphasis added]

Explanatory Value of Psychiatric Diagnosis

The notion that all problems of thinking, feeling, and/or behaving are illnesses has no explanatory value.  Consider the following conversation.

Client’s daughter:  “Why is my mother so depressed?”
Psychiatrist:  “Because she has an illness called major depression.”
Client’s daughter:  “How do you know she has this illness?
Psychiatrist:  “Because she is so depressed.”

The only evidence for the illness is the very behavior it purports to explain.  Unlike diagnoses in real medicine, there is no actual illness behind the DSM symptom lists to provide genuine explanatory value.  Those of us on this side of the debate have been pointing out this kind of circular reasoning for decades, but I have never seen or heard a convincing response from psychiatry.  Instead, they continue to promote their “diagnoses” to their clients, the media, and the general public as if they had explanatory value – when in fact they have none.

Psychiatry sometimes counters this particular criticism by denying that they ever promoted mental illnesses as causes or explanations of the symptoms.  But in fact, causative language permeates DSM-III, IV, and 5.  In almost every section of DSM-5, one can find exclusion clauses like:  “The disturbance is not better explained by another mental disorder,” the clear implication being that mental disorders are being presented as explanations of the problems listed in the criteria sets.  Additionally, the notion of a disorder/illness as the cause of its symptoms is standard in general medicine.  For instance, the illness pneumonia causes the symptoms of coughing, weakness, etc.,.  By using this kind of language in DSM, the APA is promoting the notion that their putative illnesses are indeed the causes of the symptoms.  For instance, the behavior of running around the classroom and failing to pay attention to the teacher is routinely presented by psychiatry as being caused by the “illness” ADHD, and this is precisely how the notion of “mental illness” is perceived by clients, the media, and the general public.  If it is not psychiatry’s intention to create this impression, then they need to make a concerted effort to correct the misunderstanding.  I am not aware of any moves in this direction by the APA or by psychiatric opinion leaders.

The Importance of Valid Theories

Organized psychiatry tends to dismiss this entire issue of the ontological status of the “mental illnesses” as academic or philosophical, and as having no real bearing on practice.  But imagine how different psychiatry would be today if it had retained Adolf Meyer’s formulations.  Research would probably not have been hijacked by pharma, and would be focused on social and environmental factors rather than on drug responses.  Psychiatrists would take detailed histories in an attempt to understand their clients, rather than gathering just enough information to clinch the “diagnosis.”  There would be no fifteen-minute med checks, and social skills training would be the dominant treatment modality.

Causal theories are not ivory tower abstractions.  In any systematic human activity, they are the pillars that support and drive practice.  And when they are spurious, as in the case of psychiatry, practices and procedures inevitably drift into error.  The legitimacy of a profession depends on the validity and adequacy of its underlying causal theories.  Indeed, the theories are the formal expression of the knowledge accumulated by the science at a given point in time.  This applies particularly to those concepts that are very basic and fundamental. A shipping industry, for instance, that was working on the assumption that the Earth is flat, other things being equal, would probably not be noted for excellence of service.  Similarly, a geo-centered astronomy would be a shaky foundation for the development of space travel.  Human endeavors that are based on valid theories are more likely to yield success than those based on invalid theories.

To guard against misunderstanding, I’m not saying that good theories are sufficient.  One also needs techniques, tools, skills, etc…  But working without valid theories, or worse, working with invalid theories, inevitably leads practitioners astray.  Which is exactly what has happened in the case of psychiatry.  By assuming that all significant problems of thinking, feeling, and/or behaving are illnesses, they have, very naturally, been drawn into seeing these problems as entities that they (the physicians) have to fix by means of medical-type techniques, and seeing the owners of the problems as “patients” – i.e. people who have to be fixed.  The illness theory also, because it conveys the false impression that the matter has been explained, has a dampening effect on practitioners’ curiosity as to genuine explanations.

