Is an Ominous New Era of Diagnosing Psychosis by Biotype on the Horizon?


When former NIMH chief Dr. Thomas Insel speaks, people listen. Dr. Insel famously criticized the DSM a couple of years ago for its lack of reliability. He notably broke ranks with the APA by saying there were no bio-markers, blood tests, genetic tests or imaging tests that could verify or establish a DSM diagnosis of schizophrenia, bipolar or schizoaffective disorder.

However in a new article in Scientific American, Rethinking How We Diagnose Psychosis, Dr. Insel announces research that claims to have found bona-fide physiological markers that identify three specific “biotypes” of psychosis. This system could, purportedly, identify a person as possessing a specific biotype of psychosis, instead of a DSM-category diagnosis.

The new research, from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP), is based on a battery of tests given to 711 people diagnosed with schizophrenia, bi-polar or schizo-affective disorder. The tests were described as “a brain-based panel of cognitive tests, studies of eye movements, a test of cognitive control, and electro-encephalogram. In addition, each subject had a brain imaging test.”

Dr. Insel reports that the tests results were run through a computer model “to look for what they called biotypes.” Sure enough, the  researchers found what they had already decided they were looking for; the so-called biotypes. These three new biotypes are seen as suggestive of new categories of psychosis, even though each biotype shared overlapping elements with the three existing DSM categories.

“Is there any reason to think that these biotypes are more valid than a clinical diagnosis based on symptoms?” Insel asks, then answers;

“A few observations suggest that the B-SNIP investigators may be on to something. First, some of the biotype differences were also found in first-degree family members, for whom data was also collected, suggesting a genetic basis for the new categories. Second, biotypes differed in social functioning—with people in Biotype 1 showing more serious functional impairment relative to the other biotypes. Third, the brain imaging studies (not used in defining the biotypes) showed clear differences in regional gray matter, especially in frontal, cingulate, temporal, and parietal cortex.”

Here Insel overlooks, first, the obvious and well-established problems with assuming that similarities among family members suggest or constitute heritability. Second, he repeats the conflation of “symptoms” (here, social functioning) with biology; a mistake upon which generations of discriminatory practices have been based, all of which conveniently ignore the much more verifiable and – potentially, at least – addressable environmental and psychosocial factors. Third, he commits the classic mistake of presenting correlation as causation, where there is no basis for assuming causality, and where – more importantly – there are myriad other factors (such as socially induced stress and trauma) that might easily explain the differences.

To his credit, Insel acknowledges that “none of these observations proves that the biotypes are more valid than clinical diagnosis” even as he asserts that they “together encourage a fresh approach to the diagnosis of psychotic disorders.” This approach will not only continue, we can assume, to ignore the substantial evidence pointing to psychosis’ roots in psychosocial stress and trauma in favor of an hypothesized (but never established) biomedical basis, but will in actuality double down on the theory by establishing an ever-stronger bulwark against research that looks at these psychosocial bases.

As someone who views the psychiatric disease paradigm of human emotional suffering as a failure in both theory and applied clinical practice, I’m very concerned that Dr. Insel’s report of the supposed “discovery” of new “distinct” biotypes of psychosis that can be identified with quantifiable bio-markers will help to usher in a new era of adverse consequences for individual humans, and for humanity.

Biomarkers for psychiatric conditions have been the long-sought holy grail for every practicing psychiatrist I worked alongside for 30 years – even more so than the hoped-for genetic basis for psychosis. Because, as Dr. Insel explains in his intro to the article, its been very difficult for psychiatrists that they have never been able to diagnose with the certainty of their counterpart MD’s in other specialties. So, it’s a huge game-changer for Dr. Insel to confer on these new biotypes of psychosis the status of having been identified by a quantifiable bio-marker.

However, if you’ve ever had access to the medical charts of people in the mental health system you know that, over time, almost every person receives multiple major diagnoses – sometimes four or five different ones, each with “specific” prescriptions for medication. It’s not uncommon to find that someone who has been in the system a long time has been prescribed over a dozen different medications. I believe that’s going to change if the biotype/bio-marker becomes the new standard of diagnosing psychosis.

This new diagnostic system is even more potentially ominous, because people will no longer even be seen as individuals who have discrete, if multiple, psychiatric diseases; they will be seen as a unique type of person who suffers from a biological abnormality alongside others in their biotype cohort. In apparently authoritative style, a biotype of “psychotic” will be assigned to those who test positive for an hypothesized biomarker-identified phenotype. People experiencing extreme states will be categorized and labeled as a class of people that can easily be identified with a battery of tests that “establish” a biotype, because those screening tests purport to confirm a bio-marker that’s as reliable – Finally! – as the blood work screening that establishes, for example, diabetes.

Dr. Insel celebrates, in his opening remarks for the article, the supposed advance of his NIMH research agenda that Robert Whitaker warned about in “The Taint of Eugenics in NIMH-Funded Research Today” when he writes that “…moving psychiatry into a new era of biologically based diagnosis has been a long sought goal – and a priority at the NIMH, where I served as director for 13 years. Now a study published online in the American Journal of Psychiatry raises fresh hope.” He further writes that “it will be important to know whether genomic variation, functional brain measures, or other behavioral measures can refine or further validate these biotypes.”

Thoughts of “bio-behavioral” measures and genomic variations have danced in the heads of researchers for decades, if not centuries, with no clinically useful results. Nonetheless, Insel’s approach provides the basis – if not for establishing a genetic and/or biomedical basis for psychosis – then at least for a “new and improved” eugenically-tainted approach for the next decade, or longer.  I hope I’m wrong but we may someday wish for the bad old days of the DSM.


  1. This is disturbing and it incenses me to see the arrogance and presumption that accompany these hollow proclamations from the false deities of psychiatry. This does make me think of some of the labels for deviants and defectives that were imposed by the doctors of the Third Reich in the 1930s/40s.

