Psychiatry DID Promote the Chemical Imbalance Theory


On April 15, Ronald Pies, MD, an eminent and widely published psychiatrist, wrote an article for  The piece is titled Nuances, Narratives, and the ‘Chemical Imbalance’ Debate in Psychiatry.

The main thrust of the article is that:

“…the ‘chemical imbalance theory’ was never a real theory, nor was it widely propounded by responsible practitioners in the field of psychiatry.”

This is not the first time that Dr. Pies has made this claim,  On July 11, 2011, he wrote an article for Psychiatric Times titled Psychiatry’s New Brain-Mind and the Legend of the “Chemical Imbalance.”  In that article he wrote:

“In truth, the ‘chemical imbalance’ notion was always a kind of urban legend- – never a theory seriously propounded by well-informed psychiatrists.”

And on September 2, 2011, in the comments section of the above post:

“But I stand by my claim that no respected representatives of the profession seriously asserted a simple, “chemical imbalance” theory of mental illness in general.”

At the present time psychiatry, because of intense pressure from its critics, is retreating somewhat from the chemical imbalance theory.  But instead of acknowledging that this notion was flawed, that they knew it was flawed, and that they promoted it for self-gain, they are claiming that they never really said it in the first place.

Dr. Pies is a major spokesman for this particular piece of spin:

“In the narrative of the antipsychiatry movement, a monolithic entity called ‘Psychiatry’ has deliberately misled the public as to the causes of mental illness, by failing to debunk the chemical imbalance hypothesis. Indeed, this narrative insists that, by promoting this little white lie, psychiatry betrayed the public trust and made it seem as if psychiatrists had magic bullets for psychiatric disorders. (Lurking in the back-story, of course, is Big Pharma, said to be in cahoots with Psychiatry so as to sell more drugs).”

Note the euphemism “little white lie.”  Great big black whopper would be more accurate.  And it was a betrayal of the public trust; and it did create the impression that psychiatrists had magic bullets for depression and other human problems; and it did induce people, who might not otherwise have done so, to take psychiatric drugs; and Big Pharma was, and still is, in cahoots with psychiatry.  (69% of the DSM-5 Task Force had financial links to pharma!)

Dr. Pies continues:

“But then, why do antipsychiatry groups and bloggers fail to note the nuances of what psychiatrists have been saying for at least the past decade? My guess is that doing so would undermine the derogatory narrative they wish to promote. And, of course, nuanced statements do not gin up public opinion or sell books.”

Note the ad hominem attack.  We antipsychiatry groups and bloggers simply want to promote a “derogatory narrative,” gin up public opinion, and sell books.  This kind of attack is so much easier than actually addressing the issues that we raise.


“…but it’s probably true that some psychiatrists did hold a purely biocentric view; and, alas, some undoubtedly used the expression ‘chemical imbalance’ in their clinical practice, without putting it into a broader context for their patients.”

A few bad eggs.  Tsk, Tsk!


“That said, I am not aware of any concerted effort by academic psychiatrists, psychiatric textbooks, or official psychiatric organizations to promote a simplistic chemical imbalance hypothesis of mental illness.”

In conclusion, Dr. Pies embarks on the daunting task of demonstrating that the biopsychosocial model has been the essential underpinning of psychiatric theory (and presumably practice) since the 1980’s.  He quotes passages from Theodore Nadelson, MD, Eric Kandel, MD, and from his own writings.

Commenting on Dr. Nadelson’s writing, Dr. Pies says:

“Ted Nadelson understood that the brain is the crucible in which all the elements of human life intermingle, including our genetic makeup; our brain chemistry; and the influences of parents, culture, ethnicity, and even diet. Derangements, deficiencies or abnormalities in any of these biopsychosocial elements can lead to what we call, for lack of a better term, mental illness, which often represents the end result of innumerable interacting ‘pathogens.'”

Note the truly exquisite piece of spin – “…what we call, for lack of a better term, mental illness….”  The primary issue in the present debate is that the various problems of thinking, feeling, and/or behaving that psychiatry labels mental illnesses are not illnesses.  That’s the kernel of the debate.  Dr. Pies is obviously aware of this, but in characteristic psychiatric style, he ducks the issue and pretends that they just call them illnesses “for want of a better term.”  If he would actually read some of the anti-psychiatry material that he dismisses so perfunctorily, he would come across a great many better terms, e.g.: human distress; painful memories; loneliness; sadness; despondency; feeling overwhelmed; feeling underappreciated; being a victim of abuse; sense of powerlessness; loss of hope; frustration; anger; etc..  Or how about:  problems of thinking, feeling, and/or behaving?  Or how about just asking the client to describe the problem in his/her own words?

Psychiatrists call all significant problems of thinking, feeling, and/or behaving illnesses, not for want of a better term, but rather to establish their professional turf and to legitimize their role in the distribution of psychoactive drugs.  For the past 60 years this has been their primary agenda, to which they have routinely subordinated considerations of cogency, scientific validity, ethical practice, and human respect.

Dr. Pies’ quote from Dr. Kandel is particularly interesting:

“‘…all mental processes, even the most complex psychological processes, derive from operations of the brain…as a corollary, behavioral disorders that characterize psychiatric illness are disturbances of brain function, even in those cases where the causes of the disturbances are clearly environmental in origin.’…But in practice, Kandel is no biological reductionist. He is certainly no fan of a chemical imbalance hypothesis! Rather, Kandel paints a picture of the new psychiatry, in which psychoanalytic and biological constructs complement and reinforce one another.” [Emphasis added]

It seems to me that the quote from Dr. Kandel refutes Dr. Pies’ contention.  Dr. Kandel says quite clearly that “… behavioral disorders that characterize psychiatric illness are disturbances of brain function even in those cases where the causes of the disturbances are clearly environmental in origin.” [Emphasis added].

Dr. Pies concludes his article:

“It is time for psychiatry’s critics to drop the conspiratorial narrative of the ‘chemical imbalance’ and acknowledge psychiatry’s efforts at integrating biological and psychosocial insights.”

Response to Dr. Pies

As is often the case in critiquing psychiatric claims, it’s difficult to know where to start or, indeed, where to finish.  What’s perhaps most surprising about Dr. Pies’ current paper is that he wrote it at all.  Most of psychiatry’s so-called thought leaders are just letting this particularly shameful episode of their history die a natural death.

The fact is that psychiatry, at both the organized and individual level, did promote, in characteristically dogmatic fashion, the notion that depression and other significant problems of thinking, feeling, and/or behaving are caused by chemical imbalances in the brain, and are best treated by drugs and other somatic measures.  Nor was this an innocent error.  They promoted this fiction even though they knew that it was false, because it suited their purposes and the purposes of their pharmaceutical allies.

This falsehood was promoted vigorously by psychiatrists and by pharma, and tragically has been accepted as fact by two generations in western countries and increasingly in other parts of the world.  Here are some unambiguous quotes from eminent psychiatrists, whom one might reasonably expect to have been “well-informed.”

“In the last decade, neuroscience and psychiatric research has begun to unlock the brain’s secrets.  We now know that mental illnesses – such as depression or schizophrenia – are not “moral weaknesses” or “imagined” but real diseases caused by abnormalities of brain structure and imbalances of chemicals in the brain.”  Unlocking the Brain’s Secrets, by Richard Harding, MD, then President of the APA, in Family Circle magazine, November 20, 2001, p 62.

 “More serious depression, or depression that is quickly getting worse, should be treated with medication. Antidepressants are not “uppers” and they have no effect on normal mood.  They restore brain chemistry to normal.”  About Depression in Women, by Nada L. Stotland, MD, Professor, Departments of Psychiatry and Obstetrics/Gynecology, Rush Medical College Chicago, and subsequently President of the APA.  Op.Cit., p 65.

“ADHD often runs in families.  Parents of ADHD youth often have ADHD themselves.  The disorder is related to an inadequate supply of chemical messengers of the nerve cells in specific regions of the brain related to attention, activity, inhibitions, and mental operations.”  Paying Attention to ADHD, by Timothy Wilens, MD, Associate Professor of Psychiatry at Harvard Medical School, and Psychiatrist at Massachusetts General Hospital.  Op. Cit., p 65

As noted, the three passages quoted above did not occur in peer reviewed journals or in a psychiatry trade magazine.  They occurred in Family Circle magazine, with the obvious intention of selling this theory to mothers.  This was no accident.  The articles in question were part of a “special advertizing feature” and were interlaced with ads for Paxil (paroxetine) and Metadate (methylphenidate).  This was a deliberate move to lend psychiatric support to the advertisers, and to dupe the readership.  Dr. Harding makes the point explicitly:  “Woman, especially, can lead the way in identifying mental disease in their families, friends, and loved ones – and in themselves.”

Dr. Wilens continues the theme:  “Contrary to what most parents think, medication is one of the most important treatments for ADHD and is essential for long-term success of these kids.”