Modern psychiatry has been plugging away at its so-called nosology for more than a hundred years, and the APA, in their successive revisions of the DSM, assure us that the classifications are scientific.  Thought leaders and individual psychiatrists, with few exceptions, assure us that the “illnesses” listed in the manuals are scientifically established, ontologically valid entities that provide the framework for understanding and ameliorating problems of thinking, feeling, and/or behaving.  But seldom is it acknowledged that this stance is nothing more than an assumption, the purpose of which was to establish psychiatric turf in a non-medical field.

Psychiatry is Valid Because its Treatments Work

It is sometimes argued that psychiatry derives validity and legitimacy from the fact that its treatments (i.e. drugs) work.  In rebuttal, many writers on this side of the debate have pointed out that small quantities of alcohol help a person overcome shyness, but that nobody would conclude from this either that shyness is an illness, or that alcohol is a medicine.  Drugs, whether they’re of the street, liquor store, or pharmaceutical variety, alter people’s thoughts, feelings, and/or behaviors.  In some cases, the users of these products and their families express themselves pleased with the alteration.

I have known a good many marijuana users who maintained, with, I think, good credibility, that pot helped them control their anger – made them mellow.  Over the years I have worked with several women who always kept a twelve-pack of beer in the refrigerator in case their husbands became angry or upset.  In these cases, the pot and the alcohol “worked” in the sense that they forestalled the anger and rage.  And psychopharmaceutical products sometimes “work” in this same pragmatic use of the term.  But there is no evidence that any psychopharmaceutical product fixes or alleviates any pathological process.  Indeed, what seems to be the case is that these drugs “work” by producing abnormal neurological states.  From a pragmatic point of view the abnormal state may seem better to the client, and/or his family, and/or the authorities.  But this does not establish that the original condition was an illness or that the drug is a medicine.  

Clarification

Obviously the problems listed in the DSM are real.  That’s not the issue.  What’s being challenged here is the contention that the clusters of problems set out in the manual can be validly conceptualized as symptoms of medical disease entities.  It is my position that such a conceptualization does violence to the subject matter, and has led psychiatry seriously astray.

For instance, at the present time there is a great deal of concern in professional and official circles about the rapidly increasing use of neuroleptic drugs to “treat” childhood temper tantrums and aggression.  What’s not usually acknowledged, however, is that these practices are a direct consequence of the spurious notion that all problems of thinking, feeling, and/or behaving are illnesses that warrant medical intervention.  In the “old days” parents who brought a child to a physician for temper tantrums or aggression would have been told that this, in the absence of some very obvious and compelling indications to the contrary, was not a medical problem.  Today it is a medical problem, not because there has been some breakthrough medical discovery, but simply because the APA says so, and because psychiatrists prescribe neurotoxic drugs that act as chemical strait-jackets and dampen the problem behavior.  Contrary to the congratulatory self-talk of Dr. Lieberman and his like-minded “opinion leaders,” this is not medical progress.

A Second Clarification

Again, to guard against misunderstanding, let me state very clearly that if psychiatry could produce convincing evidence that the myriad problems of thinking, feeling, and/or behaving listed in the DSM are in fact caused by specific illnesses/diseases of the brain or other organs, then my objections are moot.  And if that day comes, as I’ve said many times, I will fold my tent, apologize to all concerned, and end my days writing poetry, growing vegetables, and playing with my grandchildren.  In the meantime, I will continue to state as vigorously and as frequently as I can, that psychiatry’s most fundamental tenet is nothing more than a self-serving assumption which despite decades of highly motivated research, numerous premature, yet confidently asserted, eurekas, and virtually endless promises that the definitive evidence is just around the proverbial corner, remains nothing more than a false and destructive assumption.

 * * * * *

This post also appears on Philip Hickey’s blog,
Behaviorism and Mental Health

32 COMMENTS

  1. Philip,

    Excellent essay — very informative and well reasoned.

    Thank you so much for writing and posting it. It’s well written (interesting and readable); but, moreover, I am completely with you, on all that you say in it — most especially, as you basically indicate, that “mental illness” is a profoundly misleading term.