    If they were to admit that the DSM categories are fake – as they have already done – and then have nothing to replace them with, psychiatrists would be staring at a terifying black hole, the black hole which says you are not real doctors, the supposed categories you treat are not “discrete illnesses”, the drugs you use do not target any known illness and hardly work in the long term, there is no reason to pay you an average of $180,000 a year for lazily prescribing pills when people who earn $50,000 a year can do just as good as job, etc. It can be understood in this way what is motivating Insel’s desperate grasping toward a new categorizing system that is pseudoscience. It has nothing to do with real science or what is good for patients, and everything to do with survival – preserving psychiatrists’ income and status. Insel is nothing more than an ignorant charlatan who promotes pseudoscience to preserve guild interests and to profit from oppressing already-traumatized people. It occurs to me now that I should write a speech based on these ideas and see if I will be allowed to present these ideas at the next APA and NIMH meetings.

    The good thing is it shouldn’t be too hard to expose these categories as bullshit. This time hopefully activists can confront and reject the emerging false narrative immediately, rather than waiting years to do so until after the use of “schizophrenia” and “bipolar” labels were already well established.

    Based on common sense alone, these three categories are almost certainly false artificial divisions. If you take a group of very troubled people, it’s easy to “see” in them such divisions and shoehorn some who overlap into one or another “group”. The biological expression of terror, rage, disconnection, and suffering will tend to be more or less severe across a group. But that doesn’t mean there are actually discrete illnesses or categories within the spectrum or continuum. We already have much research countering the validity/reliability of such artificial dividing for the DSM categories (e.g. the British Psychological Society’s 2001 report) and this research can immediately be used against these supposed biotypes. It’s predictable that these three categories will fail to replicate or to provide a valid basis for research or “treatment.”

    In other words, this initiative is doomed from the start in terms of having actual validity or providing better treatment in any practical sense. Its only purpose is to maintain the illusory narrative that psychiatrists have medical knowledge and authority to treat and prescribe to suffering people.

    I hope all who see articles about this will speak out, comment, undermine, reject the assertions of validity for these pseudocategories/biotypes.

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    • Thanks BPDTransformation, B.A., for your powerful comment. I hope you’re right, that activists can challenge this new diagnosis system strongly from now on. I worry that the momentum of the NIMH research agenda that Dr. Insel was the architect for, has so much political and financial support that it will be very hard to slow it down. The fact that Dr. Insel is now proclaiming that agenda is bearing this fruit- a new bio-marker based, biotype diagnostic system, is a huge victory for him and the vision that you and I and so many so strongly oppose.
      Best wishes, Michael

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      • I would not be too pessimistic, Michael. It is only one study and an inconclusive one at that. Insel wants something, anything to crow about in the barren psychiatric wasteland that he and his ilk inhabit, the rats’ alley where the men have lost their bones (an image symbolizing the rotting away of the last vestiges of hope and humanity in their mindset), as T.S. Eliot would say.

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        • I think BPDTransformation is correct.

          On the other hand, Insel’s deal with Google means that this crowing matters. There will always be people who believe, want to believe, and look for this to believe in, and they will always hold some kind of sway with the part of the population that either believes or wants or needs to believe in it, too.

          I think the only real strategy in this perennial debate is to hold firm in what you believe, and continue to offer it, and to find ways to make sure that what you believe remains one of the options on the table. And to try as hard as you can that this option is within someone’s arm’s reach when they find themselves at that table. Although you might (with justification) think of it as a moral issue, it helps (at least in order to keep at it, when one feels dispirited) to think of it as a marketing issue. How do you make sure that what you believe is known about by the people who can benefit, at the time they find they need it?

          I believe that MIA is about keeping that option on the table, as part of a civil (in all senses of the word) dialogue. That way we do not commit the offense that we are most aggrieved by; shutting out peoples’ voices, especially those of the people who are most affected. “No sedation without representation,” we might say. I think that MIA is about creating a space to hold this much-needed conversation, but to make sure that those whose voices have long been shut out have at least an equal spot at the table. It is not about shutting anyone out of the conversation; it’s about making sure that everyone has a turn.

          I believe that the real evidence, and the statistics, and our hearts, point toward something much, much better than we have seen offered (and/or coerced) in the name of treatment for emotional anguish in the past. The trick is to find ways to make sure that that something better is part of a conversation that we are all participating in equally, and to have confidence that if what you believe is, in fact, better, it will appeal and prevail. Granted, the deck is stacked, but the way to win against that is to stay at the table and continually improve your game.

          I believe that MIA’s purpose is at least partly that; to provide the opportunity to improve the thinking and language around arguments for alternatives to the standard of care, and to provide an opportunity to practice and sharpen that argument.

          Actually, modifying that statement a bit; I think that when you look at history, there have always been quiet, compassionate people who provided an effective alternative, and who didn’t receive (or divested themselves of) rewards or glory out of either modesty or an impulse to stay under the radar, or because offering the alternative requires a modest, quiet temperament in the first place. This alternative has always been a part of the standard of care; it just didn’t get the same attention as approaches that offered the illusion of quick or certain fixes, and didn’t have the advantage of providing a mechanism for moving large sums of money around. (Large sums of money have a way of generating their own justification, either because they seem convincing in their own right, or because they provide everyone who comes in contact with them a chance to take their share – or both.)