But let’s hear from another eminent promoter of the chemical imbalance theory, Jeffrey Lieberman, MD:

“…the way nerves talk to each other, and communicate, is through the secretion of a chemical called a neurotransmitter, which stimulates the circuit to be activated.  And when this regulation of chemical neurotransmission is disturbed, you have the alterations in the functions that those brain areas are supposed to, to mediate.  So in a condition like depression, or mania, which occurs in bipolar disorder, you have a disturbance in the neurochemistry in the part of the brain that regulates emotion.”  Causes of Depression, a video by Jeffrey Lieberman, MD, Psychiatrist-in-Chief at NewYork Presbyterian/Columbia University Medical Center, and then President-elect of the APA.  Video made by The University Hospital of Columbia and Cornell. (June 19, 2012)

The chemical imbalance theory was also given clear and forceful expression in Nancy Andreasen’s book The Broken Brain: The Biological Revolution in Psychiatry (1984).  Here are some quotes:

“When we talk, think, feel, or dream, each of these mental functions is due to electrical impulses passing through the complicated and highly specialized electrical circuits that make up the human brain.  The messages passed along these circuits are transmitted and modulated primarily through chemical processes.  Mental illnesses are due to disruptions in the normal flow of messages through this circuitry, and these ‘breaks’ in the brain can occur in many different ways.  The nerves forming command centers may become ill or wear out and die.  The wires may lose their insulation.  Some neurons may in a sense become ‘overheated’ and send or receive too many chemical messages.  Short circuits may occur so that new connections are formed that should not be there, or command centers may become disconnected from one another through the loss of the wiring between them.” (p 219) [Emphases added]

“The various forms of mental illness are due to many different types of brain abnormalities, including the loss of nerve cells and excesses and deficits in chemical transmission between neurons; sometimes the fault may be in the pattern of the wiring or circuitry, sometimes in the command centers, and sometimes in the way messages move along the wires.” (p 221) [Emphasis added]

And psychotherapy is relegated to the task of helping people adjust to the consequences of having a brain illness:

“While the patient may require a somatic therapy to correct an underlying chemical imbalance, he may also need psychotherapy to deal with the personal and social consequences of his illness.  He may need help with his marriage, with learning to find a new type of work, or simply with learning to live with the fact that he has had an episode of mental illness.” (p 256)

Nancy Andreasen, MD, PhD, is an eminent psychiatrist.  She is currently Chair of Psychiatry at the University of Iowa.  She served on the DSM-III and DSM-IV Task Forces, and reportedly wrote the definition of PTSD for DSM-III.  She is past president of the American Psychopathological Association and the Psychiatric Research Society.  She has received numerous awards and, according to Wikipedia, is “one of the world’s foremost authorities on schizophrenia.”

The Broken Brain  was well received by psychiatry.  In May 1985, a book review written by Hagop S. Akiskal, MD appeared in the American Journal of Psychiatry.  This review was extremely positive.  Here’s a quote:

“Dr. Andreasen’s brilliant exposition effectively counters those who believe that psychiatric illness represents moral turpitude, inadequacy, eccentricity, or social marginality, as well as the lay belief to the effect that the professionals who treat such ills lack moral fiber.  The accuracy of her analysis of the history of ideas and current trends, coupled with her compelling prose, renders The Broken Brain the most cogent single work on what psychiatry is about.  It should be required reading in high schools, colleges, and medical schools.” [Emphasis added]

Dr. Akiskal is also an eminent psychiatrist.  According to his bio, he was Professor of Psychiatry and Psychopharmacology at the University of Tennessee from 1972 to 1990, and was the Senior Science Advisor to the Director of NIMH from 1990 to 1994.  He is currently Professor of Psychiatry at the University of California at San Diego, and since 1996 has been Editor-in-Chief of the Journal of Affective Disorders.  He has received several awards, including the Jean Delay Prize for international collaborative research from the World Psychiatry Association.

Morris Lipton, PhD, MD, wrote an opinion piece for the American Journal of Psychiatry (September, 1970, p 133).  The article is titled Affective Disorders:  Progress, But Some Unresolved Questions Remain.  Here’s a quote:

“Since the pharmacological agents that ameliorate depression and mania appear to act upon and alter the concentration and metabolism of the biogenic amines in what are presumably corrective directions, it may be inferred that in the affective disorders there exists a chemical pathology related to these compounds…positive evidence is slowly accumulating and negative evidence is thus far lacking.” [Emphasis added]

The late Dr. Lipton was a psychiatrist who had served on the faculty at both the University of Chicago and Northwestern University, and at the time of writing was Professor and Chair of Psychiatry at the University of North Carolina at Chapel Hill.

Daniel Amen, MD, is a very successful American psychiatrist.  He is the author of more than 30 books, five of which have been on the NY Times bestsellers list.  Here are two quotes from Change Your Brain, Change Your Life (1998), one of his bestsellers.

“Depression is known to be caused by a deficit of certain neurochemicals or neurotransmitters, especially norepinephrine and serotonin.” (p 47)

“Through the SPECT [single photon emission computed tomography] research done in my clinic, along with the brain imaging and genetic work done by others, we have found that ADD is basically a genetically inherited disorder of the pfc [pre-frontal cortex] due in part to a deficiency of the neurotransmitter dopamine.” (p 117)

Dr. Amen is certified by the American Board of Psychiatry and Neurology in both General Psychiatry and in Child and Adolescent Psychiatry.  He is CEO and Medical Director of the six Amen Clinics.  Dr. Amen has had many critics, including some psychiatrists.  But these criticisms have focused on his use of SPECT scans to confirm psychiatric “diagnoses” and to monitor treatment progress.  I have not been able to find a single psychiatrist who criticized Dr. Amen for the kinds of chemical imbalance claims quoted above.  Indeed, when psychiatrist Andrew Leuchter wrote a book review for the American Journal of Psychiatry (May 2009) on Dr. Amen’s book Healing the Hardware of the Soul,  he criticized what he felt was unwarranted use of SPECT scans, but also stated:

“Dr. Amen makes a good case for the use of brain imaging to explain and medicalize mental disorders.” [Emphasis added]

“While these imaging studies undoubtedly educate patients and families about the fact that psychiatric disorders are bona fide medical illnesses, it is not clear how the SPECT image provides reliable information that informs clinical decisions.” [Emphasis added]

In addition, it should be noted that Dr. Amen is a Distinguished Fellow of the APA.

It should also be noted that Dr. Leuchter is a Psychiatry Professor at the University of California at Los Angeles.  According to his UCLA bio, he is a frequently published author, and is a reviewer for a number of scientific journals.

Dissenting Psychiatrists

Although the great majority of psychiatrists adopted the chemical imbalance theory enthusiastically, there were a few dissenters, and some of these expressions of dissent provide a telling contrast to Dr. Pies’ claim.

Elio Frattaroli, MD, Assistant Clinical Professor of Psychiatry at the University of Pennsylvania, spoke at the APA’s 52nd Institute on Psychiatric Services (October 2000).  Here’s a quote from the printed summary on page 66:

“Over the last quarter century there has been a dramatic erosion of psychotherapeutic training and practice in psychiatry, caused largely by a change in our philosophical beliefs.  Psychopharmacology has replaced psychotherapy because brain has replaced soul – i.e., chemical imbalance has replaced inner conflict – as the philosophical basis for psychiatric explanation. We no longer consider it important to trouble ourselves with the inner lives of our patients – the nuances of thought, feeling, impulse, and imagery in their minds and souls.  We consider these private experiences that are of such deep concern to our patients to be largely irrelevant to their symptoms and personality problems, which we believe are caused directly by chemical imbalances in the brain.” (p 66) [Emphasis added]

And the late Loren Mosher’s 1998 letter of resignation from the APA contains the following:

“No longer do we seek to understand whole persons in their social contexts – – rather we are there to realign our patients’ neurotransmitters.”

Loren Mosher, MD, (1933-2004) received his medical and psychiatric training at Harvard.  He taught psychiatry at Yale.  He was Chief of NIMH’s Center for Studies of Schizophrenia.  He founded the journal Schizophrenia Bulletin.  He was a Professor of Psychiatry at Uniformed Services University, Bethesda, and at the University of California, San Diego.

And Steven Sharfstein, MD, President of the APA (2005-2006), writing in Psychiatric News on August 19, 2005:

“As we address these Big Pharma issues, we must examine the fact that as a profession, we have allowed the biopsychosocial model to become the bio-bio-bio model.” [Emphasis added]

It is clear that all these psychiatrists quoted above are confirming and lamenting the fact that psychiatric practice is dominated by exclusively biological perspectives.

Psychiatric Textbooks

Dr. Pies is correct on one specific matter:  psychiatric textbooks generally don’t endorse or promote a simplistic chemical imbalance theory.  Textbooks, by their very nature, discuss controversial subject matter from various aspects, and seldom come down heavily in favor of a specific theory.  However, I did find this passage in Tasman, Kay, and Lieberman (eds.), Psychiatry (2003).  It’s on page 290, Volume 1.  The chapter was written by Robert Freedman, MD, Professor and Chairman, Department of Psychiatry, University of Colorado.

“A final reason for studying the mechanisms of psychopathology is to inform our patients, their families, and society of the causes of mental illness.  At some time in the course of their illness, most patients and families need some explanation of what has happened and why.  Sometimes the explanation is as simplistic as ‘a chemical imbalance,’ while other patients and families may request brain imaging so that they can see the possible psychopathology or genetic analyses to calculate genetic risk.”

The passage is not very clear, but does seem to suggest that it’s OK to tell clients and their families the chemical imbalance falsehood, if they ask for an explanation,

. . . . . . . . . . . . . . .

In the light of all of which, it’s difficult to afford credence to Dr. Pies’ contention that “…the ‘chemical imbalance’ theory was never a real theory, nor was it widely propounded by responsible practitioners in the field.”

And I need to stress, firstly, that it did not take a great deal of searching to find the passages quoted above, and secondly, that I limited my search to psychiatrists who had achieved a measure of eminence or stature within their profession.  A less stringent search would have uncovered a great many more proponents of this theory.  I constrained my search in this way because that was the challenge that Dr. Pies laid down.  But in fact it’s a pointless restriction.  A psychiatrist who is irresponsible, ill-informed, or unrespected can disseminate falsehoods as readily and as effectively as psychiatrists of standing.

And further, it should be mentioned that psychiatry’s promotion of this theory was never any secret.  I have personally heard it proclaimed by many psychiatrists, both in private conversations and in public speeches.  I have also heard literally hundreds of clients say that they had been assured by their psychiatrists that they had a “chemical imbalance” in their brains, to remediate which they needed to take psychiatric drugs.  Fred Baughman, MD, retired neurologist, critiqued the Family Circle articles mentioned above in June 2005.

Consumer Groups

Another way that organized psychiatry has promoted the chemical imbalance notion is through the so-called consumer groups.  In a 2014 brochure under the tab “links for more information,” the APA lists a number of “Resources” including the following:

  • Child & Adolescent Bipolar Foundation (CABF, now known as The Balanced Mind Foundation/Parent Network)
  • Depression and Bipolar Support Alliance (DBSA)
  • Mental Health America (MHA)
  • National Alliance for the Mentally Ill (NAMI

Each of these organizations has endorsed the chemical imbalance theory wholeheartedly.

