I believe that Dr. Jeffrey Lieberman, the past president of the American Psychiatric Association must judge some writers and commenters here on MIA as being “anti-science” and “anarchists.” He has now published at least two articles that, in essence, suggest that critics of the DSM-5 and psychiatry should be silenced.
In an article published online in the Scientific American in May 2013, titled, “DSM-5: Caught between Mental Illness Stigma and Anti- Psychiatry Prejudice,” he said this about critics: “These are real people who don’t want to improve mental healthcare…they are to my mind, misguided and misleading ideologues and self-promoters who are spreading scientific anarchy.”
Note the ad hominem attacks against anyone who criticizes psychiatry. Critics of psychiatry apparently want worse mental healthcare than we already have.
In his Scientific American article, Lieberman wrote that it was not just the DSM-5 that he felt was under attack. “I was also alarmed at the harsh criticism of the field of psychiatry and the APA…the inevitable outcry from a small group of critics – made louder by social media and support from dubious sources – who have relentlessly sought to undermine the credibility of psychiatric medicine and question the validity of mental illness.”
I wonder how many psychiatrists who voted for Dr. Lieberman for APA President supported inflammatory remarks about critics of psychiatry spreading scientific anarchy?
Now Dr. Lieberman is at it again. On January 17, the New York Times published an article titled “Redefining Mental Illness” by anthropologist T.M. Luhrmann. She started her article by writing, “Two months ago the British Psychological Association released a remarkable document titled ‘Understanding Psychosis and Schizophrenia.’ Its authors say that hearing voices and feeling paranoid are common experiences, and are often a reaction to trauma, abuse or deprivation…The report says that there is no strict dividing line between psychosis and normal experience.”
Dr. Lurhmann also wrote, “The report adds that antipsychotic medications are sometimes helpful, but that “there is no evidence that it corrects an underlying biological abnormality.”
In response, Dr. Lieberman wrote a piece that was published on February 18 on Medscape. In it, he complained about T.M. Luhrmann’s article and the New York Times for not publishing his riposte to that piece. He titled his Medscape article, “”What does the New York Times Have Against Psychiatry?”
He began this article by stating, “My comments today could be titled- ‘Psychiatry suffers another indignity.’ ” Then he dropped several pearls.
In response to the UK report on psychosis that questions the validity of claiming that anti-psychotics treat an unproven chemical imbalance of the brain or abnormality, Dr. Lieberman wrote: “The (UK) article addresses the fact that there is no evidence that antipsychotic drugs correct any biologic abnormality, which also is inaccurate. Antipsychotic drugs work through the antagonism of the blocking of dopamine. They may have downstream and upstream effects with a neural pathway, but the link between dopamine activity and psychotic symptoms is indisputable.”
Note here that while he is seeming to defend the chemical imbalance story, he actually doesn’t claim that researchers have found that people diagnosed with schizophrenia have abnormal dopamine systems. He claims something is “indisputable,” even though when he presents evidence of that biologic abnormality, all he can say is there is some link between dopamine activity and psychotic symptoms. So clearly, it is quite disputable about whether these drugs correct a biological abnormality.
Next, he stated that the DSM-5 should be called the “gold standard” for diagnosis in psychiatry. “The clinical diagnoses that have been used and continue to be refined through the iterative DSM process are the gold standard of what needs to be used.”
I guess you could call anything the gold standard if it is the only game in town. The gold standard of restaurants might be McDonalds if it was the only restaurant allowed to be open.
Finally, Dr. Lieberman complained that the New York Times would give T.M. Luhrmann this public forum for her thoughts. “What other medical specialty would be asked to endure an anthropologist opining on the scientific validity of its diagnoses?” he wrote. “ None, except psychiatry. Psychiatry has the dubious distinction of being the only medical specialty with an anti-movement. There is an anti-psychiatry movement. You have never heard of an anti-cardiology movement, an anti-dermatology movement, or an anti-orthopedics movement.”
A psychiatrist friend of mine who read Dr. Lieberman’s Medscape piece said that she was, “Used to his over the top simplistic rants, but this one made my jaw drop- and he wonders why there is an anti-psychiatry!”
I wonder, though, if Dr. Lieberman ever asks himself whether psychiatry’s own behavior plays a role in the creation of an antipsychiatry movement? Could one reason there are more critics of psychiatry than of cardiology be because people given diagnoses of a “major mental illness” and treated for it die 25 years earlier than the general public? People diagnosed/labeled with schizophrenia or bipolar or major depression don’t have a potentially life threatening physical disease like cancer or coronary-artery disease, and yet they are dying young as though they did.
What other medical specialties like cardiology and dermatology that do care for people with life threatening illness are under the cloud of legitimacy that psychiatry is experiencing?
Psychiatry sets the diagnostic criteria for care and sets the best practice standards for care. The recipients of that care die 25 years sooner than people not receiving psychiatric care. Is it any wonder psychiatry is in a crisis of legitimacy? And that is to say nothing about much of that care, like ECT, forced medication and medicating children, are human rights abuses in my opinion.
Wouldn’t there be a great many, very vocal critics of cancer treatment if oncologists sought to get laws passed so they could strap down “treatment-resistant” patients and forcibly inject chemotherapy drugs into them?
Critics of psychiatry shouldn’t be labeled and demonized as scientific anarchists. It’s dangerous, Dr. Lieberman, to throw that kind of ostracizing, condemning language around. It’s demagoguery. Some people will feel that we should be silenced.
Am I wrong in believing that you want to silence us Dr. Lieberman ?
I believe those of us who dare to be critical of psychiatry are not the irrational extremists you would make us out to be.
Please look to your own glass house and stop your defamatory language about those you should feel blessed to serve and help Dr. Lieberman. Don’t call us derogatory names.
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.