On March 5, Bruce Levine, PhD, published an interesting article on Mad in America titled Psychiatry Now Admits It’s Been Wrong in Big Ways – But Can It Change?
Bruce had interviewed Robert Whitaker, and most of the article is the transcript of this interview.
Bruce begins by noting that Robert, in his book Mad in America, had challenged some fundamental tenets of psychiatry, including the validity of its “diagnoses” and the efficacy (especially the long-term efficacy) of its treatments.
Bruce reminds us that Robert initially incurred a good deal of psychiatric wrath in this regard, but also points out that some members of the psychiatric establishment are beginning to express a measure of agreement with these deviations from long-held psychiatric orthodoxy.
Robert was asked if these kinds of developments have rendered him optimistic with regards to the future of psychiatry, and his response is particularly interesting. He points out that it is obviously a hopeful sign that psychiatry is beginning to recognize at least some of its shortcomings. But he continues:
“Even as the intellectual foundation for our drug-based paradigm of care is collapsing, starting with the diagnostics, our society’s use of these medications is increasing; the percentage of children and youth being medicated is increasing; and states are expanding their authority to forcibly treat people in outpatient settings with antipsychotics drugs. Disability numbers due to mental illness go up and up, and we don’t see that as reason to change either. History does show that paradigms of psychiatric care can change, but, in a big-picture sense, I don’t know how much is really changing here in the United States.”
And in this regard, Robert is absolutely correct. He has also pointed us to the very crux of the matter: psychiatry has never had even the slightest interest in the validity of its concepts. Psychiatry needed illnesses to establish its dominance of the helping professions arena, and to legitimatize the prescribing of drugs. So illnesses it created.
Dissent (and there has been a great deal of it over the past 60 years) was routinely stifled, marginalized, and even ridiculed with the help of pharma money. What Robert has done – and for this he deserves a Pulitzer Prize – is spell out the shortcomings of psychiatry so clearly and so vigorously that the psychiatric leadership can no longer pretend not to hear. But there is, I suggest, nothing in the attitude of organized psychiatry to indicate any interest in fundamental change.
Jeffrey Lieberman, MD, President of the APA, in his fortnightly article in Psychiatric News, continues to insist that psychiatric diagnoses reflect real illness and that psychiatry should not only maintain its present level of activity, but should actually widen its net to embrace those populations that are “underserved,” as well as those who are “at risk.”
DSM-5 (May 2013) actually contains the phrase
“…DSM, like other medical disease classifications…” (p 5) [Emphasis added]
The psychiatric leadership may well have decided to stop bashing Robert. But this in my view does not reflect any kind of honest re-appraisal of their philosophy or their practices. For psychiatry, today, as for the past 60 years, all significant problems of thinking, feeling, and/or behaving are illnesses, best treated by psychiatrists using neurotoxic drugs and electrically-induced seizures. The only difference at this time is that they’re keeping their heads down, hoping, in politician style, that the present hue and cry will die down, that the pharma companies will re-start the pseudo-research gravy train, and that they can continue with their mission of drugging and disempowering an ever-increasing number of people.
There are, it has to be acknowledged, a very small number of psychiatrists who recognize the truth about psychiatry, and they are speaking out courageously and honestly. But the great majority of psychiatrists, including the leadership, are still marching in lock-step to the biological illness drum. They no longer have the gall to say “just like diabetes,” but the general idea is still the same. The protests, including those from the survivors, are being ignored, the drugs are still flowing like candy, and politicians are being lobbied for legislative and financial support.
We still have a lot of work to do.
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This blog first appeared on Philip Hickey’s
website, Behaviorism and Mental Health