    Also, I’m impressed with how you’ve described the ultimate morphing of the DSM (from its first edition, to the fifth) — how it was turned, ultimately, into a ‘diagnostic’ tool that’s purely obfuscating, in all matters of cause and effect.

    You’ve written an altogether excellent article.

    Now, here, as follows, I will anticipate a possible criticism, which may come up, in the minds of some readers:

    You explain,

    For the record, some problems of thinking, feeling, and/or behaving are known to be caused by organic pathology, and I exclude those from the present discussion.

    That sentence may raise questions, naturally.

    (It could possibly be helpful if, in some future essay, you expanded upon that “For the record” aside…)

    It may be important to note: Some psychiatrists, in the course of their work, do address established organic pathology, and they will call it “mental illness.”

    I don’t think it’s a good use of language, when they do it; but, they do it, and that may lead them to insist that “mental illness” can be biologically caused.

    I am not sure how the DSM addresses this matter. (I presume it simply ignores it; but, I don’t know and don’t wish to research it. After all, I deliberately buried my copy of DSM-IV in storage, for I find that tomb makes terribly depressing reading.)

    Psychiatrists sometimes address real/physical disease.

    For instance, Alzheimer’s…

    And, sometimes, psychiatrists refer to Alzheimer’s disease, by calling it “mental illness.”

    Should they do so?

    I believe Alzheimer’s disease is quite demonstrably an organic brain disorder. I think it should, thus, be deemed a neurological disorder (not “mental illness”); however, it does produce characteristic forms of ‘mental disorder.’

    “Mental disorder” need not be considered a metaphorical term.

    It can be considered a reference to some instance, of confused thinking…

    Psychiatrists (and others, who likewise, presume to know about “mental illness”) will often use the terms “mental illness” and “mental disorder” interchangeably.

    That’s problematic.

    In fact, I would go so far as to insist, that it causes mental disorder.

    Along those lines, in the literature of NAMI — and also in talks, by their leaders –, I’ve noticed frequent references to both “dementia” and “schizophrenia,” as a “mental illness” and as a “mental disorder”…which is, of course, confusing (if not always deliberately misleading).

    Quite routinely, in discussion, in that so-called ‘advocacy’ organization (which is, as we all know, largely funded by Big Pharma), “schizophrenia” is deemed “a brain disorder.”

    That is extremely misleading. (I would even go so far as to call it a professionally established lie. Psychiatrists who are associated with NAMI who do not actively refute that lie should be identified, outed and formally panned, not only by critics of NAMI — but by all well-meaning NAMI leaders and members.)

    The notion that “schizophrenia” is a brain disorder is pure poppy-cock.

    “Schizophrenia” is a blanket term, describing all sorts of cases of seeming ‘psychosis’ — the causes of which are usually, demonstrably, associated with trauma and/or severe neglect — and psychiatric abuse, including forced neuroleptic drugging… and the coerced, long-term ‘prescribing’ of such drugs.

    Ultimately, ‘psychosis’ is what is created by the standard ‘treatment’ of so-called “schizophrenia”.

    And, see the first definition of “psychosis” which Google presents us,

    psy·cho·sis

    : a very serious mental illness that makes you behave strangely or believe things that are not true

    : fundamental derangement of the mind (as in schizophrenia) characterized by defective or lost contact with reality especially as evidenced by delusions, hallucinations, and disorganized speech and behavior

    http://www.merriam-webster.com/dictionary/psychosis

    I should not go on, here, endlessly, on “schizophrenia” — as that label is not even a part of your discussion, in this blog.

    I will only add this (in the cause of scrutinizing the “mental illness” label):

    “Schizophrenia” — which Thomas Szasz called “the sacred symbol of psychiatry” — is ostensibly defined by the existence of a (seemingly) persistent ‘psychosis’; in my humble opinion, any persisting ‘psychosis’ persists because good helpers have not been located.