Here are some quotes from documents on their webpages:


“Depression is a medical illness caused by a chemical imbalance in the brain.” (here)

“Antidepressant medications work to restore proper chemical balance in the brain.” (here)

“Bipolar disorder is a chemical imbalance, which means someone with bipolar needs medicine to regulate his or her moods.” (here)

The Balanced Mind Parent Network Scientific Advisory Council consists of 26 psychiatrists, including:

  • Joseph Biederman, MD, Professor of Psychiatry at Harvard Medical School, Chief, Clinical and Research Programs in Pediatric Psychopharmacology Massachusetts General Hospital and McLean Hospital
  • Gabrielle Carlson, MD, Professor of Psychiatry and Pediatrics, Director of Child and Adolescent Psychiatry, Stonybrook State University
  • Kiki Chang, MD, Associate Professor and Director of Pediatric Bipolar Disorders Program, Child and Adolescent Psychiatry, Stanford University
  • Melissa DelBello, MD, MS, Professor of Psychiatry and Pediatrics, Vice Chair of Clinical Research, Co-Director, Division of Bipolar Disorders Research, University of Cincinnati
  • Robert L. Findling, MD, Director Child and Adolescent Psychiatry, University Hospitals of Cleveland; Professor of Child & Adolescent Psychiatry, Case Western Reserve University
  • Janet Wozniak, MD, Director, Pediatric Bipolar Disorder Research Program; Assistant Professor of Psychiatry, Harvard Medical School and Massachusetts General Hospital


“Depression is caused by a chemical imbalance in the brain.”(here)

“Scientists believe that depression and bipolar disorder are caused by an imbalance of brain chemicals called neurotransmitters.”(here)

“People with depression have an imbalance of certain brain chemicals known as neurotransmitters.”(here)

DBSA has a Scientific Advisory Board, the membership of which includes the following eminent, and presumably “well-informed” psychiatrists:

  • Gregory E. Simon, MD, MPH, Psychiatrist and Senior Investigator, GroupHealth Research Institute, Seattle
  • Michael E. Thase, MD, Professor of Psychiatry. University of Pittsburgh
  • Mark S. Bauer, MD, Associate Professor of Psychiatry, Brown University School of Medicine
  • Joseph R. Calabrese, MD, Professor of Psychiatry and Director of Mood Disorders Program, Case Western Reserve University
  • David J. Kupfer, MD, Professor & Chairman Department of Psychiatry, University of Pittsburgh (and Chair of the DSM-5 taskforce)
  • George S. Alexopoulos, MD, Professor of Psychiatry, Cornell University
  • Gary Sachs, MD, Director, Bipolar Research Program, Harvard University
  • Mark A. Frye, MD, Professor of Psychiatry, Mayo Clinic
  • J. Raymond DePaulo Jr. MD, Professor of Psychiatry, Johns Hopkins
  • William Beardslee, MD, Psychiatrist-in-Chief, Children’s Hospital, Boston


“People with schizophrenia have a chemical imbalance of brain chemicals (serotonin and dopamine) which are neurotransmitters.”(here)

“The presence of bipolar disorder indicates a biochemical imbalance which alters a person’s moods.”(here)

“…the disorder [ADHD] is genetically transmitted and is caused by an imbalance or deficiency in certain chemicals that regulate the efficiency with which the brain controls behavior.”(here)


“Scientists believe that if there is a chemical imbalance in these neurotransmitters [norepinephrine, serotonin, dopamine], then clinical states of depression result.” (here)

“A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain.”(here)

“…despite the knowledge that most mental illnesses are caused by chemical imbalances…there is a stigma surrounding mental illness.” (here)

The most recent list of NAMI’s Scientific Council includes the following eminent and presumably “well-informed” psychiatrists:

  • Nancy Andreasen, MD, PhD:  Chair of Psychiatry and Director of the Mental Health Clinical Research Center at The University of Iowa College of Medicine.
  • Ellen Frank, PhD:  Professor of Psychiatry and Psychology at the University ofPittsburgh School of Medicine; member of the Mood Disorders Workgroup of the DSM-5 Task Force.
  • David Kupfer, MD:  Professor of Psychiatry and Professor of Neuroscience, University of Pittsburgh School of Medicine; Chair of the DSM-5 Task Force.
  • Jeffrey Lieberman, MD:  Chair of Psychiatry, Columbia University; Director of the New York State Psychiatric Institute; Psychiatrist in Chief at NewYork-Presbyterian Hospital – Columbia University Medical Center; immediate Past President of the APA.
  • Henry Nasrallah, MD:  Associate Dean; Professor of Psychiatry and Neuroscience, Director of the Schizophrenia Program, University of Cincinnati.
  • Charles Nemeroff, MD:  Chair of Psychiatry and Behavioral Sciences and Director, Center on Aging, University of Miami Health System.
  • S. Charles Schulz, MD:  Professor and Chair, Department of Psychiatry, University of Minnesota Medical School.

NAMI’s Medical Director is Kenneth Duckworth, MD, Assistant Clinical Professor at Harvard University Medical School.

Is it not reasonable to assume that all these eminent psychiatrists endorse the chemical imbalance illness theory so clearly set out in the above quotes?  If these psychiatrists were as skeptical of this theory as Dr. Pies implies, shouldn’t they have taken steps to have the brochures changed?  Or was this just a “little white lie?”  What’s the point of having a scientific advisory board, if it doesn’t provide scientific advice?

And remember, all four of these organizations are on the APA’s “Links for more information” tab.  If the APA does not, in fact, endorse the chemical imbalance theory, wouldn’t it be more appropriate to label this tab:  “Links for disinformation”?  The chemical imbalance theory, as Dr. Pies so rightly states, is simplistic nonsense.  So why does the APA promote these organizations on its website?  Isn’t it, at the very least, a reasonable conjecture that the APA leaves these links in place from considerations of self-interest?  Has there ever been an attempt by the APA or any of its members to educate these organizations on these matters?

At the foot of the 2014 Resources document, the APA have inserted the disclaimer:  “These links are provided as a convenience and do not imply endorsement.”  But if they are not endorsing the various organizations’ stance on the chemical imbalance theory, why in the world would they list them as a resource for “more information?”  And isn’t it obvious that a person clicking on the “Links for more information” tab will likely go to these links, and will likely not go to the bottom of the page to read the disclaimer?  If the APA genuinely wanted to disavow the spurious chemical imbalance theory, wouldn’t they have put the disclaimer at the top of the page, or removed the links altogether?

Dr. Pies has not himself, as far as I can tell, ever promoted the chemical imbalance theory.  He recognizes it as nonsense, and is anxious to distance his chosen profession from this deception.  And this perhaps understandable human desire is blinding him to some unsavory realities.  What he is doing essentially, is cherry-picking references to support his contention, while ignoring the very large body of contrary evidence.

But he’s also doing something else.  By drawing us into a debate as to whether or not psychiatrists promoted the chemical imbalance lie, he is deflecting attention from the much more fundamental lie:  that all problems of thinking, feeling, and/or behaving are illnesses.  In comparison with this monstrous falsehood, the specifics of the putative illness are trivial.

Dr. Pies has not only promoted this monstrous falsehood, he has insulated this falsehood from any possibility of rebuttal by the simple expedient of redefining the word disease.  In his paper Context Does Not Determine ‘Disorderness’ or Normality, (April 2013) he states:

“Regardless of context, once a certain threshold of suffering and incapacity is crossed, physicians justifiably apply the term ‘disease’ (or ‘disorder’) to the person’s condition. (For purposes of this discussion, I am using the terms ‘disease’ and ‘disorder’ more or less synonymously, although the medical literature is remarkably inconsistent in how these terms are applied.…) This is also true of maladaptive symptoms attributed to the patient’s developmental context….  It is of course true that temper tantrums in a 2-year-old—or moodiness and impulsivity in an adolescent—are very often developmentally normal. But once a certain threshold of suffering and incapacity is crossed, we rightly impute disorderness to the child’s condition, make a diagnosis, and offer appropriate treatment. That the child’s symptoms occur in an understandable context does not render our diagnosis a ‘false positive.’ Context helps explain pathology—it does not annul it.”

And in case there might be any residual ambiguity, in April 2013 in Psychiatry and the Myth of ‘Medicalization’, he wrote:

“So long as the patient is experiencing a substantial or enduring state of suffering and incapacity, the patient has disease….”

So if a person is significantly suffering and incapacitated, from any cause – not just physical pathology – he has a disease.  Dr. Pies acknowledges that all three terms – significantly, suffering, and incapacitated – defy definition and measurement.  But he promptly dismisses these concerns, and focuses instead on “…the first duty of all physicians is to relieve pronounced or prolonged suffering and incapacity.”

But what he ignores entirely is that this is not the normal meaning of the word “disease.”  In its normal usage, the word “disease” implies physical pathology.  Indeed, even psychiatrists acknowledged this implicitly when, for decades, they told their clients that depression was an illness “just like diabetes.”  The phrase “just like diabetes” makes it perfectly clear that they were not using the word “illness” in Dr. Pies’ arbitrary and esoteric sense, but rather in the conventional sense of organic pathology – and this is how psychiatric clients and the public generally interpret this statement.

Dr. Pies’ statement above that “…the first duty of all physicians is to relieve pronounced or prolonged suffering and incapacity” is seductively convincing, but in fact is false.  It is a physician’s business to relieve suffering and incapacity that is caused by organic pathology.  I think this is how the great majority of non-psychiatric physicians would conceptualize their role.  I’m not saying that physicians shouldn’t be allowed to branch out into other areas.  Plumbers can do carpentry work.  In fact, most plumbers have to do some carpentry to expose pipes and tidy up afterwards, etc…  But a plumber who conceptualized all carpentry problems as leaks, and tried to fix these problems with copper pipe and solder, would not be very successful.  In the same way, physicians who conceptualize non-medical problems as illnesses do more harm than good.