          The trick, as I see it, is to find and support those who share your beliefs. That is MIA’s main raison d’être. Bob’s books provided affirmation for what had been many people’s experience, and became a gathering point for many who had felt alone and voiceless. We at MIA feel a deep sense of obligation – indeed indebtedness – to those people and that voice. Not out of a desire to shut anyone out – including Dr. Insel, whose motivation is, I am sure, principally to relieve suffering – but to keep the conversation going. I have personally found in my clinical work that when I could keep the conversation going long enough, eventually even people who had the most apparently adamant bio-medical view of the situation eventually came around to seeing a whole person in a whole system, and would then come around to a different approach. The trick was to make that happen without (necessarily) calling the person out or calling them bad names, which usually just ended the conversation, and not to the benefit of the person I was trying to help. It was less immediately satisfying to keep my temper – I’ve had my times of stomping around the streets filled with inchoate rage at what I’ve seen perpetrated in the name of “treatment” – but it was generally what I found actually got what I’d hoped for to happen.

          That said, I am thankful for those who storm the streets with inchoate rage. There is a place for that, for sure. But I believe that MIA is a place for civil dialogue that doesn’t shut anyone out. By “civil” in this case I don’t mean nice and pretty and neat. I mean by “civil” that we are all a part of this community, and we don’t have the option of cutting anyone out; we either find a way to all move forward together, or we all lose. Nobody gets tossed off of this boat without everyone paying a price.

          I recall Bill Clinton once saying of his opponents something like “you see, they don’t want you to think about it, because if you think about it, we win.” I think that applies here. MIA resolutely provides a place where we say “let’s keep thinking about this.” Because, if we think about it – together – we win.

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          • Wow Kermit! I really hope everyone reads your awesome comment here. It is very wise and inspiring- a succinct summing up of why MIA is so crucial to the present and future lives of all of us who come to this site for the abundant gifts it freely offers us. Many thanks to you and Bob and the MIA team for your tireless work and dedication.
            Best wishes, Michael

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    • There are a number of biomarkers for a number of the altered states (urinary pyrolles is one of the oldest I know of), but the problem with them is that anyone knowledgeable of them can do a better job treating “psychoses” than a shrink, who isn’t. Picture a chiropractor, who can’t prescribe anything, successfully treating a Diplomate Psychiatrist’s treatment failures as a routine part of his/her practice. This humiliation can’t be endured by mainstream psychiatry for any length of time.

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  2. It seems to me that there is a place for genetic, biological marker research, as long as it does not fall into the overly simplistic “gene for” type of thinking. As an assessment psychologist, I am well versed in unstructured methods such as the Rorschach and TAT, and have done many assessments on young children. I can tell you that the children of those who experience bipolar and psychotic states show up on these tests as having latent propensities for these states. Although they may not be actively manic or psychotic, the way they process information and deal with stress is much different than norms. That being said, the propensity does not mean one has a disorder, that these states will manifest, or one should be treated with some medication as a result of an assessment. However, psych testing, and perhaps this genetic research, can help identify those with the proclivity, and therefore can tailor interventions toward this means. For example, I was able to convince a psychiatrist to discontinue stimulant meds and convince the child to avoid marijuana due to a very psychotic testing profile with an absence of overt psychosis. I also suggested family therapy in lieu of her individual therapy to work on family communication. I could not diagnose her with a psychotic disorder, but I could clearly see the beginnings of psychotic processes in her mind. Perhaps the “biotypes” can offer us the same insight. However, I suspect you are correct in that it will become a simplistic manner of diagnosing with pharmaceutical, not therapeutic solutions.

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    • “However, psych testing, and perhaps this genetic research, can help identify those with the proclivity, and therefore can tailor interventions toward this means.”

      I think we know this is not how it will be used by most practitioners. It will primarily become an excuse for more drugging and, covertly, for more stigmatization about those with “brain illnesses”.

      Most psychiatrists are not as nuanced or non-concrete in their thinking about “disorders” as you appear to be; they swallow the myths about diagnoses being brain illnesses requiring drugging hook line and sinker. This majority of psychiatrists are the ones that Peter Gotzsche wrote about as being unable to safely and responsibly handle drugs, and they are ones of the reasons the use of psych drugs should be greatly curtailed.

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  3. This “breakthrough” in understanding “mental disorders” will proceed like the rest of them; it cannot be replicated over time and will slowly loose the spotlight as another angle is pursued. This is the problem with abandoning the scientific methodology of stating a hypothesis before research to prevent fishing for coincidences and unscientific correlations.

    It seems important to document this and the multitude of other potential “breakthroughs” in understanding “mental disorders” to establish an unending pattern of abandoned “breakthr0ughs” especially abandoned bio-markers. Jay Joseph has listed multiple failures to identify the pattern of failed promises but there should be a website for a collection of failed promises to identify the severity of the problem.

    Best wishes, Steve

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    • I wonder what will happen if and when psychiatrists run out of angles that will actually dupe the public into halfway believing in their validity. There should come some breaking point, after DSM diagnoses, after biotypes, as treatment and research continues to fail miserably to improve outcomes year after year after year… there should come some point at which the public will not accept it any more on a larger scale. The point when belief in the system begins to fade and more people opt out, as Charles Hugh Smith writes about on

      It is interesting to note that the third generations of antipsychotics is largely being abandoned by the drug companies because they cannot create any “improvement” over second generation antipsychotics, not that they were much better than first generation anyway. This is a covert admission by the drug companies that the biological treatment paradigm is a failure.

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    • Thanks Steve, for your comment and for pointing out a research methodology problem of fishing for coincidences and correlations. Yes, is this another breakthrough that will not sustain itself? Again, my concern is that Dr. Insel, who I think is probably a good poker player, risked a lot by betting this biotype diagnostic system can be defended by the powerful alliance of the NIMH, NAMI, psychiatry, pharma and the politicians who do their bidding.
      Best wishes, Michael

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    • Of course, you are right, but it will never deter the determined biopsychiatrist from wetting his pants about the next “great breakthrough.” In the end, psychiatry is so determinedly non-scientific in practice that actual failures to produce results over time seem to have not the slightest impact on the hope for the new Holy Grail to appear.

