In a recent discussion on Mad in America (MIA) I made the following statement: “I am NOT anti-psychiatry, but I AM proudly anti-Biological Psychiatry. And I believe anyone who critically reads the science reported at MIA, combined with the narratives of survivors and other dissidents, should be too.” This comment was part of a spirited, and at times, contentious discussion about Daniel Mackler’s recent blog titled “An Ode to Biological Psychiatry.” This blog was a scathing critique of the pervasive historical trend in psychiatry that essentially dominates the entire mental health field in this country and throughout most parts of the world.
The distinction I made between being “anti-psychiatry” versus “anti-Biological Psychiatry” is NOT one of simple preference or just some type of semantic argument. This is a strategic distinction that could actually mean the difference between a movement that remains isolated and on the fringes of society, or one that has a real chance of gaining enough allies – including within the broader struggle for human rights internationally – to truly end all forms of psychiatric oppression.
Some participants in that discussion, including a practicing psychiatrist (Sandra Steingard) who is a popular blogger at MIA, along with the actual founder of this website (Robert Whitaker), expressed deep concern about some of the content and tone of the blog. They passionately stated their belief that if we “demonize” (I will comment on the word, “demonize,” in Part 2 of this blog) all psychiatrists, and psychiatry as a whole, we will end up cutting off real dialogue and limit our ability to attract people to critically reevaluate the current mental health system.
Others in that discussion fully supported the content and tone of Mackler’s blog targeting Biological Psychiatry for all its abuses, and they emphatically responded that we have an historical obligation to expose and identify all forms of psychiatric oppression, and all those responsible for it, no matter who might be offended. And furthermore, many stated a position indicating that if we don’t decisively draw clear lines of demarcation between right and wrong, we will stand for nothing of substance and inspire nobody to want to join with us in this movement.
I fully agree with BOTH positions and I believe I can prove that they are NOT mutually exclusive. In fact, grasping and combining the essence of both positions is essential for developing a winning strategy to end all psychiatric oppression. In Part 2 of this blog I will present a clear strategic approach for how we can accomplish a joining of these two positions in a revolutionary way. However, in order to achieve this goal we must first become thoroughly scientific and look at the current reality in the world as it truly is, NOT what we might LIKE it to be.
What the Hell is “Biological Psychiatry” Anyway?
Some writers at MIA have suggested that to treat “Biological Psychiatry” as a target, or as THE enemy for our movement, might be confusing because of a commonly accepted interpretation of the word “biological.” For these people this is especially true since most activists here would affirm (as would I) that human behavior and thoughts are related to many biological processes. They suggest that we need to come up with a different name to describe the oppressive forces within psychiatry, despite the fact that the name “Biological Psychiatry” or “bio-psychiatry” has been used thousands of times on this website and within this movement for decades as a descriptive name for psychiatric oppression. In this context, the other MORE accepted interpretation of the word “biological” is meant to describe a genetic/brain disease-based/drug-centered medical model of so-called psychiatric treatment.
Some bloggers, such as Dr. Sandra Steingard, seems to be so focused on the first interpretation of the word “biological,” that she is apparently not (as of yet) uncomfortable with identifying herself as a “biological psychiatrist.” This remains true despite the fact that most people at MIA would absolutely NOT see this as an accurate label to describe her, based on her evolving beliefs and the descriptions of her practice as a psychiatrist. Some might say (including myself) that she has been clearly INFLUENCED by Biological Psychiatry, but not actually DEFINED by it.
I must add the point that I have learned from Sandy Steingard’s blogs and from her evolution in theory and practice as a psychiatrist. We ALL (including myself in my role as a therapist) have been influenced by Biological Psychiatry, and based on our positions of power within the current system must carefully examine our thinking and practice in order to avoid doing potential harm to people.