Dr. Pies’ definition of disease is just one more attempt on the part of psychiatry to prolong the destructive deception:  that all problems of thinking, feeling, and/or behaving are illnesses.

This is emphatically not an academic debate. The illness/disease concept is the fundamental underpinning and justification for the administration of drugs and other somatic “treatments.”  If the illness lie collapses, then psychiatrists are exposed as the frauds and drug pushers that they are.  The “illness” lie is actually a mechanism that psychiatrists use to overcome clients’ resistance to taking psychoactive chemicals, and as a marketing tactic it has been extraordinarily successful.  The fact is that psychiatric drugs distort and impair neural functioning.  But if people can be convinced that the opposite is the case – that the drugs actually correct a neurochemical imbalance, or a neural circuitry anomaly, or whatever, then consumer resistance diminishes, and the marketing battle is as good as won.

Fortunately, the neurotransmitter imbalance deception has been so discredited in recent years that, as mentioned earlier, it is being quietly slipped to the wings, but the notion that all problems of thinking, feeling, and/or behaving are illnesses is alive and well, and is still being actively promoted by psychiatry.  In 2005, the APA published an “educational” brochure titled Let’s Talk Facts About Depression.  Here’s the opening sentence:

“Depression is a serious medical illness that negatively affects how you feel, the way you think and how you act.” [Emphasis added]

In 2014, nine years later, they produced another brochure, this one titled simply Depression.  Here’s the opening sentence:

“Depression is a serious medical illness that negatively affects how you feel, the way you think and how you act.”

Apparently not much had changed between 2005 and 2014.  Incidentally, there’s a truly delightful piece of psychiatric side-shuffle in the closing paragraph in the 2005 paper mentioned above.

“This brochure was developed for educational purposes and does not necessarily reflect opinion or policy of the American Psychiatric Association.”

Why in the world would a professional association put a disclaimer of that sort on an educational brochure?  What are they saying?  Our educational material does not necessarily reflect our opinion or our policy?  We know that there are some lies in here, and we will repudiate them in the future if it becomes expedient to do so?

Psychiatrists’ Links to Pharma

In one of the passages quoted earlier, Dr. Pies mockingly rejected the notion that psychiatry was “in cahoots” with Big Pharma.  In fact, of the 31 psychiatrists mentioned in this post as promoting the chemical imbalance theory, or of being on the advisory boards of consumer organizations that promote this theory, 19 (61%) have, or had, financial ties to one or more pharmaceutical companies.  (Sources: Dollars for Docs and journal article disclosures.)


So to recap, Dr. Pies’ insistence that the chemical imbalance theory was never “…widely propounded by responsible practitioners in the field of psychiatry” is simply false.  (unless, of course, the statement is meant to reflect the paucity of responsible psychiatrists).

But it is also a red herring.  The central issue is psychiatry’s spurious assertion that all problems of thinking, feeling, and/or behaving are illnesses.  Whether these putative illnesses are caused by an excess of “black bile,” a serotonin imbalance, or a neural circuitry anomaly, or whatever the next fad will be, is very much a secondary issue.

We have seen how the APA endorses the illness notion, as does Dr. Pies himself.  Dr. Pies even manages to define disease in such a way that psychiatry’s subject matter must always be considered illness, regardless of any future empirical findings.  For Dr. Pies, any condition or circumstance that entails significant distress and impairment is a disease.  Dr. Pies offers no arguments or proof in support of his position.  He simply – in the best psychiatric tradition – proclaims it to be true.  And within the framework of psychiatric logic, that makes it true.  He defines disease in such a way that it embraces virtually all significant problems of thinking, feeling, and/or behaving, and then proclaims, as if it were a significant fact or discovery, that all these problems are diseases.

But Dr. Pies is by no means alone.  The notion that all significant problems of thinking, feeling, and/or behaving are illnesses is an integral part of psychiatric dogma, and has been enshrined in the APA’s definition of a mental disorder since DSM-III.  But there is no coherent or convincing statement of pathology to support this contention.  Like so much else in psychiatry, it is considered true because psychiatrists say so.  And they say so because it’s good for business.  The chemical imbalance theory is arguably the most destructive hoax ever perpetrated.

* * * * *

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


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.


Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.


  1. And the sad fact is, every psychiatrist at the state hospital where I work, from the Medical Director down promotes the “chemical imbalance” quackery. Even the very few psychiatrists whom I feel to be decent people spout this at the drop of a hat and there’s no dialoging with them about it since they hold it as an absolute fact.

    Psychiatry is the greatest example of double speak and spin in the entire history of humankind. If it wasn’t for double speak and lies psychiatry wouldn’t have a leg to stand on. It’s time for this house of cards to be toppled.

    Report comment

    • Above all we must remember that psychiatry is and has historically been the step child of medicine. Psychiatrists have always longed to be considered medical doctors and the specialty of psychiatry has struggled with the following image that has been repeated in words thousands of times when a person is referred to psychiatry “can I see a real doctor?”
      Psychiatrists have been threatened by the possibility of psychologists being awarded prescribing privileges; they are threatened by nurse clinicians and physician assistants who have increasingly broad privileges. psychiatry is and will continue to be a profession that struggles for validity for recognition and it is failing miserably.

      Report comment

  2. And as I have mentioned in previous comments, this type of thinking has now made its way to mainstream medicine. If I am depressed because my treatment isn’t working, I have a biological illness and need an antidepressant for that. Thanks a lot psychiatry and all you doctors you prescribe to this BS.

    Stephen, even if psychiatry is toppled which I feel sadly is not going to happen, you still have the mainstream medicine doctors to deal with who are spreading these lies.

    Report comment

    • AA

      True, I keep forgetting that 80% of all psychiatric drugs are dispensed by GP’s. And, as you state, they have accepted this quackery hook, line, and sinker.

      After fighting with my new GP, who is now my ex-GP, I’m starting to believe that the entire field of medicine, and not just psychiatry, has been taken over by incompetent and arrogant people who believe that they’re the “experts” on my life simply because they have MD stuck behind their names. Thanks for reminding me that psychiatrists are not the only ones promoting this untruth.

      Report comment

      • Yeah, when I got frustrated with my doctor for not being able to find a reason for my physical problems she suggested that it’s all because I’m depressed (after looking at my medical history where the psychiatric “treatment” was mentioned). Surely enough it turned out I had problems with my spine and not “depression” but have I been more naive I’d still have a spine problem+psych med problem.

        Report comment

  3. A crack in their armor – a minor victory. Neurotransmitter deregulation, most often called a chemical imbalance, has been touted by the various drug companies as the sole cause of the various mental illnesses. This is blatantly false. At best, these chemical imbalances are merely the result of other forces acting upon the body, including the brain. While the existence of various neurotransmitter, receptors and chemical messengers is not being disputed here, the symptoms that can result in a mental health diagnosis can result from many diverse causes. No normal amount of any of the various chemical messengers has ever been established and likely never will. Varying circumstances and environments will alter preferred ratios of chemical messengers. Normal is a variable, not an absolute. (For more information on this subject see: Molecules of Emotions ©1997 & Your Body is your Subconscious Mind © 2004, both by Candice Pert Ph.D. who was on the team which proved the existence of neurotransmitters.) …
    In the popular PBS program, and in the book Healing ADD: The Breakthrough Program that Allows You to See and Heal the 7 Types of ADD, Dr. Amen talks about the seven types of Attention Deficit Disorder (ADD) he was able to identify by using brain scans. The seven types, (Type 1: Classic ADD, 2: Innattentive ADD, 3: Overfocused ADD, 4: Temporal Lobe ADD, 5: Limbic ADD, 6: Ring of Fire, 7: Anxious ADD) each show up differently in MRI’s and he has found different treatments to be most effective for each type. Often certain foods have been found to be the best remedy. It is well past the time that the APA dropped its labeling methodology and adopted a similar method for the various categories, replacing the DSM series with one based on scientific findings. It is likely similar patterns will be found which will give sound reasons for the sources of various troubling behaviors, and psychiatry can begin to earn back the trust they have lost over the past few decades. (excerpts from the son to be released Liberty & Mental Health – You Can’t Have One Without the Other.)

    Report comment

    • Good point. You can’t treat a disease when you don’t define how normal looks like. Physical diseases have defined the normal for most part (blood sugar levels, bacterial count in urine, how an unbroken bone looks like) but show me someone who will define how “normal” should look like? What is the “normal” response to seeing a child being run over by a vehicle (like this soldier in Afghanistan did)? What is a “normal” response to you mother dying or you losing a job? You can’t say what is normal because people respond different to things like that depending on their internal and external state (how emotional they are, how much social support they have, how much additional stress they’ve endured in their lives).
      Psychiatry is pathologizing being a human being with functioning emotional brain. Any response short of being a total sociopath is sick – I believe it says more about them than about the people they’re labelling.

      Report comment

  4. Thank you for clarifying the truth, once again, Dr. Hickey. The medical evidence proves that the psychotropic drugs DO cause “chemical imbalances” in people’s brains, which is logical. Claiming people have “chemical imbalances” in their brains, prior to being drugged, is counterintuitive without proof – and there is no proof, after decades of trying to prove it. It’s time we end the defamation and forced drugging fest being utilized to unjustly take away civil rights, cover up easily recognized medical mistakes by the mainstream medical community, and child abuse by the religions, due of course, to their greed. Oh, dear, the “dirty little secret of the two original educated professions,” has gone viral. How sick.