      Take ADHD and stimulants for an example: we now have 50 years of research trying to prove that giving kids stimulants over time improves their academic and social outcomes. No such evidence has ever emerged, despite some fairly biased attempts to infer it. Any real scientist would say, “Gosh, we’ve got 50 years and hundreds of studies that fail to find an effect. It sounds like there is no such effect.” But in psychiatry, all they’ll say is, “There is insufficient evidence to prove that ADHD children do better in the long term with stimulants, but we’ll keep working and we’re sure such evidence will emerge when enough studies are done.”

      Intellectual dishonesty lies at the core of the DSM-based psychiatric worldview. No amount of reasoning or scientific facts will dislodge their faith in their interventions. It’s more like a religion than a medical practice.

      —– Steve

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      • Right on Steve, and religions are based on beliefs that are deeply held personal values, that are really non-negotiable, fundamental, revealed truths. Revealed truths that the religion codifies into dogma.
        Psychiatry does something very similar when they claim their theory and applied practices are based on irrefutable scientific evidence. Like many of us here I’ve debated with many psychiatrists over the years about issues as you raise. like the efficacy of giving stimulants to children. Because of my alternative orientation they say I’m wrong because they have science on their side, much like a fundamentalist saying that about god.
        Even when I hold up research refuting them they say the research itself is compromised because I’m coming from a faulty belief system- because I don’t embrace bi0psychiatry. It’s like someone telling me I’m going to hell if I don’t accept Jesus.
        When I say they also have a belief system it gets very interesting.
        They say no, they don’t!
        Once again science is claimed to be a pure basis for their claiming what to them, has clearly been proven to be true.
        So, my trying to point out that we all operate from our belief systems is seen as proof that I just haven’t received the revealed truth.
        Best wishes, Michael

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  4. It appears that Dr. Mengele, excuse me, Dr. Insel and his cohorts put the cart before the horse in almost all their “experiments.” They start out with people whom they have already subjectively and unscientifically “diagnosed” and extrapolate from there. Or as the Queen of Hearts would say, “Sentence first! Verdict afterwards.”

    Is eugenics considered by current scientists to be a discredited field, or does it have currently “respected” proponents? (Serious question.) Because that’s what this is.

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    • Hi Oldhead, I think if eugenics is based on identifying types or groups of people who are somehow publicly shown to be very biologically or physically different from an arbitrary norm because of a heritable trait or condition, then I believe the disease model of human emotional suffering that psychiatry espouses, has always been tainted that way. We know that some diagnosed people are often called schizophrenics- “She’s a schizophrenic.”
      I wrote an article here on MIA called- “Does the psychiatric diagnosis process qualify as a degradation ceremony?” It explored the experience of a total identity re-assignment that happens via diagnosis. Won’t this new biotype system surely result in the common identity assignment parlance being used too, but with a more Orwellian twist- instead of “He’s a schizophrenic.” I imagine it will be-“He’s a type 1 or she’s a type 2.”
      Not- ‘”She has been diagnosed with type 2 psychosis” but- “She is a Type 2.”
      When humans start getting classified by biological types then it’s not a stretch to start ordering or ranking which types have more value and utility in society, and which types are less productive or pose a risk. Especially when even now for people labelled with certain DSM diagnoses of psychosis, we see they are being demonized as dangerous to society and our homeland security, and are believed to need laws to force psych drug treatment in their homes.
      Best wishes, Michael

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  5. In his article published in Scientific American, Dr. Insel writes:

    “If you are unfortunate enough to develop acute chest pain this winter you will probably be assessed by a clinician who will order a battery of tests to determine if your symptoms result from pneumonia, bronchitis, heart disease, or something else. These tests not only can yield a precise diagnosis, they ensure you will receive the appropriate treatment for your specific illness.
    If you are unfortunate enough to have a psychotic episode this winter, the process of arriving at a diagnosis will be quite different. In fact, there are not many choices. Most people with a psychotic disorder are labeled as having either schizophrenia or bipolar disorder…Sadly, there are no blood tests or scans to distinguish schizophrenia from bipolar disorder.”

    While there are no tests to determine a person experiencing a psychotic/manic state is suffering from either schizophrenia/bipolar disorder, there are many medical tests that will detect underlying medical conditions and yield a precise diagnosis, ensuring patients receive the appropriate treatment for the specific illness manifesting as symptoms of a “mental disorder”.

    Unfortunately, mental health professionals ignore the fact psychotic/manic symptoms are caused by many different underlying medical conditions/exposure to substances, including prescribed medications.

    Even a flu shot or the routine use of over-the-counter cold medicine can induce psychotic symptoms that are clinically indistinguishable from paranoid schizophrenia.

    The British Medical Journal created guidelines for doctors to follow as a best practice standard of care for individuals who present with psychotic symptoms.

    Because some individuals suffering from psychosis/mania are a threat to themselves or others, the failure to follow best practice assessment is not only cruel and unethical, it jeopardizes the health, safety and welfare of the public.

    Psychosis Due to a Medical Condition involve a surprisingly large number of different medical conditions, some of which include: brain tumors, cerebrovascular disease, Huntington’s disease, multiple sclerosis, Creitzfeld-Jakob disease, anti-NMDAR Encephalitis, herpes zoster-associated encephalitis, head trauma, infections such as neurosyphilis, epilepsy, auditory or visual nerve injury or impairment, deafness, migraine, endocrine disturbances, metabolic disturbances, vitamin B12 deficiency, a decrease in blood gases such as oxygen or carbon dioxide or imbalances in blood sugar levels, and autoimmune disorders with central nervous system involvement such as systemic lupus erythematosus have also been known to cause psychosis.

