Allen Frances on Anti-Psychiatry

Philip Hickey, PhD
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On February 22, Allen Frances, MD, published an article titled Psychiatry and Anti-Psychiatry on the HuffPost Blog.  The general theme of the article is that psychiatry may have some problems, but it is basically sound, wholesome, and necessary.

Here are some quotes, interspersed with my comments:

“Psychiatry used to be a biopsychosocial profession that allowed time to get to know the person, not just treat the symptom. But drastic cuts in the funding of mental health services have dramatically reduced the quality of the service they can provide. Psychiatrists are now forced to follow very large panels of patients. Most of the limited time they are allowed with each is spent discussing symptoms, adjusting the meds, and determining side effects. Little time is left to forge a healing relationship, provide support, and teach skills through psychotherapy. And patients usually get to a psychiatrist- if at all- as a last resort, only after other things have failed- and with the expectation by the patient and referral source that the main purpose of the visit is just to prescribe medication.”

The impression being conveyed here is that psychiatry’s abandonment of a biopsychosocial approach and embracing of the brief med-check was the result of “drastic cuts in the funding of the mental health services.”  This is very misleading, in that psychiatry’s interest in, and enthusiasm for, psychosocial concepts was largely confined to the psychoanalysts, the great majority of whom worked in private practice, and were paid directly by their clients. There was some acceptance of psychoanalytic concepts in the asylums, but for the most part psychiatrists working in those facilities had always shown a marked propensity for biological “cures,” and enormous creativity in the development of these “treatments,” which included:  fever therapy; insulin coma; rotational therapy; hydrotherapy; mesmerism; malaria therapy; chemically induced seizures; lobotomy; high voltage electric shocks to the brain; etc.

It is also worth noting that when Thorazine was introduced to American psychiatry in the early 1950’s, the psychoanalysts objected strenuously, but their objections were swept aside by the enthusiasm of their colleagues.  By about 1965, the bio-bio-bio approach dominated psychiatry, but it was not forced on psychiatry.  Rather, it was embraced avidly, and for two self-centered reasons:  firstly, it provided misplaced credibility and prestige for psychiatrists, who could now claim to be real doctors, treating real illnesses with real medications; and secondly, because it enabled psychiatrists to make a great deal more money than was possible providing psychotherapy.

The contention that psychiatrists “are now forced to follow very large panels of patients” is not only false, it is absurd.  The notion that tens of thousands of psychiatrists in the US would really like to be practicing psychotherapy, where they could forge “healing relationships,” “provide support,” and “teach skills,” but are frustrated in these desires and “forced” to trudge endlessly the tiresome treadmill of the 15-minute med check is pure fiction.  Heartrending, but still fiction.  The fact is that psychiatry set its own course when it jumped enthusiastically on the pharma bandwagon, and apart, from a miniscule minority who remained aloof from the drug-pushing, has made no attempt to alight.

. . . . . 

“Psychiatrists didn’t invent this system, but they have to live within it (except for those whose patients can pay out of pocket for much more personalized care).”

Actually, psychiatrists did invent this system.  They pursued the pharma money shamelessly, embraced and pushed pharma’s products, conducted the fraudulent research, drafted the treatment guidelines, invented “diagnoses” to justify the administration of the drugs, and pocketed the money.  If, as Dr. Frances contends, this was all “forced” on psychiatrists, then it has to be acknowledged that the victims of this coercion have put an extremely good face on the matter, and have borne the yoke of their servitude with unstinting courage and valor.

. . . . .

“Another important factor in treatment failure is that most ‘psychiatry’ is not done by psychiatrists. Primary care doctors prescribe 90% of benzodiazepines; 80% of antidepressants; 60% of stimulants; and 50% of antipsychotics. Some are great at it, but most have too little time and too little training and are too subject to sales pitches from drug salesmen. Psychiatrists are clearly responsible for some of the harm done by excess medication, but the bigger problem by far is rushed primary care doctors, prescribing the wrong meds, to patients who often don’t need them. Misleading drug company marketing increases inappropriate prescription by convincing both doctor and patient that there is a pill for every problem.”

The blame-it-on-the-poorly-trained-and-naïve GPs has become a common theme among psychiatry’s elite in recent years.  But it is seldom acknowledged that not a single one of these prescriptions could be written if psychiatrists hadn’t invented the “illnesses” for which they are prescribed.