    And, there is no biological marker to prove that ‘schizophrenia’ is an organic disease, but some manifestations of apparent ‘psychosis’ can be caused primarily — or, even exclusively — by certain very tangible, organic processes, affecting the brain. (E.g., I think of the bacterial disease, Malaria.)

    Perhaps, whenever a clearly biological cause of a seeming ‘psychosis’ is discovered, that ‘psychosis’ should not be considered a “mental illness”; however, quite honestly, I admit, it may be impossible to make a convincing case that its effects shouldn’t be considered a manifestation of “mental disorder.”

    (Again, I can see how “mental disorder” can be used, literally, to refer to thinking that is apparently not well ordered.)

    Like you, I have no use for the categories of “mental disorder” in the DSM.

    But, I cannot deny, there may be some usefulness, in the term “mental disorder.”

    Simply, my personal feeling is that the term “mental illness” cannot be redeemed — because so many who use that term will apply it metaphorically, but they will not be clear, admitting when they’re doing so…

    That is ultimately misleading.

    Those who wish to speak clearly on these matters should at least keep that “mental illness” term sandwiched in quotation marks (and frame it in ‘air quotes’ when engaged in face to face conversation).

    Again, I thank you for writing and posting such a fine essay…

    Respectfully,

    Jonah

    • Jonah,

      Thanks for coming in and for your encouragement and thoughts.

      I think that the disorder-illness confusion is largely historical. When they wrote the first DSM, there wasn’t enough consensus in psychiatry to go with the word illness. Disorder is vague, and can mean almost any kind of sub-optimal condition. In the 50’s and 60’s, the drugs started to come on stream, and psychiatrists realized that they needed illnesses to justify prescribing drugs. Changing the DSM title from disorders to illnesses would have aroused some suspicion/resistance, so they stayed with disorder, but allowed it to morph into illness by dishonest promotions like the just-like-diabetes travesty.

      And thanks for the drafting suggestion re: the genuinely organic neural problems.

      Best wishes.

  2. Excellent. Right from the start psychiatry was about Dr’s making money out of distressed and disruptive individuals. Other’s were offering this service too, but Dr’s said they could do it better so they had to invent reasons, or as they called them, diseases, to justify themselves. Then they invented so called treatments.

    It’ a sham, built on a couple of centuries of business opportunities. Nothing has changed, except Big Pharma had jumped on the bandwagon so it can make Big Profit

  3. Wonderful article. I think that refined and clear reasoning like this is what most powerfully resonates as accessible truth. When I read the title, “Psychiatry is Not Based on Science,” my first thought was, neither is the rich and unpredictable experience of life.

    After reading through the article, it occurred to me that what psychiatry has hijacked is our individual creativity, and turned it into an exorbitantly profitable chronic illness-creating business.

    How long can this extreme vampirism go on? Psychiatry has sucked the energy out of all of us. Were psychiatry not available to undermine and kill the creativity in the world, we’d probably enjoy a full-blown Renaissance!

    • Alex,

      Good points – especially when we remember that individual creativity is not the same thing as uninterrupted and unmitigated bliss. It involves ups and downs. In fact, I remember a third grade teacher telling us that all great artists suffer! Nowadays, if they get into psychiatry’s clutches, they get a “diagnosis” and a drug. Oh happy day.

      Best wishes.

      • Thank you, Philip. Indeed, what made me think of the creative process is your emphasis on our thoughts, feelings and behavior–i.e., how we embody and experience our creativity.

        If we are to be our true selves, then we need to have permission to experience the entire range of human emotions and experiment with our perception without it being equated with pathology. This is natural to being human, it is what our consciousness calls for. Squelching this process is to deter our spirits from self-expression, and that is what is truly harmful.

        To me, art and nature are all things possible–life and feeling experiences of all shades, colors, and textures. I don’t think we’re on the planet to be bored, but we could sure make our ups and downs more enriching and meaningful if we were to cease calling our experience a disease. The alternative is to actually *celebrate* our diversity, both inside and out.