    A substance-induced psychotic disorder, by definition, is directly caused by the effects of drugs including alcohol, medications, and toxins. Psychotic symptoms can result from intoxication on alcohol, amphetamines (and related substances), cannabis (marijuana), cocaine, hallucinogens, inhalants, opioids, phencyclidine (PCP) and related substances, sedatives, hypnotics, anxiolytics, and other or unknown substances. Psychotic symptoms can also result from withdrawal from alcohol, sedatives, hypnotics, anxiolytics, and other or unknown substances.

    Some medications that may induce psychotic symptoms include anesthetics and analgesics, anticholinergic agents, anticonvulsants, antihistamines, antihypertensive and cardiovascular medications, antimicrobial medications, antiparkinsonian medications, chemotherapeutic agents, corticosteroids, gastrointestinal medications, muscle relaxants, nonsteroidal anti-inflammatory medications, other over-the-counter medications, antidepressant medications, neurleptic medications, antipsychotics, and disulfiram . Toxins that may induce psychotic symptoms include anticholinesterase, organophosphate insecticides, nerve gases, heavy metals, carbon monoxide, carbon dioxide, and volatile substances (such as fuel or paint).

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    • Just to throw a slight wrench into the works:

      These tests [for chest pain] not only can yield a precise diagnosis, they ensure you will receive the appropriate treatment for your specific illness.

      Just because they deal with actual diseases doesn’t make the AMA any less sinister than the APA. MD’s are primarily interested in suppressing the symptoms of diseases they fail to prevent or cure, some of which are actually the body’s own immune responses.. .

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    • Thank you, encephalopathycauses-smi, a much more thorough explanation of the many causes of “psychosis,” than my mere personal experience, mentioned below. Lots and lots of things cause “psychosis,” and the US medical community of today seemingly has “odd delusions” the only thing that causes “psychosis” is either “bipolar” or “schizophrenia.”

      No doubt, in part because old head is right, “Just because they deal with actual diseases doesn’t make the AMA any less sinister than the APA. MD’s are primarily interested in suppressing the symptoms of diseases they fail to prevent or cure.” Or iatrogenically create, I’ll add.

      I was dealing, not just with a medical cover up of the abuse of my child by my ex-religion, but also a medical cover up of a “bad fix” on a broken bone of mine, by my paranoid of a non-existent but potential malpractice suit PCP, since my PCP’s incompetent husband was the “attending physician” at the “bad fix.”

      A situation an ethical subsequent pastor told me was “the dirty little secret of the two original educated professions.” Shame on the paternalistic religions and the entire medical community for their trust in the psychiatric industry to cover up their child abuse crimes and easily recognized iatrogenesis, via the psychiatric industry’s well honed, albeit scientifically invalid stigmatization, defamation, discrediting, “psychosis” creating, torture and murder system.

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      • Psychosis is just a name, similar to saying that you have knee pain when you tell a doctor your knee hurts. They don’t know what it is, what causes it, what to do about it, or anything. Best not to say too much about it to them.

        The real question is, do YOU think you are sometimes paranoid? If you do, what do you think is behind that? Is it something you want to change? What can you do to get control of that process?

        Don’t let the doctors fool you. They have no more understanding of your situation than you do, and may in fact have less, because they are most likely brainwashed into thinking that your “condition” is a result of a “chemical imbalance in your brain” and to try to do everything they can to make it go away without ever bothering to figure out what is actually going on. Kind of like pain relievers for a broken leg. Not really going to address the problem, are they?

        —- Steve

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          • time33,

            My doctors called a dream query, odd thoughts caused by a synthetic opioid, and gut instincts “psychosis,” in her medical records. The psychiatric practitioners think everything is “psychosis,” so I wouldn’t place much import in such medical claims. And you do have a choice.

            The drugs may work for you in the short run, so you may believe it’s best to stay on them, which is your choice. But you can choose to wean from them, too. Just be wary, since the drugs can cause mind altering effects for many months, even years, after withdrawing from them. But there are many here who have withdrawn from the drugs successfully.

            And I agree with Steve, the doctors are less than knowledgable, many have actually been extremely deluded by the psychiatric industry’s silly little “chemical imbalance” theories and the pharmaceutical industry’s fraudulent research and misinformation. Best of luck on your healing journey.

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        • Kind of like pain relievers for a broken leg.

          That’s exactly what occurred to me just recently, don’t know why it took so long:

          Since much psychiatric drugging is justified based on the contention that there is demonstrable brain damage, shouldn’t the “medicines” developed to treat this work to help repair the observably damaged brain tissue, rather than altering the central nervous system to make those affected feel less concerned about it?

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      • I was against psychiatry many years, cause I was diagnosed as bipolar. Even though it was emotional wounds. Through therapy I almost cured myself. Till my mother came to my country and I had big argument with her. Later after that I saw a neighbor from my window. I pulled my head from window and I saw him in balcony. Thats it I become so paranoid cause of my neighbor, that it seemed I didnt have no privacy. My paranoia was so clinical that I couldnt escape it not using medications.

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          • Is it possible that after the fight with your mother you were self-conscious about whether other people were watching and listening to you arguing, which is why you became ultra-aware of your neighbor?

            “Paranoia” is technically supposed to describe an “irrational fear” — or one the shrink doesn’t comprehend, as what’s “irrational'” is subjective, i.e. a judgement call.

            Think some more about why you think you need a “diagnosis”; many people here are trying to shed their own.

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  6. Personally, reading the Scientific American article, reminded me of this NPR warning about “how bad health information ripples through the news:”

    As to Insel’s statement, “Psychotic disorders are among the most disabling conditions in all of medicine—with enormous costs in dollars and suffering for patients and their families.”

    As one who has actually dealt with “psychosis,” which I doubt Insel personally has. I’d like to question, and suggest we rethink, this type of fatalistic view on what the psychiatric practitioners call “psychosis.”