Note also how Dr. Frances deftly moves the blame to “misleading drug company marketing.”  And indeed, a great deal of pharmaceutical marketing in this field has been misleading – actually to the point of blatant falsehood.  But it is also the case that psychiatrists – including eminent and prestigious psychiatrists, the “thought-leaders” of the profession – have been hand-in-glove with pharma in this process.  Remember the conference jamborees where “CEU’s” were awarded to psychiatrists for listening to one of their colleagues present a pharma infomercial?  Remember the not-so-distant days when psychiatric associations (including the APA) ran misleading pharma ads in their own journals?

And note the blaming of GP’s for “prescribing the wrong meds to patients who often don’t need them.”  This is truly exquisite spin.  Psychiatry creates a  “diagnostic system” called the DSM, the essential message of which is that every significant problem of thinking, feeling, and/or behaving is a medical illness.  The DSM provides simplistic lists of “symptoms” to enable any practitioner who can read to make – and more importantly to justify – any of these hundreds of “diagnoses.”  And in addition, the psychiatric researchers (and I use the term loosely) fill reams of journal pages with “research” proving the effectiveness of the spurious drug companies’ products in the “treatment” of these so-called illnesses.  But now here comes the very eminent Dr. Frances castigating these GP’s for believing, what has been the central pillar of psychiatric “treatment” for at least 50 years:  that there is a pill for every problem, that these pills correct chemical imbalances in the brain, and in many cases, need to be taken for life.

Pharma-psychiatry’s bogus hype has been so successful in fact that a conscientious GP, who failed to prescribe a drug for a significant problem of thinking, feeling, and/or behaving, could conceivably find himself defending a malpractice suit, if his refusal to prescribe was followed by a serious adverse event.

Portraying psychiatry as the helpless innocent spectator in this scenario is not consistent with the facts.

. . . . . 

“Psychologists criticize psychiatry for its reliance on a medical model, its terminology, its bio-reductionism, and its excessive use of medication. All of these are legitimate concerns, but psychologists often go equally overboard in the exact opposite direction- espousing an extreme psychosocial reductionism that denies any biological causation or any role for medication, even in the treatment of people with severe mental illness. Psychologists tend to treat milder problems, for which a narrow psychosocial approach makes perfect sense and meds are unnecessary. Their error is to generalize from their experience with the almost well to the needs of the really sick. For people with severe mental illness- eg chronic schizophrenia or bipolar disorder- a broad biopsychosocial model is necessary to understand etiology- and medication is usually necessary as part of treatment. Biological reductionism and psychosocial reductionism are at perpetual war with one another and also with simple common sense.”

Some psychologists do indeed criticize psychiatry for its reliance on an inappropriate medical model and its bio-reductionism.  But, at least in my estimation, most psychologists do not.  On the contrary, most psychologists, and I say this with a measure of professional embarrassment, have bought the psychiatric agenda lock, stock, and barrel.  In some states they are legally authorized to prescribe psychotropic drugs, and they continue to lobby for this in other jurisdictions.  The American Psychological Association has even published a list of “practice guidelines” for this activity.

Dr. Frances’s contention that psychologists “go…overboard” with what he calls “psychosocial reductionism” in the same way that psychiatrists do with bio-reductionism has a nice ring of fairness and equability.  But it misses the point.  There is no argument among psychologists, or any other group, that brain injuries and malfunctions can have an adverse effect on a person’s thinking, feeling, and behaving.  Where psychiatry has gone wrong is in making the spurious leap from this obvious reality to the false conclusion that all problems of thinking, feeling, and /or behaving are caused by brain malfunctions.

When those of us on this side of the debate contend, for instance, that depression is caused by depressing events or depressing life circumstances, this is not some kind of distortive reductionism.  It is simply the most parsimonious way of looking at the matter.  To assume, without evidence, a neurological etiology in all such cases isn’t just blind doctrinaire reductionism, it is frankly inane, particularly in that no biological etiology has ever been discovered, despite psychiatry’s fraudulent claims to the contrary, and despite decades of highly-motivated, and lavishly funded, research.