        I just read more of your writings online. I’m very inspired and encouraged by your clarity and certainty around these issues. Thank you.

  4. It’s amazing to me that psychiatrists can stand up and with a straight face call themselves real “doctors,” especially after the debacle of the laughable and ridiculous DSM-5. Psychiatry and its bible are probably the biggest hoaxes pulled on the American people in the history of this country.

    Short, sweet, and to the point. Thank you for telling it like it is.

    • “Psychiatry and its bible are probably the biggest hoaxes pulled on the American people in the history of this country.”

      Beautifully put, Stephen, it’s exactly how I’d frame it.

      Your comment reminded me of a blog that a friend sent me just yesterday, written by Chaz Ebert, Roger’s widow. Reflecting on his passing last April, she writes:

      “Roger said that he didn’t know if he could believe in God. He had his doubts. But toward the end, something really interesting happened. That week before Roger passed away, I would see him and he would talk about having visited this other place. I thought he was hallucinating. I thought they were giving him too much medication. But the day before he passed away, he wrote me a note: “This is all an elaborate hoax.” I asked him, “What’s a hoax?” And he was talking about this world, this place. He said it was all an illusion. I thought he was just confused. But he was not confused. He wasn’t visiting heaven, not the way we think of heaven. He described it as a vastness that you can’t even imagine. It was a place where the past, present, and future were happening all at once.”

      When I read it, I thought about psychiatry, along with a sizeable list of illusions perpetuated by this study and practice—as if psychiatry is being used as a tool (by whom?) to block truth, authentic reality, etc., however we’d define that–this ‘vastness’ to which she refers. Like an “anti-Christ,” so to speak. Sure has worked well for them, et al–brilliantly, in fact.

      I believe the purpose of this would be to keep a few people very rich, and feeling powerful, while unsuspecting others remain confused, enraged, agitated, grief-stricken, and fighting amongst each other.

      I think what Chaz Evert is saying here, based on her husband’s reflections at the end of his physical life, opens up a whole host of possibilities. If this is all an illusion—a hoax for profit, at the expense of so many people and communities—then what is this vast, concurrent past/present/future multi-dimensional reality? How would we experience this? Would it be where we’d find justice, along with true support for whatever creative process we choose to experience? Seems like ‘heaven on earth’ to me. Could this be what is behind the illusions fostered by this psychiatric hoax? Just a thought.

      Here’s the full article, for anyone interested in reading it. I found it very moving.

      http://www.rogerebert.com/chazs-blog/reflecting-for-the-new-year-on-rogers-last-day

      • string theory is a system of 10 dimensions in space and one in time. Roger may have been become a little bored with the old x, y, z and zoned his focus more into the subtle changes observable in our reality that can only be described by influential changes in extra dimensional space uh… i think

  5. Excellent post Phillip.

    When you describe how psychiatrists debate the point that there is no biochemical illness, you offer their rationale that the meds work. And then you go on to say…well…alcohol works for shyness but no one would conclude that shyness is an illness or alcohol is a medicine.

    I think this gets to the meat of the matter. How is prescribing Ritalin for the “mental illness” of ADHD acceptable, but offering them methamphetamine or cocaine is not? Why is it ok to prescribe Xanax for the “biological illness” known as Generalized Anxiety Disorder, but not ok to prescribe a fifth of Jim Beam, or some quaaludes?

  6. After some consultation with “wiki” 🙂 I agree

    Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method .

    Complementary medicine is alternative medicine used together with conventional medical treatment in a belief, not proven by using scientific methods, that it “complements” the treatment.

  7. Great Post Philip ! If the American Medical Association, and the American Psychiatric Association , primarily practiced pseudo science , and had a near total monopoly established , as a barrier to entry against competition, plus a virtual stranglehold on insurance coverage payouts to themselves, a cooperative revolving door fascist government , and pseudo “foodagriculture” and pseudo “medication” cartels pumping out merchandise, and an academy award winning media presence, they would have a huge growing numbers of suffering humanity as customers too debilitated to even think of mounting an effective counter offensive or understanding that they were being weakened, robbed ,tortured, and culled by the Rockefeller ,Carnegie cartels and their ilk .