    Number 1.
    Initially a dream query of mine was claimed to be “psychosis.” I had asked a Christian psychologist what a dream about being “moved by the Holy Spirit” meant. Resulting in this dream query being interpreted, according to her medical records, into her belief that the Holy Spirit is a “voice,” proving “psychosis.” Dreams are not actually “voices,” nor “psychosis,” but doctors (at least one, whose actual goal was to profit off of covering up the abuse of my child, for her pastor and friends) have odd delusions dreams are “psychosis,” according to my medical records.

    Number 2.
    This resulted in a ‘bipolar’ misdiagnosis. Which led to numerous currently recommended ‘bipolar’ poly pharmacy drug cocktails, that actually caused “psychosis,” via poly pharmacy induced anticholinergic toxidrome, according to the actual medical evidence. I will say anticholinergic toxidrome induced “psychosis” is quite disgusting. I did get the “voices” of the people who raped my child and their pastor, who’d denied my other child a baptism on the morning of 9.11.2001, in my head. Incessantly bragging about their murder of their own first born child, their rape and spiritual abuse of my children, scheming ways to try to get me to kill myself, and when that didn’t work eventually scheming ways to try and get the pastor character to kill himself. You know, exactly the type of “psychosis” Insel claims is, “among the most disabling conditions in all of medicine—with enormous costs in dollars and suffering for patients and their families.”

    But, in reality, this type of ‘bipolar’ drug cocktail / anticholinergic toxidrome induced “psychosis” was really just very, very annoying, disgusting, and stupid. But it was not a “disabling condition.” And since the only difference between the central symptoms of anticholinergic toxidrome, and the positive symptoms of “schizophrenia,” is I was made “hyperactive” rather than “inactive” (albeit, I slept way too much, since that’s what the antipsychotics cause people to do). I coped with these appalling psychotomimetic “voices” by keeping copious calendar notes and extremely busy with other people doing lots and lots of volunteer work, because interacting with real people helped to keep the psychotomimetic “voices” at bay. And my neighbors / fellow volunteers did appreciate my extreme organization, and all the “hyperactive” work I did for the children in our local school system, and my friends did struggle to keep up. Who can be the most “super,” of the “hyperactive” “super moms”?

    Number 3.
    I was finally weaned off the appalling “bipolar” / anticholinergic toxidrome inducing drug cocktails. Which eventually resulted in a drug withdrawal induced “super sensitivity manic psychosis.” In my case, since I had had a “spiritual” dream initially misinterpreted and misdiagnosed as a “mental illness,” this resulted in a very “manic,” but quite amazing and serendipitous spiritual awakening to my dreams and spiritual journey, also called a “psychosis” by doctors.

    My point in explaining my personal experience with “psychosis,” which is actually, at least in part, quite similar to many people’s “psychosis” experiences, based upon my research (especially John Read’s findings / what I’ve read about the Hearing Voices groups). Is to point out that I’m quite certain today’s psychiatric industry really doesn’t understand much of anything about so called “psychosis.” Good God, they think dreams are “psychosis.” Not to mention they’re seemingly in complete denial that their “bipolar” drug cocktails are actually a recipe for how to create “psychosis,” via anticholinergic toxidrome. Which is not “bipolar,” thankfully, my current doctor is smart enough to understand my medical research. I hope the psychiatric industry wakes up soon, and changes their current “bipolar” drug cocktail recommendations.

    As to “Thoughts of ‘bio-behavioral’ measures and genomic variations have danced in the heads of researchers for decades, if not centuries, with no clinically useful results. Nonetheless, Insel’s approach provides the basis – if not for establishing a genetic and/or biomedical basis for psychosis – then at least for a ‘new and improved’ eugenically-tainted approach for the next decade, or longer. I hope I’m wrong but we may someday wish for the bad old days of the DSM.”

    I have not yet researched Insel’s newest “eugenically-tainted” theology, but am quite certain we should be looking more into psychiatric profiteering off child abuse cover ups, psycho / social issues, abuse, injustice as the root causes behind what psychiatrists claim to be “psychosis.” As well as the psychiatric drug induced “psychosis” reality.

    Especially, given Read’s research pointing out 2/3’s of all so called “schizophrenics” today are actually people who’d dealt with child abuse / ACEs issues being misdiagnosed as “psychosis.” Which, of course, results in a neuroleptic prescription. And the neuroleptics, alone, can result in “psychosis” via anticholinergic toxidrome, when wrongly given to a child abuse victim, rather than a person actually suffering from “psychosis.”

    I don’t claim the antipsychotics can’t benefit one who is actually suffering from “psychosis.” But they can create both the negative and positive symptoms of “schizophrenia” in a person wrongly prescribed them, via neuroleptic induced deficit syndrome and anticholinergic intoxication syndrome. And the psychiatrists are seemingly completely ignorant of this reality.

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  7. No matter how premature or inaccurate an “aberrant” brain (Rep. Tim Murphy’s word) theory may be, determined activists for coerced treatment use it to justify their cause. In 2004, “anosognosia” was estimated to affect 15% of people diagnosed with schizophrenia and bipolar disorder. Now, it’s said to affect 50%. Rep. Murphy, whose HR 2646 may be making headway through Congress, recently stretched the estimate even more in a radio interview in December.

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      • It is highly amusing that those people labeled “schizophrenic” who assert that they don’t have an illness are, as you say oldhead, demonstrating insight. They are in many cases rejecting the biological model.

        This is a supreme irony that makes those idiots in NAMI and E. Torrey Fuller look like a laughing stock. Those people who they think are the “sickest”, who cannot even realize that they are “ill”, are in fact more in touch with reality than those delusional “normal” people who judge them as lacking insight due to an illusory brain disease.