Then of course, there is another separate vocal group at MIA who clearly state that they are firmly “anti-psychiatry” and do not think there is ANY importance in making a distinction between historical trends within the psychiatric profession. To them it is all the same; all of psychiatry and those that practice it, must be condemned. So the big question is: where will each of these different positions lead us, and what is the best strategic orientation to “unite all who can be united” moving forward in our struggle to end psychiatric oppression?
I have important news for everyone at MIA. All the confusion on this question regarding the true definition and origins of the name “Biological Psychiatry,” and why it is so important to know, can be rather easily resolved once and for all. If everyone here would take the time to make even a causal examination of the available literature related to this question, the debate would be all but over; they would clearly see that an historical verdict has already been rendered on the name Biological Psychiatry.
I used to believe that it was Peter Breggin who came up with the name “Biological Psychiatry” in the 1980’s, but upon further research on this question it is clear that the name actually started to be used by others much earlier in the 1950’s. As it turns out the major forces of oppression within psychiatry love the name “Biological Psychiatry” and they have very good reasons why they chose it. Let’s briefly examine this history.
I challenge everyone here to make a Google search of the name “Biological Psychiatry,” and then read through at least the first few dozen pages on the history of this term and discover for yourself who has eagerly claimed it as a perfect descriptive name for who and what they represent in the real world. When you start that search you will find some of the following organizations and publications:
- Biological Psychiatry; the journal of the Society of Biological Psychiatry
- The World Journal of Biological Psychiatry
- 12th World Congress of Biological Psychiatry
- The World Federation of Societies of Biological Psychiatry
- Biological Psychiatry Laboratory at McLean Hospital
- Biological Psychiatry Institute
- Progress in Neuro-Psychopharmacology and Biological Psychiatry
- Swiss Society for Biological Psychiatry
These are just some of the journals and organizations that have the name “Biological Psychiatry” in their heading. There are dozens of other journals in psychiatry that may not have the name in its title, but clearly have Biological Psychiatry as its guiding ideology and practice.
Now read what Wikipedia has to say:
“Biological psychiatry or biopsychiatry is an approach to psychiatry that aims to understand mental disorders in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on science such as neuroscience, psychopharmacology, biochemistry, genetics, epigenetics and physiology to investigate the biological bases of behavior and psychopathology . . .
“Biopsychiatry . . . is structured to follow the organization of the DSM-IV, psychiatry’s primary diagnostic and classification guide.
” . . . Because of the focus on the biological function of the nervous system, however, biological psychiatry has been particularly important in developing and prescribing drug-based treatments for mental disorders.
” . . . Biological psychiatry is a branch of psychiatry where the focus is chiefly on researching and understanding the biological basis of major mental disorders such as inipolar and bipolar affective (mood) disorders, schizophrenia and organic mental disorders such as Alzheimer’s disease.
” . . . Thorazine, the first widely used antipsychotic, was synthesized in 1950 …
” . . . The phrase biological psychiatry was first used in peer-reviewed scientific literature in 1953. (emphasis added)
” . . . Iproniazid, one of the first antidepressants, was first synthesized in 1957. In 1959 imipramine, the first tricyclic antidepressant, was developed…
” . . . In 1965 the seminal paper “The catecholamine hypothesis of affective disorders” was published. It articulated the “chemical imbalance” hypotheses of mental health disorders, especially depression. It formed much of the basis for the modern era in biological psychiatry.” (emphasis added)
Wikipedia (as one might expect) gives us some factual history and ultimately only a PARTIAL definition of Biological Psychiatry. The Google search, however, further leads us to a very important journal article written in 2006 with a simply brilliant title. From the journal Behavior and Social Issues, 15, 132-151, by Wyatt and Midkiff, we have the following article: “Biological Psychiatry: A Practice In Search Of a Science.” Included in that article is a significant addition to a more accurate definition:
“The term “biological psychiatry” describes a phenomenon of increasing visibility in both the professional and popular cultures in the past thirty years. It reflects growing acceptance of the notion that chemical imbalances, genetic defects, and related biological phenomena cause disorders such as schizophrenia, depression, anxiety, substance abuse, and attention deficit hyperactivity disorder (ADHD). As biological causation has gained attention, acceptance of environmental causation has necessarily declined, and psychotropic medications have become the treatment of choice for mental and behavioral disorders.”