  8. Dear Philip,

    Thank you for enriching the ‘never ending debate’ on the pretense that unusual forms of feeling, thinking, perceiving, behaving are caused by ‘irregularities’ in ‘the brain’ (with the exception of lesions). I much appreciate the stringency of your arguments.

    I wish to add that I strongly disagree with two fundamental assumptions in these kinds of conceptions:

    1/ I wait for the day that we stopp to apply causality to the understanding (or explaining) of human agency and experience. Ever since the establishment of biology the challenge was to be able to conceive circular and dialectic processes as modalities of human conduct in reciprocity with relevant others or ‘things’ in the environmental context.
    2/ For proper human sciences the dialectic and reflective nature of emotional and mental experiences which always presuppose specific social, cultural and spiritual contexts needs to be considered.

    It has been demonstrated many times that no perception, no emotion, no consciousness nor conduct are reducible to or can be caused by brain/organic processes. As the nervous system within the living organism is part of broader mediating systems, drugs or lesions/organic malfunctions can disrupt the above mentioned ’emergent’ abilities which will always be dependent on the interrelations with social agents and environmental factors.

    For the reasons mentioned above I am disappointed that the nature of the critical thinking on human experience has not a long time ago said good bye to the never ending debates between many different rationalist and causal conceptualisations which compete for a consistency that in its linearity and ‘physicality of chains of arguments’ misses the challenging complexity of biology as well as human experience and conduct.

    I would much appreciate suggestions for more adequate ways to conceive of human experience which may make oblivious the false claims of mental illnesses. ‘Der Geist kann nicht erkranken’ – The human mind/thinking can’t get sick – some old German Psychiatrist stated. A ‘thought disorder’ is an impossible concept. I hope this example illustrates the logical fallacy.

    It does nothing to reveal the complexity in animal and even more human experience, emotions, interactions, interrelatedness, conduct and consciousness/thinking.

    With kind regards
    Ute

    • Ute,

      Thanks for your interesting comment.  I think you’re right, human experience is not reducible to the firing of neurons.  I have written an article on this topic: Understanding Human Behavior.  It’s scheduled to be posted on my own website, Behaviorism and Mental Health, on Monday, January 13, 8:00 a.m. EST.

      Best wishes.

  9. Thank you Philip for a brilliant post. I have read many posts on the chicanery that exists to promote a diagnosis of mental illness. I understand the enormous profits that must be generated by pharmaceutical companies to stay in business aided and abetted by some unprincipled, money orientated psychiatrists. I fail to understand why family doctors are also complicit in this scam. Surely their medical training demands reliable evidence is necessary before prescribing dangerous mind altering drugs.

    • Sarah,

      This is a very good point. The tragedy is that psychiatrists have succeeded in getting their spurious concepts and their dangerous “treatments” recognized and accepted as standard care within medicine generally. A physician who doesn’t prescribe an antidepressant to a depressed person is going out on a limb, and if that individual should kill himself or cause harm to someone else, the physician could easily be held negligent. I suspect that a great many family doctors have to “hold their noses” when they engage in this sort of practice.

  10. Dr. Hickey, Your appreciation for the qualitative and quantitative factors required for good explanations, and your respect for the overall compexity of pyschiatric syndromes is great to learn of and very encouraging to follow to the respective conclusions in your argument. Obviously, if the psychiatrists that most of us know consulted their masses of specialized research with the same principles by which you critically approach them, things would become much more livable for millions of people.

  11. I wrote this last night, i guess it’s for you Phil.

    I remember once when I was a little boy, I realized that all I had to do is try as hard as I could and I could run faster than my older sister. I compensated for my learning disabilities and disorganized thought with my exuberant desire to discover and invent. At the peak of my career in computer science I made $110,000.00 per year based on this childhood philosophy. I can thank my mother and father for their emotional support, although I don’t accept help from people because there is way too much to be gained from the experience of doing something yourself.