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  8. Great point oldhead! A great many people sharing here on MIA and on countless other forums are telling everyone that there came a day for them when they realized the disease model explanation wasn’t true or valid for them.
    But that day of insight isn’t counted by the powers that be as a day of personal liberation and celebration- no, it’s counted as a day when the person fell victim to the dreaded symptom, anosognosia. A person stops believing in the disease model and they believe that’s a personal victory- but the exact opposite attribution is often made by powerful caregivers and family members in their life. How crucial it is at that juncture that the person who stopped believing has support from others who also have stopped believing.
    Best wishes, Michael

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    • “But that day of insight isn’t counted by the powers that be as a day of personal liberation and celebration…”

      Michael, thanks for saying this. I encountered very disheartening cynicism pretty much all the way through, as I healed and found my grounding. Fortunately, many people witnessed my changes over the years, and cheered me on with only validation and encouragement. But it was eye-opening to witness the response of others, who were not so kind.

      I found there to be an insistence from some on conforming realities, and if not, here come the labels and projections. Diversity is what leads to marginalization in a stigma-oriented, discriminatory society. I find this to be such a tragic paradox that undermines the community at large a great deal in so many ways, and keeps it stuck in a downward spiral. We really need to honor that diversity, imo, otherwise we will never expand our potential as a society. At least that is within each of our control, how we respond to differences in others.

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    • For Dr. Shrinkenstein it is a personal defeat when his patients dare to take responsibility for their lives and recover. Not only is he cheated of the honor and worship he considers his due, but his wealthy, prestigious medical career is in danger of being questioned.

      Some of these quacks honestly consider themselves to be benevolent humanitarians of the people they damage. They’re insulted, but also amazed–perhaps hurt–at the ingratitude of people whose brains have been ruined through electroshock and chemical lobotomies they ordered.

      Can they really consider themselves impervious to the $800 an hour they earn from imposing these treatments on unwilling people? Are they really above desiring prestigious awards and other ego-boosters that go with the psychiatric territory? I don’t see any of them opting for humble lifestyles of voluntary poverty like St. Theresa of Calcutta.

      Talk about lack of insight!

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  9. Very important post and big thanks to the author and MIA for it. The ‘biotype marker’ concept is horrifying. Author rightly notes that things are bad when the DSM looks good by comparison.

    I only wanted to comment that the anti-psychiatry movement needs to push back harder against the mound of sand these arguments are built upon: that is, the ‘precision’ of conventional medical treatment.

    Insel rests his whole ‘Scientific American’ piece upon: “…probably be assessed by a clinician who will order a battery of tests to determine if your symptoms result from pneumonia, bronchitis, heart disease, or something else. These tests not only can yield a precise diagnosis, they ensure you will receive the appropriate treatment…”

    Usually these types of arguments trot out the diabetes trope, but this one went for lungs and heart. [By the way, Type 2 diabetes can indeed be reversed without drugs, and some clinicians have even seen Type 1 reversed. But I digress.]

    Anyone with a Grade 6 education can read the eye-bugging stats and facts on: Tests that fail, testing error, doctor error, medical error, hospital error, treatment error, accidental hospital death, misdiagnosis, misprescribing, overprescribing, drugs that kill, treatments that kill, and more. And Integrative health research regularly reveals where conventional medicine has completely misunderstood an issue or illness because of its narrow, compartmentalized, symptom-based view of the body. To Insel’s example of heart disease, we now understand that the conventional view of cholesterol has been entirely misunderstood.

    Sorting out the viral from bacterial (to Insel’s example of pneumonia versus bronchitis) alone has created a world so randomly overfed antibiotics that they are failing to function in the biological world. There is nothing ‘precise’ or beyond-a-doubt ‘appropriate’ at all about medicine. ‘Approximate’ and ‘hopeful’ are truer positive descriptors for medicine. Class-action lawsuits are being filed as we speak over antibiotics, multitudes of pharmaceuticals, and medical devices that have harmed and have nothing whatsoever to do with psychiatry.

    This is the ‘precision’ of medicine of Insel’s argument. Is this the kind of ‘precision’ we can look forward to from a shiny, brand-new field of ‘bio-psychiatry’? Yikes.

    Liz Sydney, [email protected]

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    • Right you are. Receiving medical care was found to be the third leading cause of death in the USA in an article published in the JAMA in around 2000 or so. The biggest cause was properly prescribed and properly administered medication (120,000 deaths a year). The idea that Good Medicine somehow magically leads to people getting better is delusional. The hard truth is, most of medicine is so corrupted by pharmaceutical and other money that you’re better off doing your own internet research and using alternative and folk medicine for most conditions, especially anything chronic.

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      • Don’t want to get overly tangential, but I’ve been giving more & more credence to the contention that cancer — if one defines the tumor as the cancer — is itself a last ditch immune reaction to chronic toxic overload and related stuff; and that unless it’s blocking a vital function, to remove it and then overwhelm the body with horrid chemicals and radiation at its most vulnerable point ever is likely a prescription for death.

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        • After the untimely death of one of my children’s teachers, I did read about a pharmaceutical cancer treatment that was tested short term to “cure” cancer, since it broke up tumors. But it was found to be that this cancer drug treatment did, long run, cause more deaths. Since breaking up the tumors, resulted in sprending the cancer throughout the body.

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          • It’s been suggested that the function of the tumor is to “wall off” toxins that have for whatever reason (probably toxic overload) failed to be eliminated by the body’s standard means. The case you mentioned could be an example of this.

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      • Hi Steve,

        As one who has had bad experiences with alternative folks, I would caution people on this board to against thinking they are the answer to most medical problems. By the way, I say this as someone who greatly distrusts conventional medicine also.

        My frustration with both sides is they have made it an either or situation. The issue for the best care is what is the remedy that will help the patient that is proven to work with the least amount of side effects.

        And if a nasty med is needed like an antibiotic, any medical professional who is not recommending that folks take probiotics ahead of time should be treated with extreme distrust in my opinion.

        And if anyone thinks I am being extreme, several years ago, I had a relative who had a c difficile infection that didn’t resolve until she was finally put on probiotics.