    Report comment

      • After years of looking into the functional complexity of brain/cns/peripheral ns neuro-humoral delicate functioning, only some weeks ago, I came to the conclusion that a crude chemical imbalance is only caused by neuroleptics and other psychotropic substances. Yes there is myriads of neurochemical transmissions and compunds travelling nuances in the brain/cns/peripheral ns, but they are a delicately concerto of the most fine tuned neurological functioning informed by many levels of bodily ‘experiences’. Never is there anything as an non-specific and widely targeted imbalance apart from drugging up the brain (medical and street drugs) – thereby disabling the fined tuned and interrelated neuronal intercomplexities as enablers and transistors of bodily, emotional functions of living creature in flexible interactions with its lived environments. The latter was the reason that I withdrew from neuroleptics after excaping from psych’ ward. With gratitude to Prof Gerd Rehkämper, neurologist and animal behavior field researcer, who taught his students of the delicate and wonderfull complexity and concerto of brains/peripheral ns, the living creature and lived environment. I just knew these drugs to be shoved into my brain would finish with its delicate-live-enabling fine-tuning. I wish there were majorities of inspiring and honest real biological neurophysiologist researchers. What the hell are psychiatrists taught to believe that overall inundation of brain and peripheral ns could be anything but disabling and harmful in longer term? Thanks Philip Hickey for speaking the ‘biological’ truth to neurotechnocemical abuse of power – enlightenment in the most humane and intellectually liberating sense.

        Report comment

      • Thanks Philip, They do cause chemical imbalances in the brain, and they turn young people with problems that can be dealt with into psychiatric patients.
        If a person takes Valium for long enough they will eventually develop anxiety, its the same with the major tranquillisers only worse.

        Report comment

  5. I don’t think that my commentary can illuminate anything that you haven’t. I just want to thank you for taking the time to make it clear to people that the backtracking bullshit that is now being put out there — probably with the purpose of heading off criticism and what I hope will be the massive class-action lawsuits to come for all this blatantly bad science, bad medicine, and damage to people’s lives — will not escape anyone notice any more than the lies and misrepresentations of the tobacco industry were able to escape detection in the end. I hope that your post becomes the basis of a book. Someone needs to document all this. Someone needs to put it all down so that history and society have a record of what really happened — now, before it is too late to make restitution to the victims.

    Report comment

  6. Doctor Hickey, thank you once again for your cogent and clear debunking of psychiatric BS.

    One small detail in your quotes from Dr. Pies stands out in my mind though. He rails against “anti-psychiatry,” which tells me that the psychiatric establishment is starting to become quite worried about the increasing rejection among the public of psychiatric dogma. This is the fourth or fifth time in this past month that I have heard psychiatrists talk this way.

    More and more people, including me, are identifying as anti-psychiatry, and more and more psychiatrists are freaking out about it.

    We must be doing something right!

    Report comment

  7. First of all, why registering would not accept my name, Joel Hassman MD as the name for my comments is bizarre. So, I guess I have to sign every comment here in the future with my name.

    Everyone rails about psychiatrists and other prescribers just dumbing down mental health care complaints to writing scripts, but, in the last 10 years or so, people come into treatment venues just wanting drugs, and dismiss any other intervention for care, irregardless of how appropriate and indicated as a standard of care such a treatment is warranted. So, where are all the blog authors and commenters moaning about patients demanding drugs from providers who don’t want to reflexively write them at moment one?

    Seems to me it fits the antipsychiatry narrative at the end of the day. It is easier to crucify the doctors, harder to attack the general public who are reinforcing “better living through chemistry”, eh?

    Joel Hassman, MD

    Report comment

    • Dr. Hassman, never thought I would see you on MIA but welcome! Anyway, I don’t attack the “better living though chemistry crowd” because there are not the ones influencing doctors who provide poor care to me because I was stupid enough to disclose my psych med history. They aren’t the ones responsible for my having to lie to doctors in the future about my psych med history so I don’t prevent myself from getting poor care and possibly threaten my life.

      They also aren’t responsible for a doctor putting my condition under a psychiatric category when it was totally unsubstantiated by the fact. They aren’t responsible for this same doctor psychologically pathologizing understandable frustrations I had with medical treatment of my condition.

      I don’t doubt it is frustrating for you to have patients who want drugs when they aren’t warranted. But to expect me to speak out against them when they aren’t the cause of my problems with doctors is extremely unreasonable in my opinion.

      Report comment

      • AA,

        You should know a decent and ethical pastor, after being kind enough to read my chronologically typed up medical records and medical research, was kind enough to admit to me that the “dirty little secret of the two original educated professions” [medicine and religion] is that the psychiatric industry has historically always been, and is still in, the business of covering up easily recognized medical mistakes for the incompetent doctors.

        And I’ve found that when you go in to a new doctor, and explain that you’re fully aware of the historic and current function of psychiatric stigmatization, and explain you were stigmatized to cover up prior easily recognized iatrogenesis. Decent doctors will work with you, take the stigmatization off your records, and try to provide you with proper medical care.

        And I mention this to you because I have medical proof that, even if you do not sign HIPPA forms, giving a doctor the legal access to your prior medical records, doctors do break the HIPPA laws and gain access to people’s prior medical histories illegally. So being honest with doctors, about your imperfections, as well as theirs, may be your wisest move.

        Report comment

    • Dr. Joel,

      I wish you’d been in my life 13 years ago when I sought help for a simple phobia and ended up on three psychiatric meds for over a decade from a board-certified psychiatrist who refused to refer me to a therapist, saying, “Your brain is broken, you need medication to restore that balance and you will need them for the rest of your life. You have a GENETIC DISEASE.”

      When my drugs put me in the ER after a suicide attempt, I took charge of my own recovery and even then, no doctor was willing to help me. I went to three, all of whom said in so many words, “Maybe you need to be on these medications. You have a psychiatric diagnosis!”

      So, sorry if I tend to blame doctors but we are told as laymen that we have to trust and obey you!

      When I tried to “buck the system” I met resistance, and ended up tapering off of the drugs myself. I took FMLA leave to get through the first months and just suffered in silence the rest of the way with no help from your profession whatsoever!

      Hopefully my experiences give you some more insight.

      Report comment

    • Joel, “Irregardless” is a truly irridiculous word.

      But aside from this locution, you are talking to people who in fact question everything, including other consumers who go gonzo for quick fixes. But how again is it that this this “path to healing” has gotten so popular? We did it?

      Report comment

      • “Irregardless” is in the dictionary, while Webster’s New World dictionary does note it to be an “Americanism” term, it is there. And it gets old when the first attack is about spelling, punctuation, or other “English teacher” pontifications. Come on, focus on a legit issue.

        I have NEVER debated against there are idiots and cretins in my profession, but the way antipsychiatry has carried on for the past 4 plus years I have been reading at blogs now, are they going to carry it on to attacking the police profession next, after all, certainly are idiots and cretins in that field too!

        Sorry, but if there is going to be a valid and honest discussion/debate about who is at fault in the “chemicalization” of mental health, don’t just pick on the doctors. Patients are pervasively demanding drugs, often ones of abuse potential of late, and have little to no interest in problem solving nor wanting to implement real and effective change for the better.

        When people come onto public sites and then want to demonize a select percentage of the group at fault, and just conveniently or plainly villainize one portion to further an agenda, does it make it more acceptable than similar actions like what pre World War Germany did or current extremist Islamic leaderships are doing?

        Everybody wants a scapegoat when things don’t go as planned. I’m just curious of the antipsychiatry crowd, are all the mirrors in your homes covered or just removed? No culpability for negative outcomes on your parts, eh? Oh, my mistake, the other part of the equation, everybody has to have a victim too.

        Just like how our politicians problem solve these days. I guess we do get the electorate we deserve. Not a mistake in terms there, see the George Carlin rant in one of my recent posts at my site, it will make sense then.

        Joel Hassman, MD

        Report comment

        • It’s sad how you are trying to blame the victims because some of them come to you demanding psych drugs, when they are bombarded daily with advertizing (and the presentation of those advertizing messages as truth in other corporate media and even by the government) that tells them they have a chemical imbalance and that their suffering will be alleviated if they just take the drugs – advertizing by the pharmaceutical companies, without whom psychiatrists would not enjoy careers.

          And you’re further embarrassing yourself by making comparisons between Nazis and critics of psychiatry, especially since it was German psychiatrists that taught the Nazis how to conduct their genocide.

          Report comment

          • I am sorry, where are the muzzle prints on these “victims” foreheads that demand they take medication?

            And yes, I stand by my interpretation that the rhetoric of the antipsychiatry movement as mirroring that of the World War II German Hierarchy in looking for scapegoats and villains for the very behaviors of the leaders and blind followers, that is what movements that demand people be exiled or exterminated. But, I don’t expect the very group I excoriate here now to see it.

            The antipsychiatrists here will never get it, but I will remind honest and fair minded readers what is going on here, yes, there are villains in psychiatry, and there are responsible clinicians, but, antipsychiatry vilifies ALL who have the title Psychiatry/MD after the name.

            There are years of posts and thread comments to back me up, and just like the past Germans and current Jihadists of Islam, if you are in the vilified group, you must die or be ostracized horrendously. Tell me I have not read that from writers at various mental health sites?

            As long as extremists, from both sides mind you, hijack efforts at reasonable and fair debates, forget psychiatry for a second and watch the debacle of the Bergdahl matter this past week, people in the middle gets screwed. I can’t reason at all with my impaired and dishonest colleagues, because we all know money talks in this country until proven otherwise. I continue to offer possible ideas to derail them, but, it takes a group to rid the village of the idiot!

            Oh, and funny how I don’t read about people looking to get rid of the most notorious and pervasive equally disruptive elements to health care consequences, the insurers and politicians. Anyone here deal with an “authorization” problem getting legitimate and fair meds theses days? I will not belabor what managed care has done that equally the public was complicit in going along with, forget the idiocy of psychiatrists in the 1990s!!!

            But, returning to the point at hand, you as a patient come to someone with an expertise and then have the gall to argue and demand interventions that do not fit as treatment A for the problem in front of the clinician, and I am to refer to him/her as “victim”?? Get real!

            Joel Hassman, MD

            Report comment

          • Interesting how you didn’t even address my point about drug company propaganda and the relationship between pharmaceutical companies and psychiatry. As I said, you are putting the responsibility for the effects of a corrupt system onto the shoulders of those people who turn to that system for help in their darkest hour because their society has told them that this is the right thing to do – that these psychiatrists are medical professionals and that their “treatments” (chemical and physical brain damage) are backed by science. I’d thought with a link called “can’t medicate life,” that you might at least agree with me on that. I guess not.