    I had trouble focusing in calculus so I was written a prescription for a huge bottle of methyphenidate pills, but they were making me feel upset. I offered to give them to friends but they didn’t want them either so I just threw the bottle in the trash.

    At 18, I remember being okay with people teasing me about being gay once I had started taking Paxil. I felt like I didn’t care about anything anymore. I started ignoring my bosses instructions at work, and didn’t finish my degree in computer science despite having completed all but 2 math and 1 phys ed. I actually completed the tennis class for phys ed, but there was a recording glitch but I didn’t care. The last 4 years had meant nothing to me.

    Moving on, I began working for a great little company in Springfield named Infostructure. It was rought at times, but the love was there. My new chevy lumina was broken into and he stole my beloved Sony Handicam and some irreplaceable video. I didn’t care about the rest of the damage to the car, but that camera was precious to me and I miss it to this day. The cop told me that I needed to watch it because this was Springfield, not Wilbraham. I started to feel upset and ended up on Effexor XR 300mg. When I had first started at Infostructure, I did what they wanted me to. Active Server Pages, Stored Procedures, Java, Visual Basic. I was able to earn enough respect for them to let me do whatever I wanted. Eventually I didn’t care about my job anymore and started writting endless amount of computer code that did absolutely nothing!! I showed up to work later and later and was eventually issued a written warning. I Quit and interviewed for a great company named Softscape in Wayland, MA. I was interviewing for consultant role, but they immediately hired me instead as software engineer to develop their product itself, to which I added a few features and was quickly welcomed to an aggressive, but fantastic new league of friends, and some might say, family. The same thing happened to me again. I eventually stopped listening to my boss, and did whatever I felt like doing, which was playing with computer programming for the most part and not actually getting my job done. After a couple angry conversations with my boss, I stopped going to work and was eventually Terminated. They loved me, and let me get away with murder, so to speak. I didn’t care at all about any of that. I started doing illegal things with my vehicle such as driving 145 MPH on i90, i495, i290 and as fast I as could everywhere else. I tossed heavy objects at the other vehicles because I felt they where not moving with a sufficient rate of speed. Once a man followed me back to my home to yell at me from my reckless behavior. It’s a miracle that no one was hurt. I lost everything and moved in with my parents.

    I was diagnosed Bipolar I after some time, and put on antipsychotics, antidepressants and mood stabilizers. It’s hard to say in what order or for how long, but the list included zoloft, risperdal, lamictal, trileptal, welbutrin, seroquel and zyprexa. 1, 2, 3, 4, 5, 6, 7… Ok…

    Things started to pick up for me, I took a web developer position for FCHP in Worcester. Nothing bad happend there, and in the end I was making $67,000 per year on salary. FCHP is a fantastic employer. They sent me to Las Vegas for a week to stay at Mandalay Bay for the ASP.NET connections seminars. The experience was magic, and I could expense every purchurse. I had never been that far from my home town before. Before I knew it, I was the lead developer on the most important projects for example I designed the medicare part D formulary and played a key role in intranet and extranet applications as well as legacy MS Office applications in premium billing, underwriting, provider appeals, even human human resources. When I wasn’t getting work done, I was there on the weekends with a box of joe from dunkin donuts. I had a refridgerator on my desk, had a great relationship with my boss and sometimes he shared information with me about the performance of the other employees. Had I wanted to return to school to finish those few courses, my benefits would cover every single dime. I decided that I didn’t have enough so I took a job in Wellesley making $110,000.00 per year. Then I took a job in Waltham for a little while at $95,000.00 per year. At my last job they caught me lying about having a degree in computer science, but they hired me anyway. I was selected over stacks of resumes. I had money to burn. We were allowed to take frequent breaks in order to play table tenis and foos ball in the recreation room. I walked outside in the woods on hiking trails, sometimes taking a nap on a bench because I had it all to myself. Holliday parties were at places like the Boston Meseum of Science, and we would have team building experiences of all kinds, the kitchen had every tea and coffee there is and purified water and ice in the freezer there for you any time. They allowed my to arrive as late as 10:30 AM. I stayed as late as 11:00 PM because I was always manic. When I wasn’t working I was body building or doing chores or sleeping.