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      • I agree, Steve. I stopped using any kind of conventional medicine as healing support over a decade ago. I turned to all the alternative stuff years ago, and eventually just stuck to these practices and philosophies.

        Eventually, it led me to learn how I was my own guide and healer. The internet really does help in this regard, so much diverse information, it’s really a matter of what rings true to each of us, personally. I think healing anything–physical or otherwise–is ALWAYS a personal and subjective process which we learn as we go, that’s the nature of healing, to my mind–creative, unique, and in the moment.

        In this age of distrust and trauma from betrayal of our current medical system, I think it’s so powerful to consider that, perhaps, we are on our way to no longer needing an outside practitioner in order to heal; we can learn our own healing process and take full control of it. That’s more empowering than anything I can think of.

        There are ways to make the ground fertile for healing, and that would be about a community being open to new things and humble to the process of learning, we all have our learning curves. So once we learn how to support our natural self-healing mechanisms and process, then we can influence to community at large in the most positive way (even though it will squawk and squirm, because healing is change and change is not easy for most people). Still, change is inevitable and ever-present, so I think the best way to go is to embrace change. That’s my personal opinion, others are free to disagree of course. But it rings true to me.

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    • Thank you for these great points you make Liz. The fantasy of precision in medicine is that, a fantasy as you show, but it may be a more a compelling fantasy for psychiatrists. They may really long for psychiatry to be a medical specialty that ranks with cardiology in it’s perceived precision and diagnostic sophistication, as Dr. Insel dreams of.
      For 15 years in a public clinic, i shared a wall with a psychiatrist in the next room. He was a nice, friendly man who greeted me every morning. He wanted to help people as the practicing physician he had trained so long and hard to be. He believed in the biological and genetic causes of his patient’s suffering.
      I never referred any of my clients to him for meds. I never referred any of my clients to any of the other psychiatrists in the clinic either. He, like them- knew I was a dissident therapist. Sometimes he and the other docs would refer someone to me for therapy.
      Everyday the doctor in the room next to mine sat in his room with a DSM and a prescription pad and pen. All day long he wrote out prescriptions on the pad. For anxiety he used 2 or 3 drugs. For depression, 2 or 3. For psychosis 2 or 3. Sometimes he would order a blood test.
      That was it. A small room, a DSM, a prescription pad, a pen, 3 to 4 patients an hour.
      There are over 25,000 psychiatrists in the US and a I believe most of them spend their days like he did.
      How wonderful if that changed- if he and the rest could order bio-marker tests soon as Dr. Insel seems to promise is coming for them to do. Then would the psychiatrist in the next room be happier? Would this new era of bio-markers mean he was practicing precision medicine?
      I don’t think so. I think there still will be the small room, the DSM with the new 10 page biotype guide for psychosis, the prescription pad, and a pen. I think that’s the future because any way you cut it, first and foremost, the drugs still will need to be prescribed.
      Best wishes, Michael

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      • Michael, you might want to remind your psychiatrist friend that there is no evidence that poly pharmacy works, and to the contrary, it is known to be harmful. As I personally experienced with psych drug combinations already known to cause “psychosis,” via anticholinergic toxidrome. This article points out the lack of “evidence based medicine” behind poly pharmacy.

        And it is a tremendous shame the “bipolar” drug cocktails currently being recommended by today’s well respected hospitals, are also known to create “psychosis,” via anticholinergic intoxication syndrome. And this medically known toxidrome is not included in the DSM, thus creating a problem of “out of sight, out of mind,” for the entire psychiatric community.

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        • Not to mention, neuroleptic induced deficit syndrome should also be included in your psychiatrist friend’s “bible,” since the neuroleptics alone are also known to cause the negative symptoms of “schizophrenia,” and these are also frequently misdiagnosed by psychiatrists. Likely also since this known neuroleptic induced syndrome is also not in the DSM, resulting in an “out of sight, out of mind” problem for all the psychiatrists.

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        • Thanks for writing Someone Else and for sharing that damning and truthful information about the dangers of medications. I worked at that clinic 9 years ago and while there I frequently shared such information with all the doctors about the risks and dangers of meds and how helping people without meds as I did every day was possible. Then as now, such warnings that I repeated were ignored. They usually responded by saying that they had been trained to believe that brain imaging tests could show that psychosis damages the brain, so they were required to stop such damage with meds.
          Psychiatry has become a morally bankrupt and failed social institution in my opinion because of such gross negligence and the enormous harm done through the wholesale use of harmful meds- now even on toddlers under three years old.
          Best wishes, Michael

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          • Ultimately the difference between a long term sick person and a longterm recovered person is about $2.5 million hard earned taxpayer dollars.

            I have been psychiatrically disabled and psychothereupticallyrecovered. All the the guys did was ask me what I had problems with, and then offered me help – and this cost very little.

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          • They usually responded by saying that they had been trained to believe that brain imaging tests could show that psychosis damages the brain, so they were required to stop such damage with meds.

            OK. So why would they treat objectively demonstrable brain damage with drugs that basically play with the central nervous system to stifle or distort one’s perception of the problem? Are bronchitis or sepsis treated with painkillers?

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          • But the brain is constantly reacting to stimulI which means brain scans would result in random responses and be almost impossible to duplicate. As for the damage, we are constantly ingesting, inhaling, bathing in etc chemicals. There is absolutely no way to say with any certainty that what they’re seeing is damage due to mental illness. Plus, what mental illness? The DSM clearly separates them, they can’t all be the same damage in the same area… I really need some science in my psychiatry…

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  10. So basically, antipsychotics are the most profitable medication on the market. If you magically create more “psychotic” people, you make more money. That is the whole theory in a nutshell, isn’t it? You kn ow what I would like to see? As much research going into the treatment as is going into how to raise the profit margin on the drugs they are pushing as an answer.

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