Clearly some of the specific language in their definition needs repair, but their description of the emphasis of biology over the role of environmental causation is an important addition to other known components of this specific historical trend in psychiatry. Later on in their article they introduce the key role of the pharmaceutical industry:
“The suggestion that our biology is the source of disorders such as schizophrenia, depression, anxiety, addiction, and numerous childhood disorders is heavily promoted by the pharmaceutical industry. Biological causation suggests biological treatment.” (emphasis added)
As this journal article articulates, Biological Psychiatry has been in a desperate search over many decades for a science to justify its existence. Since it has never found one it has been forced to make one up, starting with the “chemical imbalance” theory first postulated in 1965. Fifty years and billions of dollars later, with literally millions of human victims from its drug experiments and other coercive forms of “treatment,” we now have an entrenched historical trend within psychiatry that has evolved into an institution that lies at the very core of the Psychiatric/Pharmaceutical/Industrial Complex.
Many writers such as Peter Breggin, David Healy, Marcia Angell, Robert Whitaker, and Peter Gotzsche (to name a few) have detailed and exposed the history of collusion, at the highest levels, between leaders and organizations in psychiatry with other highly placed executives and research and development leaders in Big Pharma. Many of the strategic machinations on the part of this emerging trend of Biological Psychiatry were the result of the psychiatric profession’s desperate state of affairs given their seriously declining economic and cultural status, especially during the 1960’s.
During this low point in psychiatry’s history it needed a way to gain legitimacy while overcoming the eclectic nature of its profession’s theory and practice, especially in its competition with other branches of medicine. Some of its leaders at that time were driven to give psychiatry the appearance of being based on the hard science of genetics and neurobiology, combined with the added discovery of “magic (pharmaceutical) bullets” targeting real “diseases” of the brain and so-called “chemical imbalances.” This immerging trend of Biological Psychiatry was predicated on a thoroughly reductionist approach; a science constructed on an unproven hypothesis justifying a newly manufactured paradigm of psychiatric drug centered “treatment” options.
All this led to the establishment of psychiatry’s series of evolving DSM “Bibles” that categorized a set of brain diseases and disorders completely divorced from a material world that actually creates the very symptoms they so desperately needed to pathologize. In this context the name “Biological Psychiatry” and the use of the word “biological” was a perfect fit. And all of this merged quite conveniently with the dynamic rise of the highly profitable pharmaceutical industry during the same period of time in our recent history.
Also, during the last several decades Biological Psychiatry, while colluding with Big Pharma, has virtually taken over all the major institutions of “higher learning” that train psychiatrists as doctors. These schools and their curriculums are heavily funded and influenced by the pharmaceutical industry with its own economic and political agenda. This “education” is centered on what could be described as a pseudoscientific combination of neurobiology and psychopharmacology; education in therapy and other social interventions for people in distress are mere electives, if offered at all. In this context the line between real education and propaganda is well beyond being blurred. Indoctrination would not be an exaggeration to describe this so-called learning environment.
Biological Psychiatry, as the dominant force in psychiatry, now represents a perfect melding of three very powerful institutions – psychiatry, the legal drug industry, and the medical schools that train psychiatrists. This unification was necessary to create favorable conditions for the complete takeover of the entire mental health system in this country and throughout most parts of the world. I, myself, witnessed (over more than two decades) the gradual takeover of the community mental health system in this country. A takeover that has now made psychiatric drugs, not therapy/counseling, as the new standard of care. Biological Psychiatry has grown exponentially in power in recent years and it negative influences permeate practically every pore within our society.