    I had an upsetting medical problem and the colorectal surgeon gave me oxycodone for pain. I was prescribed lorazepam and then clonazepam for anxiety related to chronic an anal fissure, which still exists in my nightmares. I got so depressed that I had to go on FMLA, or family medical leave of absence. Eager to return to work, I did so in a psychotic state. At lunch I told everyone malicious stories about how the director of technology was incapable of leading our group. She allowed this to go on for months until issuing a 30 day warning followed by a letter of termination.

    In time i stoped listening to my boss and started redesigning every part of the system I touched. I was insane. I was eventually let go, and my bosses last words were, “I really do want the best for you, Ryan”

    Things went from really bad to undescrible and I eventually moved back in with my parents. After several years living with my parents, I incured an anal fistula, got it removed, and got prescriptions for both oxycodone and hydrocode for the pain. I suffered a psychotic break and was hospitalized for over 70 days. I thought that at age 33.333 that my neuroelectomagnetic system had achieved a maximum standing wave ratio and this would allow me to exist over a greater area in space and time — laugh out loud, right? Eh, makes for a good story at least.

    When I was released I hired a different psychiatrist who allowed me to once again have a prescription for… methyphenidate. I was also given abilify which has caused permanent akathesia in my right foot. Cybalta made my eyes feel sleepy years after discontinuation, and had a short lived initial effect that I can neither confirm nor deny. There was also Valium this time, although I didn’t fill the script because I assumed it would be hazardous to my health.

    I am currently taking Lexapro and Lamical. I have no way of knowing if these drugs are nessessary, and I haven’t decided to stop taking them yet, but I hope to eventually be off of them completely. Psychiatry is not medicine, it is “meddleling” with people’s brains in an inhumane way that society pays dearly for.

    I am now 35 and I am dissabled for life, and I know psychiatry has played a key role in the destuction of my life.

    During my second major manic episode, I never hurt anyone, never hurt myself, because I actually… was never psychotic or manic at all. Subconsciously I was simply playing with my mind as a boy plays with his penis for the first time. It was an experience as important to me as discovering the nature of my sexual attraction to males in my first major manic episode. I woke up from a zone i had been in since the day i was first traumatized by my this artificial reality of bullshit and needed to “stretch” out my “me”

  12. Good article Dr Hickey, you’re existence empowers me. I define a mental illness to be a treatable phenomenon that is a determent to one’s ability to explore both intra- and extra- “self”

    Therefore, any “symptom” of “mental illness” is no symptom at all if can not be characterized as a detriment.

    Sorry about all the text, doctor, I’m just glad I met you. Well, in my mind at any rate.

  13. This is an argument with which I am familiar but this is one of the clearest and most concise articles on the matter that I have read. I have long felt that psychology is, in general, a more scientific pursuit than psychiatry. That coupled with the fact that psychiatrists are doctors who specialise in mental health, whereas until recently clinical psychologists had to acquire a research PhD, which I feel gives them an appreciation for what genuinely valid scientific research consists of.

    As a hobby I am a bit of an amateur futurologist, I like to imagine and predict how the advances in science and technology will affect us and the world we live in, in the future. One of my hopes is that with the continuing advancement in technology relating to brain imaging we will reach a point where neuroscience and neuroimaging will be able able to identify when there is an underlying organic disease state in a mental illness (whether generally for that illness or personally for that individual) and in this instance treat the disease with whichever medical procedures we deem appropriate. And in the instance when we can’t identify a disease state, as presumably the symptoms are a manifestation of social, psychological and behavioural problems, we will be able to employ scientifically verified psychological techniques.

    I am not sure where this will leave psychiatrists and psychiatry as a profession, but I suspect it will evolve to fill a new niche.