Of Missing Links and Dead Ends in Psychiatry


Noted researcher Giovanni Fava explores the disconnect between clinical practice and research in psychiatry, concluding in “The Missing Link” (in Psychotherapy and Psychosomatics) that “an increasing number of psychiatrists are wondering why the cures and clinical insights that neuroscience have promised have not become available.”

In a second article,  “Road to Nowhere,” (World Psychiatry) Fava suggests that the NIMH’s proposed solution–a restructuring of clinical research known as the Research Domain Criteria (RDoC)–will not work. “Its strong ideological endorsement by leading figures of the National Institute of Mental Health has resulted in suppression of an adequate debate,” Fava concludes. “How many investigators who are likely to submit funding applications to that agency may afford disclosing that the emperor has no clothes and theta the strategy may be a road to nowhere?”

Previous articleOde to Biological Psychiatry
Next articleOscar Pistorius Anxiety Diagnosis Causes Panic in South Africa
Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


    • Psychiatry has built a massive rube of a system to avoid talking to their patients as if they were human beings capable of being just as intelligent and capable as the psychiatrists, generally speaking. There are good ones out there, but they’re terribly outnumbered.

      I can understand the fear of vicarious trauma and the challenge of having to deal with people who are in crisis and clearly disorganized in their thinking; but to respond to that with a diagnosis, a life sentence, and with drugs and only drugs is to treat their patients like lab rats and creatures not nearly as complex as doctors. Pay no attention to that history of wrong and stupid scholarship— our world is scientific and sophisticated. Just look at all those machines, and numbers, and the large variety of pills in a wide array of colors, shapes, and sizes! Plus, MRI! See how sciency it all is.

      Compliance is a terrible goal for people who recognize the other as capable of getting a hold on themselves and their situations. It seems to me that they’ve turned what should be an empathetic and nurturing role and made it the very model of modern manliness— numbers, obedience, unchecked power of the psychiatrist, a cloak of scientific integrity that is, for the most part, simply not there and the inherent assumption of superiority of the “doctor” being supported unquestioningly by our courts.

      Psychiatrists (most of them) have completely divorced themselves from all that messy feminine stuff— they’re men of science and the patients had better see that, or risk becoming a problem patient, who may have to be dealt with by force.

      Report comment

  1. Based upon my last nine years of researching medicine (albeit online in my “spare” time) and the psychopharmacutical industries; by gaining an understanding of medical lingo, then by reading thousands of medical journal articles, patient accounts, and numerous books, the big picture of what’s going on seems pretty clear to me.

    I am, however, a person who was told she should be a “judge” or “architect” based upon 40 hours of unbiased psychological career and IQ testing prior to being drugged to cover up easily recognized iatrogenesis, and based upon documented lies from people who wanted to cover up medical evidence of the abuse of my child. And I was given further psychological testing by a potential employer, after I’d been weaned off drugs. I was hired by this employer because this employer took his business psychology test at the same time I did. He was a lawyer, and missed 5 on the IQ portion of the test; I missed only one, and my biggest flaw was that I wasn’t “hard core sales.” But I am good at the ol’ soft sell, which worked at that job beautifully. And this employer gave me the business psychology book the test was based upon, which stated that those with high IQs tend to be good at seeing the big picture, thus are good at pointing out potential flaws in an organization (or industry) to prevent long run major catastrophes.

    My personal experience is that those who studied psychiatry in undergrad were the ones not intelligent enough to get into the engineering, architecture, business, or other science colleges in the university. And I was fascinated with my psych classes in college, but was insightful enough to realize listening to other’s problems all day long would get depressing, and I had no childhood traumas or family history of mental illness to lead me into the field due to personal curiosity. I think the psychiatric industry did not attract enough healthy people with IQs in the top 1%-2% in intellect, to be able to spot the major flaws within their industry, prior to creating a major societal disaster.

    “The Missing Link” article seems to be missing an actual link to the article (at least on 6.4.2014), as ironically, does the “Road to Nowhere” link. Forgive me for not searching for them, prior to getting to my point. The medical evidence now points out, as was my personal experience, that the antidepressants (and ADHD drugs) CAUSE the bipolar symptoms and the “bipolar” “cures,” the antipsychotics, CAUSE the long run (and in some patients, short run, too) schizophrenia symptoms.

    And I’ve been told what happened to me is how psychiatrists have covered up easily recognized medical mistakes for the incompetent and unethical doctors, and child abuse for the religions historically. And the pharmaceutical industry has now confessed the “new miracle drugs” weren’t actually new and they have now largely gotten out of the business of developing new psychotropics due to the lack of actual scientific markers and Thomas Insel’s confession of the “lacking in validity” nature of the DSM disorders.

    But it strikes me, we’ve actually found the etiology of bipolar and schizophrenia – it’s the psychiatric drugs. But I do understand this is staggeringly embarrassing to admit to for the psychiatric industry, for good reason. And, of course, pretty much all the rest of the DSM “mental illnesses” are nothing more than the medicalization of normal human emotions, with the intent of railroading as many people onto psychiatric drugs as possible, and turning them into life long “mentally ill” for profit.

    What an embarrassment to the psychopharmacutical industries, and all of the mainstream US medical community, that it took a scientific journalist to point out the enormous crimes being committed against humanity; prior to these appalling crimes against humanity being considered potentially inappropriate. I hope the psychiatric human rights abuses end some day.

    And, I agree with what Fava theoretically suggests. Without the psychiatric industry’s confession that their drugs can and do cause their serious DSM “mental illnesses,” and that all their “mental illnesses” are scientifically “lacking in validity,” even NIMH’s RDoC will likely also be a “Road to Nowhere.”

    But what’s wonderful is we likely have found the cause of most of the “bipolar” and “schizophrenia” on the planet. Let’s stop forcing people to take antidepressants, ADHD drugs, and antipsychotics, please. These drugs harm more people than they help.

    Report comment