            But congratulations on your construction of the straw man you have called “anti-psychiatry.” I’m not even sure who you are trying to address with that, because there are diverse opinions on this site and many of them are reformist and certainly not “anti-psychiatry” in any way.

            Having said that, I personally think that psychiatry should not exist, and I find it offensive that you should paint those who actually do fit the general description of being “anti-psychiatry” as some kind of oppressive group. Who has the power in the relationship between a psychiatrist and a person labeled with a “mental illness,” when the psychiatrist can imprison a labeled person on a whim, decree that anything that person may say has no meaning, and assault that person with harmful drugs or ECT for as long as the psychiatrist deems it necessary? And who had the power in the relationship between the Nazis and the millions who were slaughtered by them? I think those are fair questions, since you insist on doubling down on your comparison.

            Report comment

          • You know what I love when people use that term “straw man”? It is their outlandish projective spotlight saying “I am going to accuse you of what exactly I am really doing”.

            I am going to leave readers with this comment below from “Uprising” which, to me, seems to just echo my earlier point:

            “Having said that, I personally think that psychiatry should not exist, and I find it offensive that you should paint those who actually do fit the general description of being “anti-psychiatry” as some kind of oppressive group.”

            Great, a profession that has some people who do help others should be relegated to the scrap heap, thanks for arguing my point for me, Uprising.

            Done with this thread, I guess I should have really thought out commenting here before I have my Deja Vu moment with Philip Dawdy’s “Furious Seasons” blog. I guess some things, and some people, just don’t change.

            Be safe, be well.

            Joel Hassman, MD

            Report comment

          • Again, my initial point is ignored.

            I don’t know what you mean, Joel, in terms of me proving any point you tried to make. You were ranting about “anti-psychiatry” people being like jihadists and Nazis – “extremists” who think someone or other “must die or be ostracized horrendously.” I didn’t say anything of the sort.

            What I did say is that psychiatry should not exist. In reply, you said, “Great, a profession that has some people who do help others should be relegated to the scrap heap, thanks for arguing my point for me, Uprising.” Yes, I think psychiatry should be relegated to the scrap heap. I know for a fact that there are psychiatrists out there that do help others. My impression is that they are a minority in the profession and that they are helpful in direct proportion to the extent to which they do not act like psychiatrists. Therefore, if psychiatry ceased to exist tomorrow as a profession, those present psychiatrists who are helpful to others would still be helpful to others; they just wouldn’t be psychiatrists. In contrast, those psychiatrist who are doctors of nothing, petty tyrants with a medical degree that they don’t use, capable only of arbitrary and pseudo-scientific labeling of vulnerable people, for whom the only “treatments” those psychiatrists can deliver are harmful to the human body, those psychiatrists should be unemployed. Those things which a psychiatrist CAN provide to actually help people in emotional distress and extreme states (empathy and enlightened witness, for example) are things that do not require a medical degree to provide.

            Irregardless, I hope you come back soon.

            Report comment

      • Yes, every day the psychiatrist struggles to survive under the tyranny of the mental patient.

        But seriously…

        It is true that many people go to the doctor and ask for psych drugs and don’t want therapy, but it’s not because those people are lazy or are drug seekers (in the pejorative sense used by “mental health” professionals). Many people have been conditioned by the dominant and ubiquitous societal narrative of human-problems-as-chemical-imbalance that has been propagated by psychiatry and pharmaceutical companies. Many people, therefore, don’t see any alternative to psych drugs, because their pain is unbearable and they don’t feel like there is any alternative. Many people feel it’s less stigmatizing to get some pills once a month than to go to talk therapy every week. Many people can’t afford talk therapy, even if they want it. Many people just don’t want to talk to “mental health” professionals about their problems because they sense that even if the counselor is skilled and well-intentioned (a rare find to begin with, in my experience), something about the situation doesn’t feel right. It is healthy that they feel this way, for many reasons, including the fact that their suffering has been turned into a commodity and the fact that this “MH” professional to whom they are expected to bare their souls will drop dime on them in a heartbeat and have them imprisoned if they talk too much about rage, suicide or so-called psychosis.

        So yeah, in my opinion, ripping all of this out of its social context (which I barely touched on) and finding fault with suffering people who ask their doctor for psych drugs is cruel and reveals a very limited understanding of all the factors at play here.

        Report comment

    • Well, but you’re the doctor, right? So what that they come for drugs? You should tell them the truth and refuse to prescribe drugs if you think they are not for them. In which universe it’s ok for a doctor to prescribe whatever the patient wants if the medical indications are not there and the drug can harm them? You’re supposed to be a doctor not a dealer. You’re supposed to know better than the pharma ads. You’re supposed to be the one who studied medicine and read the research critically. Sure that it’d be better if everyone was informed and you didn’t need to do your job providing information and convincing. But you’re the doctor so you are responsible.
      Bill Maher summed it up well:
      “Tell your doctor…” Tell your Doctor? Shouldn’t your doctor tell you what drugs you need? If you tell your doctor, isn’t he just a dealer at that point?

      Report comment

      • And that’s where the psychiatric industry has seemingly chosen to take itself, to being dealers of drugs that are chemically similar to formally illegal mind altering drugs. And they’re claiming the victims of those who trusted doctors not to get them addicted to mind altering drugs are equated to the “Nazis?” Wow.

        I’m quite certain it was the Nazi psychiatrists who espoused fictious eugenics based theories that the Jews were “mentally ill.” And we’re now dealing with the new fraudulent psychiatric eugenics theories that the DSM “mental illnesses” are genetically valid. And what’s particularly insidious about this is that the psychiatric drugs cause the symptoms of the DSM “disorders.”

        Report comment

  8. And to add, Dr. Joel-

    I dutifully took those drugs (including Xanax) for over a decade with office visits for monthly med checks, which cost me 150 bucks a month (and he still missed- or ignored-my deterioration). Do the math and ask yourself why your brethren find the medication route so appealing. When you have a lot of bills to pay, from insurance to staff to office rent, it’s easy money, and the APA, the media, and Big Pharma all have your back.

    Wake up. It’s not your patients who are the problem.

    Report comment

  9. I would be happy to do all of those things if he could just take a moment and explain how his medications work (treat) the disorders they are prescribed for, and also explain for me, how does one design a drug to treat a disorder if one doesn’t know the cause of that disorder? We don’t give patients chemo simply because their cough might be lung cancer, right? Also, if there is no alliance between Big PHARM and the APA, why do we keep trotting out the same disproved theories every few years or so instead of considering a different school of thought and making advancements? I know anything but the medical model would hurt the pharmaceutical companies, but as a doctor, surely, a cure would be better suited to the well being of your patients? In fact, if your patients are so very important, why is it we are the only people no one ever hears from?

    Report comment

  10. I really have to thank you once again Dr Hickey.

    Another article that is like a big stone for me to throw at those who believe this .BS. when i do it on my own i feel like it’s a hand full of sand I’m throwing.

    Its important that this information is presented in such a well researched manner.

    I would like to tell a psychiatrist that when i travel i have this fear that I’m going to fall off the edge of the earth, when they explain why this is not possible, i might ask why the same sort of logic and reasoning isn’t applied to mental illness lol


    Report comment

  11. They could have, of course, simply added artificial flavourings to their controlled substances, and then have advertised the chemical imbalance as having been for the lack of it, beforehand. Just like the Junk Food industry. As in: these medications treat proven and unproven chemical imbalances in artificial and unproven non-artificial ways. Or they could have just used a placebo (with or without artificial flavouring).

    That’s a LOT OF money folks for something that could have just been a spoon full of sugar.

    And, I promise, that if there’s a test on whether this post is sarcastic, it’s not me giving the test or marking you down, if you don’t pass.

    Report comment

    • Honestly, there is a lot of fuss in the media about homeopathy being scientifically unproven and quackery. Which is true but… it’s harmless. Some people do need to believe in a magic pill and they get better with sugar pills or psychic surgery or whatever it may be and I believe that there may be a place for it in medicine. Psychiatric meds are not placebos, they’re active substances with not understood effects and taking them is straight dangerous, especially when they’re taken daily and not as party drugs. No one is able to predict who is going to commit suicide or homicide after a SSRI, who’s going to develop mania on anti-psychotics and there are real risks for physical disease involved with long-term “treatment”. Yet the pills are used widely for even the most minor problems and even on toddlers. It’s sick.

      Report comment

  12. “The central issue is psychiatry’s spurious assertion that all problems of thinking, feeling, and/or behaving are illnesses. Whether these putative illnesses are caused by an excess of “black bile,” a serotonin imbalance, or a neural circuitry anomaly, or whatever the next fad will be, is very much a secondary issue.”

    My thoughts exactly as I was reading this, so thanks for returning to the central issue (though your main point has been proven admirably). If psychiatry did not still postulate as its central tenet that mental illness exists then it would not require a medical degree to qualify.

    Report comment

      • Well, and concerns of child abuse, with medical evidence, was also claimed to be “bipolar” by all the psychiatrists I dealt with. Thank God an oral surgeon understood that “concerns of child abuse aren’t cured with antipsychotics,” since none of my psychiatrists were intelligent enough to comprehend this reality.

        Report comment

  13. “While these imaging studies undoubtedly educate patients and families about the fact that psychiatric disorders are bona fide medical illnesses, it is not clear how the SPECT image provides reliable information that informs clinical decisions.”
    In other words: these studies are useless crap from the point of view of actual medicine but they may be used to sell more pills.
    Wow, that’s a remarkable piece of propaganda.

    Report comment

  14. Thank you for this brilliant rebuttal.

    Some very interesting comments also above.