Dr. Frances then attempts to score cheap points by undermining the credibility of psychologists.  They “tend to treat milder problems”; they haven’t worked with the “really sick”; their work is with the “almost well.”  The implication being that only psychiatrists can understand the problems of “people with severe mental illness…schizophrenia or bipolar disorder.”  In working with the latter individuals, Dr. Frances tells us that “a broad biopsychosocial model is necessary to understand etiology …”  The implication here is that psychiatrists understand the biological etiology in those individuals that they label schizophrenic and bipolar.  In reality, no such biological etiology has ever been discovered.

. . . . . 

“The most important and troubling attacks on psychiatry come from people who feel harmed by it. It has been surprising to me that my many forceful critiques of psychiatry have met so little criticism from psychiatrists, while my much less frequent and muted defenses of psychiatry have drawn such flak from dissatisfied patients. Whenever I twitter or blog anything suggesting that psychiatric treatment is valuable for some people but not others, I receive a flurry of angry responses declaring it is totally harmful for everyone.”

Well, Dr. Frances should not be surprised by this at all.  His criticisms of psychiatry have always been of the excessive-drugging-is-bad, or drugging-people-who-don’t-need- it-is-bad.  Criticisms of this sort are the injunctive equivalent of tautologies.  They are always valid, and for that reason, are empty and void.

For instance, although I know next to nothing about bridge engineering, I can say authoritatively and without the slightest fear of contradiction, that excessive measurement tolerance in the construction of box-girders is a bad thing; or that the use of steel rivets in situations in which they are inappropriate is a bad thing.  The point is that words like excessive and inappropriate already contain within themselves the value judgment, and the statements amount to nothing more than pious platitudes.  In effect, all that Dr. Frances is saying is that bad things are bad, the appropriate modern response to which is:  “Duh!”  His psychiatrist readers feel no threat from this kind of “criticism,” precisely because there is none.

. . . . . 

“Typically, they [dissatisfied patients] have had a disastrous experience with psychiatric medication that was prescribed in too high a dose and/or for too long and/or in odd combinations and/or for a faulty indication. They are angry for a perfectly understandable reason- meds made them worse & going off meds made them better. Their natural conclusion is that medicine is bad stuff- for everyone.”

These are the kind of injunctive tautologies that I discussed above.  Perfect examples, actually.

. . . . .

“The shameful coercion today is the criminalization of mental illness and being forced to live in dungeons.”

This is nice rhetoric, but it’s false.  In the US, and I believe in all western democracies, people get sent to jail and prison for committing crimes.  Whether or not an accused individual carries a stigmatizing psychiatric label is a secondary matter, and is usually adduced by his defense, and accepted by the bench, as a mitigating factor.

. . . . . 

“People with psychiatric problems who used to be coerced in state mental hospitals now suffer the much worse coercion of extended jail time (about 350,000)…”

Dr. Frances apparently considers this number excessive, but if we remember that, according to psychiatry’s own much-touted figures, one-fifth of the population at large have a diagnosable “mental illness” in any given year, it is clear that these individuals are underrepresented in prison and jails.  One-fifth of 2.2 million (the number of people incarcerated in the US) is 440,000.  This is particularly striking in that several psychiatric “diagnoses” are heavily weighted with blatantly criminal activity (e.g., conduct disorder, antisocial personality disorder, intermittent explosive disorder), which should have the effect of skewing the numbers in the opposite direction.

It is also highly questionable whether the coercion experienced in jails and prisons is “much worse” than that in the state mental hospitals.

. . . . . 

“The Psychiatry/Antipsychiatry rift has had a devastating effect on the lives of people with severe psychiatric problems. For them, this is the worst of times and the worst of places – the lack of effective advocacy has many of them shamefully neglected in prison dungeons or living on the street. The wrong battle lines have been drawn. We should all be fighting together so that our most vulnerable citizens will have access to a decent place to live and to humane and comprehensive care.”

Note the beautiful spin:  people with “severe psychiatric problems” are experiencing great difficulties because of:  the lack of effective advocacy, and the Psychiatry-Antipsychiatry rift.  If those of us on this side of the issue would just stop being so obtuse; if we would just be reasonable and accommodating (like, e.g., Dr. Frances); if we would just get on board and stop challenging psychiatry, and pull together; then our “most vulnerable citizens” will have decent homes, and will receive humane and comprehensive care.