This takeover by Biological Psychiatry was a slow and protracted seizure by attrition. It took place over several decades and was significantly aided by Big Pharma’s deceptive marketing campaigns. A trillion dollars of advertising later, this system has successfully preyed upon a vulnerable population and created millions of victims out of people only looking for solutions to problems in an often traumatic and stressful world. This wholesale promotion of psychiatric drug use seized upon and expanded our already well-established culture of addiction. Biological Psychiatry has now created a huge public demand for a new legal form of mind altering substance abuse, where enormous harm clearly outweighs any benefits.
Based on all of this above history I would suggest the following additions for a more comprehensive scientific definition of Biological Psychiatry:
Biological Psychiatry is the wedding of genetic based theories of so-called “mental illness” with the American Psychiatric Association and other leading psychiatric organizations in the world, together with the pharmaceutical industry, and the major training institutions for psychiatry.
It promotes and maintains a genetic/brain disease based/drug centered medical model of treatment. It also promotes and enforces various forms of coercive types of so-called “treatment,” including forced drugging and electro-shock. It controls, conducts, and corrupts most psychiatric drug research which has led to millions of people throughout the world being severely harmed and/or dependent on brain and body damaging drugs.
Biological Psychiatry is useful for the ruling classes in society to maintain power by using “genetic theories of original sin” to shift people’s focus away from the innate inequalities and daily traumas experienced by people living within their system. Their drug centered model of social control has especially targeted youth, prisoners, non-conformists and other more volatile sections of the population.
Biological Psychiatry, when combined with Big Pharma’s innate drive to maximize profits, has now become the driving force within the Psychiatric/Pharmaceutical/Industrial Complex.
While others may want to add to or tweak this definition of Biological Psychiatry, I believe a strong case has been made as to where this name came from and what it represents in the real world. Can there be any debate at MIA as to whether or not Biological Psychiatry is an oppressive force in the world? People may prefer it to be something different, but this simply cannot, and will not happen. People may wish to cling to another interpretation of the word, “biological,” but that debate has long since passed. I think we can say with some certainty that an historical verdict has clearly been rendered on this question; as Yogi Berra might finally say: “Biological Psychiatry is what it is!”
I would then ask the following important question: To those who were confused by the name, do you still want to cling to or somehow be identified with Biological Psychiatry as an historical trend? Let’s be clear about my question. Notice I DID NOT ASK if you still believe that genetics may somehow play some type of a role in what gets labeled as “mental illness,” or whether or not psychiatric drugs can have a limited positive role for some people experiencing extreme symptomology. I would even add the controversial issue as to whether or not there are extreme circumstances when force should be used to detain people who are in danger of self-harm. These are all clearly debatable questions within our ranks, and will be for some time. We can still debate these questions while being perfectly clear that we are vehemently OPPOSED to Biological Psychiatry as an overall oppressive force in society.
If most of us could unite around a clearer definition of Biological Psychiatry, then the next step is to more systematically educate people throughout society exactly what it is and what harm it is doing to people. It is then that we can begin to create a dynamic politically charged environment similar to the 60’s where broadly throughout society the question was asked and debated: Are you for or against the war? In today’s situation the question that needs to be forcefully raised is: Are you for or against Biological Psychiatry, and if you are against it, what are you doing to stop it?
Now I am aware that, so far, I have not addressed those people at MIA who believe that all psychiatry must be equally condemned, and that making a separate distinction regarding Biological Psychiatry is not important or misguided. Part 2 of this blog will address (in much greater detail) why this distinction between Biological Psychiatry and the REST of psychiatry is so critical to developing a correct strategic approach to building a successful movement to end all psychiatric oppression. Part 2 will also explore specific ideas for how we can create the material conditions for a seismic shift and major split within both psychiatry and the entire mental health field that could potentially win over more allies and much greater numbers of people throughout society who support our cause.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.