Robert Whitaker: Looking Back and Looking Ahead

Philip Hickey, PhD
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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.

* * * * *

This blog first appeared on Philip Hickey’s
website, Behaviorism and Mental Health

8 COMMENTS

    • Robert Whitaker, explains things very well.
      In my case, once I gained insight into my anxiety and found ways of dealing with it, there was no more ‘Schizophrenia’. Basic Psychotherapy did this for me.

      Psychiatric drugs also, have real long term withdrawal syndromes. I think this is where most of the long term mental illness comes from.

  1. The truth about psychiatry doesn’t change the fact that people like taking drugs. Sad ? Nervous ? Take these pills and those feelings will go away promises the ad on T.V . Side effects ? They only happen to other people. Withdrawal reactions ? What’s are those ? Nobody told me about those.

    Anyway the medicated youth generation is growing up, I think the voice of opposition is going to get louder .

  2. Philip , Thank You ,
    “We still have a lot of work to do”

    In addition to all the work being done we need to collaborate on certain things in different ways in order to give as many people as possible ,a fighting chance to survive and thrive as a part of this David and Goliath battle . Survival tool kits of info for the various stages in which a human finds themselves. From before birth through old age. For all stages of distress including severe crisis .We need to cast a wider net for useful info letting first do no harm be our guide. It makes no sense to demand multi million dollar double blind extensive trials for every natural modality that can be of help.If a peer tells us they discovered something that they’ve tried, but no one never ever heard of it, that worked for them……we must be able to find a 1/2dozen or so….. for real volunteers willing to try it the way the discoverer describes…… to individually test the idea without contacting each other ….and then report to all the results .Forget about QuackWatch , it’s as bogus as a paid for drug trial by big pharma. Yes new info even if it helps ,takes us through a stressful stage. Thats life. No one can tell me that it’s only some form of paid for counseling technique that is the only acceptable tool . People need many “First do no harm options.” ” And they need to be believed if they say their discoveries might help another. “Or they won’t speak, to just open themselves up for derision.” People here have spoken of energy healing systems for example. and other natural modalities some invented themselves.Too many, ignore them ….it is our own and others huge loss. The field of healing is boundless .

  3. Philip, I always know when you have written an article/blog, etc., to expect a clear and consistent argument. And you did it again here. Thank you so much for pointing out what needs to be said. We *need* to have this discussion! In my opinion, you accurately pointed out how things are far worse than most of us realize, when you wrote, “politicians are being lobbied for legislative and financial support”….in my view psychiatry is entirely political, never medical. Never. I believe much more criticism and pressure needs to be paid to this political front.