    Well, if Dr Pies is right, and no serious member of his profession has ever *really* promoted this – can he possibly give the staff at Beth Israel Medical Centre a call, as they clearly must have:
    1. Missed the ‘Memo’ and are spectacularly ill-informed people, who shouldn’t be licensed medical practitioners (least of all the type of MD’s that can imprison people against their will!); or
    2. Got the Memo, but they just don’t think the lawyers were serious when they talked about that whole pesky “informed consent” nonsense, and they reckon it’s for their patients’ own good to believe (or profess to believe in fairy tales, urban legends and little white lies) – er, in which case, they probably should be licensed medical practitioners either…

    Prior to ever even knowing about MIA, or reading anything remotely contrary to mainstream psychiatry, I was told in this Beth Israel Medical Centre in 2011:
    – “Your depression is caused by a physiological illness”
    – “You have a chemical imbalance in your brain. This is what causes your depression”
    – “Just like a diabetic needs to take insulin, you have to take this medication for the long term, if not the rest of your life”.
    – “For a diabetic, they wouldn’t think to treat diabetes without medication, how could you think you could do the same without antidepressants?”
    – My family was told the same thing.


    When I made any expression of skepticism “don’t you think that sounds a bit facile?” – I got shot down, along the lines of “the science is proven beyond a doubt” – and labelled in my file as having poor insight…

    Looks like I wasn’t the one with the poor insight after all…

    Report comment

  15. Actually, you know what would be amazing/hilarious…

    Dr Pies (who says this chemical imbalance stuff is BS);
    E. Fuller Torrey (who says it’s categorically ‘true’ and justifies incarceration of, well, people like me);
    That Murphy Bill maniac; and
    Juan Mendez (who’s the guy at the UN who apparently gets to decide whether a ‘little bit of torture’ on the basis of “treatment” is ok or not)
    Into a room, and sitting back with a big box of popcorn…and just watching them go for it…

    These views which Pies says are not taken seriously…are taken seriously at a practitioners level. This apparent falsehood is also the underpinning of all legal justification (O’Connor v. Donaldson onwards) and hawks like Torrey, for stripping us of our rights, and reducing us to the status of second class citizens. All of which is sanctified as “ok” by the UN…all because they’ve been led to believe this is treatment of a real “thing”.

    Sorry, it’s late in Sydney…I’m ranting…

    Report comment

    • I’ve always found the notion that things which constitute torture when applied to prisoners suddenly change to “therapy” when they’re done on psychiatric patients. It’s a remarkable piece of illogic but that’s nothing new in this field. Every single one of coercive interventions constitutes inhuman and degrading treatment: physical restraint, isolation (also known as solitary confinement), electroshock treatment (oh, sorry ECT “therapy”) and forced drugging. All these techniques were pioneered by psychiatry hand in hand with abusive governmental agencies as means to interrogate and torture detainees and political opponents and have been shown time and again to lead to physical and psychological damage, trauma, PTSD, you name it.
      I wonder if every psychiatrist had to go though the whole “treatment plan” for like 2 weeks as part of their “education” how fast would things change…

      Report comment

  16. In the Connecticut newspaper “The Advocate” dated Sunday, June 8, the article, “Schools Working to overhaul mental health program” is this quotation by a NAMI staff member advocating for more of a psychiatric presence for young people:

    a staff member of the Stamford/ Greenwich chapter of the National Alliance of the Mental Illness, suggested getting pediatricians more involved in mental health treatment. She wants pediatricians to have training in adolescent psychiatry and that, just like regular physical checkups, children be given mental health evaluations.

    My thoughts: Upon reading this, I was not surprised. Early prevention of mental disorders being desired by everybody, I am not sure there is a better option than Psychiatrists. Then I thought of psychologists and social workers and how those fields perhaps would be less likely to give a child a life-long diagnosis and also unlikely to prescribe medication. If the hypothesis is correct that we do not know enough about the brain or the mind-altering medications for these medications to be used, then psychiatry has no place giving “evaluations” to children. I am in favor of psychologists, counselors and social workers, but psychiatrists and psychiatry and the risk of iatrogenic effects of their medications and permanent labels makes me think they should be evaluating themselves for quite a while. They should be their own client base. For a while. Maybe they’ll find that how they make people different is traumatizing and representative of their own obtuse banality. They can break the hearts of children and their parents by claiming to know something about the child that blindsides both the parents and the child by alienating the child in disease and disrupting the child/ parent bond using a flimsy biological hypothesis.

    Report comment

    • truthteller,

      The APA at present is pushing very hard to “integrate” mental health evaluation and treatment into mainstream medical practice. And they’re being very successful in this. GP’s have questions about depression and anxiety on their assessment checklists and questionnaires.

      Report comment

  17. Hi Dr Hickey,

    just came across this little series of gems.

    An example from one on psychosis (P2)

    [blockquote]What causes psychosis?
    Psychosis is caused by changes in the
    chemical environment in the brain.
    Our understanding of these changes
    is still limited, but is improving. [/blockquote]

    Depression? a ‘chemical imbalance’.

    Do you think it is worth contacting this organisation and engaging in some form of discussion about how they are spreading this ‘urban myth’? Or would it be a waste of time?

    Report comment

  18. To be honest I’m really having a hard time understanding why this “did too” “did not” argument really matters. Reading the article, I very much do get the impression that the purpose of anti-psychiatry activists in this debate is to discredit psychiatry by painting the profession as guided by simplistic notions that even a layperson can readily reject on casual inspection. I think the truth is more nuanced than this polemic suggests.

    Several hundred years of scientific research have clearly established the brain as the organ most closely associated with both emotive and higher cognitive functioning. While I think everyone today clearly understands that depression cannot be explained by simplistic notions such as a deficit of synaptic serotonin, asserting an absolute duality of brain and mind constitutes little more than mysticism. Mood and cognition are empirically tied to the biochemistry of the brain by many experiments, including Michael Meaney’s studies showing that mice raised in social isolation (and mice raised by mothers who were raised in social isolation!) exhibit social difficulties in adulthood that are closely correlated with brain biochemical and DNA changes relative to mice raised normally. And of course, evidence for interaction between brain and mind in the opposite direction is well established by the ability of many drugs to impact both emotion and cognition.

    What would be nice to see would be articles more addressing the actual issues, and less focus on what strike me as side issues. Did psychiatrists suggest that depression is due to changes in the biochemistry of the brain? Maybe they did, and maybe they presented it in a grossly oversimplified manner. But it would be nice to see more detailed critique of the actual issues of optimal care for people who have difficulties functioning and less argument about issues intended to present the other side as lacking intelligence, integrity, and common sense. We see enough of the latter in political campaigns.

    Report comment

    • Hi JohnSmith,

      Phil has an excellent blog summarizing why there is an anti-psychiatry movement here

      including the damage caused by telling people that they have a brain disease when they don’t have a brain disease.

      Before discussing the nuances, as you say, I think it is necessary to think long and hard about the vast, enormous tragic damage that these ideas have caused to literally millions of people. Psychiatry is responsible for this damage, and acknowledgement of this fact, and, I think, a very, very large dose of humility is required at this point.

      – Saul

      Report comment

      • “including the damage caused by telling people that they have a brain disease when they don’t have a brain disease.”

        Exactly Saul, as one who feels being on psych meds caused long term damage. And no JohnSmith, it is not due to normal aging which you used to blow off someone who made a similar type complaint.

        JohnSmith, you claim that anti psychiatry activists have agendas but you don’t come across on this forum as non biased either. You seem to think that psych drugs can never cause any harm.

        Anyway, if cardiologists had lied about blood pressure and statins for years, there would be a big time uproar. But for some reason, it is ok for psychiatry to lie about psych meds I guess because patients with “mental illness” don’t deserve the truth.

        Report comment

    • Did psychiatrists suggest that depression is due to changes in the biochemistry of the brain? Maybe they did, and maybe they presented it in a grossly oversimplified manner.

      They absolutely did and many still do. I was personally told this by at least six psychiatrists. I was also told this by psychiatric nurses, social workers, peer workers, family doctors, and well-meaning but misinformed friends, all who had gotten their information from psychiatry.

      This is not a “side issue.” This is a serious problem and I don’t appreciate your trying to minimize its import. If I had not been told this faery tail over and over by people who were supposed to know what the hell they were talking about, I would never have consented to taking any of psychiatry’s toxic drugs and I would not have been disabled by them.

      Report comment

  19. Well, let me try again. Here is one way to think about this.

    When a person has a heart attack, the proximal cause of their symptoms is a blood clot occluding their coronary artery. More fundamentally, the cause is decades of overweight, smoking, and lack of exercise, possibly exacerbated by a genetic predisposition.

    An interventional cardiologist explaining the need for a PCI procedure to a man who has just had an MI might focus on the clot. After discharge from the hospital his cardiologist will counsel him to exercise snd quit smoking.

    If one believes as I do, that the brain is the organ that processes our genetics and experience and produces an output we call a soul, the physical and chemical state of our brain is always the proximal “cause” of the state of our souls, and if we are unsatisfied with that state, it can be said to be “unbalanced”. If I can offer a drug that directly relieves that distress, I am likely to emphasize that proximal cause. That does not necessarily deny the role of the experiences that are the fundamental causes of a persons distress.

    Report comment

    • John, I think the issue is not so much about whether biology is connected to emotion and behavior, which it obviously is and which few on this website would ever deny.

      It’s more that the psychiatric profession helped to promote the mythology of the “chemical imbalance” in order to promote their product, namely psychotropic drug prescriptions, as the ultimate answer to mental health problems of all types. Naturally, they had a great deal of help from the drug companies who stood to profit far more than the psychiatric profession from this viewpoint. But the issue isn’t really about the brain, it’s about institutional corruption and the intentional deception of patients to further the professional and financial interests of those who profit from this “story.”

      To that extent, it IS important whether psychiatrists were simply misguided and overenthusiastic, or were blinded by their own guild interests despite believing they were doing right, or were consciously and intentionally engaging in dishonest propaganda with the full knowledge they were lying and probably hurting their clients. The answer to this question has a great impact on whether one believes psychiatry is a redeemable or reformable entity, or whether its very purpose is destructive and dishonest. A misguided psychiatry should be able to be redirected with the truth, whereas a consciously corrupt psychiatry would resist any attempts to undermine their market advantage, regardless of the truth of their position.

      As I remarked above, your “Moncrefian” view of drugs as a practical aide for particular symptoms neatly avoids this pitfall, but I think you are a minority viewholder amongst the many psychiatrists I have interacted with over my career. I think most fall into the blinded category, believing what is generally believed and not wanting to rock the boat too much, even if they see some issues with the current model, but I also see evidence that there are a large number at the higher echelons of the profession who do actively suppress any data contrary to the psychiatric storyline (Jeffrey Lieberman would be a perfect example) and attack the presenters of such information rather than deal with the actual information presented. Such people are not just following the herd for career reasons – they are setting the tone for the profession, and their continued support for purely biological explanations for “mental illness” and for the factual validity of the DSM diagnoses that even the head of the NIMH admits are of questionable validity and utility shows that they most likely are corrupt rather than misguided, and are probably not amenable to change this side of criminal charges or death.

      —- Steve

      Report comment

    • Hi JT.

      I’m glad that you spelled this out, because I think it’s important. You say:

      “If one believes as I do, that the brain is the organ that processes our genetics and experience and produces an output we call a soul, the physical and chemical state of our brain is always the proximal “cause” of the state of our souls, and if we are unsatisfied with that state, it can be said to be “unbalanced”. If I can offer a drug that directly relieves that distress, I am likely to emphasize that proximal cause. That does not necessarily deny the role of the experiences that are the fundamental causes of a persons distress.”

      I think that this is an honestly held belief help by at least many psych patients and, I presume, many researchers too. I claim, however, that this is a very serious mistake, even from the hardest, most biological, hard science point of view. The best way that I know of to illustrate the point is to imagine that you have to fix a laptop which has developed “laptop psychosis” because you have downloaded some malware. Taking your point of view, everything happening on the laptop is determined by electrical signals, so the laptop must have an “electrical imbalance.” Your proposed solution is to re-balance the electrical signals as best you can. This can perhaps be done by adjusting the clock speed or adding some wires or removing some capacitors. I think that you will agree that this is totally wrong and likely to harm the laptop and will not solve the underlying problem. Why? Because you have presumed that the laptop has a hardware problem when the laptop actually has a software problem. Brains, I would claim, like laptops, can have “software problems” – problems which are caused by past experiences, trauma, and habitual patterns of thinking and feeling and not by anything being wrong with the underlying hardware. As with a laptop, the solution in this case is to “stop running the bad software” and not to have a hardware intervention.

      – Saul

      Report comment

      • Hi Saul,

        I guess I was not very clear in stating that I think the role of drugs is to address symptoms and not the underlying issues. Even in a purely biological model it is hard to fathom that something as simple as a drug can correct the trauma of childhood abuse.

        With respect to Steve’s comments and those of many others here, the concept of psychiatrists as a monolithic block that seeks to drug people to protect their profession and drug company clients is outside my personal experience. I’ve interacted with a score or more of them over the last 40 years, and the ones I’ve known are generally warm, compassionate people who bemoan the quality of drugs available (one refers to “the dull misery of dopamine blockade” in describing antipsychotics), hate the fact that third party payers will not reimburse them for counseling, and generally try to do the best they can for their clients given these rstraints. One of them wrestled a suicidal client to the ground when he pulled a shotgun out of his car in the office parking lot, which entailed considerable personal risk. Its also worth noting that most members of the profession chose to undertake additional training to become psychiatists, though as a group members of the specialty make no more than primary care docs. Its hard for me to see self selection of people with the sort of cold blooded mercenary attitudes I often see described here under these conditions, though I am sure there are many sellouts and shills as there are in any profession.

        I agree there is an over reliance on meds, but I think this largely arises from a much broader range of economic forces. Insurance companies want to minimize costs, as do state foster care agencies, nursing homes want to keep patients quiet and compliant, and pharma wants to sell drugs (though most psychiatric drugs will be off patent by year end)

        Report comment

  20. Saul I’d also mention my personal experience here, which of course is anecdotal and thus falls far short of a RCT.

    I had a lot of trouble keeping my level of anxiety under control when I was young, such that it really affected my quality of life. I spent 4 years in therapy with some excellent counselors and gained a lot of insight into the experiences that underlay the problem, but experienced no improvement in symptoms. Amitriptyline shut that problem down. I took it for a decade and it did wonders for me. At that time I was able to stop without a return of symptoms, perhaps the passage of time and dilution of trauma with other experiences did what insight could not. I will say that I experienced some fairly umpleasant discontinuation symptoms, but there is no question in my mind that if Ihad to do it over again, the only thing I would change would be to start amitriptyline 4 years earlier.

    Report comment

  21. Hi JohnSmith,

    I wanted to acknowledge your post since this site is supposed to value lived experience. I’m glad that the amitriptyline worked for you. I’ve been following people’s experiences based on their postings at other web sites and I’m confident in saying that your experience is quite unusual.

    I’m also not too surprised that even excellent counseling didn’t help you all that much. I have a suspicion that this is just because most mental problems are self-reinforcing unconscious reactions to stress and, being unconscious, it’s hard to talk your way out of it even if you understand how it started. I suspect that’s why talk therapies in general don’t work that well and something like meditation seems to be good for everything even though it is completely non-specific.

    By the way, I think you might be unintentionally rubbing people the wrong way with your use of the term “anecdote”. Calling someone’s description of their own experience an “anecdote” can be read as “your narrative is unreliable and insignificant” when I think you just mean “your experience is a single case, with meaning, but limited statistical meaning.” I’m sure that you realize and agree that very strong evidence can come from outside the domain of RCTs.

    – Saul

    Report comment

  22. So Lieberman called Robert Whitaker a menace to society?!?

    One of my favorite (sarcasm intended) quotes from Lieberman’s 2015 history of psychiatry “Shrinks: The Untold History of Psychiatry” appears on the last seven pages. It reads as follows:

    “I believe we will soon have useful diagnostic tests for mental illness.” (1)

    Where do you get your medical authority if you diagnostic tools are admittedly useless?

    I did not know whether to laugh or cry when I read that line because Lieberman – the recent former President of the A.P.A. – just admitted that as of 2015 – the existing diagnostic tools for “mental illness” were NOT useful. If the diagnostic tools are not useful, then 1) how can you determine whether or not the underlying illness exists? 2) how can you defame me by assigning MULTIPLE overlapping, false and generalized diagnoses to my medical records that have a real impact on my civil rights? 3) and how can you prescribe medications and design treatment plans?

    For an example, I am diagnosed as having a “Personality Disorder” in my medical records, because I got a little agitated with my psychiatrist when he simply would not listen that the benzo withdrawal was intolerable. I did not yell at him. I did not curse at him. I certainly did not threaten him, but I instantly had a personality disorder because “I cannot control my emotions.” This is what I have now come to call the “co-morbid version of the shame the patient game.”

    Frankly, given the intensity of the withdrawal, my emotional restraint was commendable under the circumstances, because I got impatient with a shrink so I have a personality disorder. Do you know how many psychiatrists have become impatient with me when I had reasonable questions? I have lost count but I bet none of them received diagnoses for personality disorders.

    So I wrote the hospital’s Patient’s Relations Department, reminding them that there are four clusters of “personality disorders” and 12-15 diagnoses, with a wide range of symptoms and implications – so could they be more specific please? How can I seek treatment if I don’t know which one I have?

    To make a long story short, I received a letter apologizing for not being able to answer my questions. My neuropsychologist defended them saying that a psychiatrist can assign you a generalized diagnosis – and I replied that with all due respect, that is tantamount to an oncologist telling me I have cancer, but sorry – we don’t know which kind of cancer or what organs it has effected, and we don’t have to – its not our problem. He thought that my analogy was funny. Its not funny. Bottom line, psychiatrists are the only medical professionals (and I use the term loosely) that just get to make stuff up – and it sticks. And it has consequences – lifetime consequences.

    No wonder I am now on disability after two decades of benzodiazepines prescriptions. In the mid-nineties, the on-campus psychiatrist at Harvard University had me on seven concurrent prescriptions for Clonazepam with early refills. I was very young and stupidly naive until the pharmacist (god bless her) fussed at me. I asked her – is this illegal? She said no, but highly inappropriate – and filled the prescription. I then broke down and told the campus psychologist.

    She put me in the hospital right away – but guess what? I left Boston’s most prestigious “mental hospital” without a taper or any information regarding protracted withdrawal and I almost lost my job over my “sensibilities,” which I now recognize were not “mental illness” but prolonged withdrawal symptoms denied by the medical establishment. So they just diagnosed me with something worse and put me on more medications. So the cycle began until it spiraled. The big problem is that these medications disable the very organ that enables you to recognize what is really happening.

    The rest is unfortunately my history….and I must own it.

    To quote Holly Hunter speaking to George Clooney in Brother Where Art Thou: “Lots of respectable people get it by trains.” Well I got rolled over by the freight train psychiatry and its bad medications. This same pill that people today are calling “America’s Deadliest Pill” and “worse than heroin” in terms of withdrawal. If you don’t believe me, there is a great video interview on youtube with Stevie Nicks talking about how her battle with Clonazepam was worse than her decade-long cocaine addiction:

    In the quote above, Lieberman admits to everything wrong about psychiatry in writing – as part of the concluding chapter. But Lieberman is so blinded by utter hubris he could not see that he just belied the pseudoscience he has practiced his entire career, without a second thought. But wait…it gets so much worst – he then goes on to conclude this history by hoping that emerging brain-scanning technologies will lead to effective treatments. So he ends his book by not only admitting to the uselessness of existing diagnostic tools, but the non-existence of effective treatments.

    Boy, then he has the nerve to call Whitaker a menace to society?

    Ugh. Sorry – this struck a nerve.

    1) Lieberman, Jeffrey A. (2015-03-10). Shrinks: The Untold Story of Psychiatry (p. 307). Little, Brown and Company.

    Report comment

  23. Just thought I’d mention that Pies’s article has been “misplaced.” A computer glitch I’m sure. Not like there was too much traffic from this site to the shrinks’ dirty little secret conflicting with those cute commercials.

    Report comment