Why, oh why, dear readers, are we not convinced by the logical and conciliatory tone of Dr. Frances’s compassionate pleas?  Why do we, in the manner of stubborn children, reject the wisdom and assertions of those who know better than we do?  Why do we remain so willfully blind to the “patient-centered and humanistic” quality of psychiatry, and to its unstinting devotion to the welfare and care of “our most vulnerable citizens”?

And the answer is clear:  because psychiatry is not something good that needs minor corrections.  Rather, it is something fundamentally flawed and rotten, based irretrievably on spurious premises, and, in its practices, destructive, disempowering, and stigmatizing.  No amount of rhetoric or spin can alter these realities, in the creation of which, Dr. Frances himself has been, and continues to be, a major player.

54 COMMENTS

  1. I am making notes about this in my Word file as I read it, to add a little to the dialogue…

    In saying “have dramatically reduced the quality of the service the can provide”… Frances is implying that there was a past time when mental health services provided high quality help. This is completely unevidenced. For decades now, psychiatrists have mainly taken a diagnose and drug approach where people are rarely able to access intensive family or individual psychological help if they want it. I’d say the halcyon days that Janus (Frances) imagines never existed…

    Hickey is correct that depth intervention in American psychiatry was mainly confined to its psychoanalytic wing working with outpatients privately in the 1950/60s/70s especially. This help was not available to most people.

    The bio-bio-bio approach was adopted primarily for monetary reasons; psychiatrists could make 3x as much by seeing clients for 15 minutes at a time, making an arbitrary diagnosis, and lazily prescribing pills that don’t treat any known illness. That is what psychiatrists do.

    As Whitaker documents in Psychiary Under the Influence, leading psychiatrists and the APA very intentionally directed psychiatry as a profession toward the disease-model approach. They did invent this system; although part of the blame must go to the drug companies, and a smaller part of the responsibility to everyday Americans who are far too willing to believe what doctors tell them and far too eager to take a pill to “solve” their problems.

    Regarding primary care doctors, this problem will not go away so long as America is dominated by corporate advertising directly to doctors. This is one of the worst and most harmful things ever allowed in an advanced nation… and America is one of two nations that does it along with New Zealand.

    It’s funny to hear Frances say “prescribing the wrong meds”… there are no wrong or right meds. All psychiatric drugs do is limit a person’s ability to feel/think be exerting a generalized effect on the CNS… they never treat any specific illness. It’s always guesswork with these drugs and most people will be harmed or helped little if at all.

    To Phil, you should stop calling these people “very eminent”… they are not. Janus (my name for the two-faced Dr. Frances) is not eminent. Would you call a leading astrologist eminent? No… so don’t elevate these people. They are charlatans.

    It is amazing to hear Frances say that psychologists “deny any biological causation”… when no biological cause of any so-called DSM disorder has ever been proven, including with people labeled schizophrenic or bipolar. This is essentially a fabrication on Frances’ part. He is referring to evidence that is not there. We should call him out on this more publicly in every online forum possible. In fact I think I will go to the HuffPo forum and do so now.

    I see now that Phil made the exact same arguments that I just have… great minds think alike.

    It is interesting to note how Frances writes in a tautological,“e.g. excessive drugging is bad” that is hard to attack or pin down, but on the other hand is essentially meaningless and nonspecific. They are empty platititudes. Duh is right.

    It is amazing rereading all these statements from Janus to think how simplistic his thinking really is. It is like reading statements from a 4th or 5th grader…

    Haha it’s so funny to read the words intermittent explosive disorder. I can’t believe that term exists. What idiot believes in that…

    Phil’s ending is exactly right. Janus was complicit in creating the DSM 4 and expanding medicalization, and he is still nothing more than a Trojan horse. We should redouble our efforts and speak out in every possible forum against psychiatric diagnosing and treatment, as well as lobbying/supporting antipsychiatry initiatives legally and policy wise.

  2. Bravo Phil Hickey! Please, please keep saying these things. Allen Frances clearly means to save psychiatry with his faux “criticisms”. In the face of the Inquisition, he would have been an advocate for better methods of torture and more accurate identification of witches and non-believers. And (dare I say it?) in the face of the Final Solution, he might only have asked for better documentation of geneology.

      • What I find interesting is the way Frances and Ron Pies keep setting themselves up to be demolished every time. Both seem to either have very bad memories or believe that everyone who disagrees with them is stupid, blind and illiterate. Both are wolves who seem to think that everyone around them is Red Riding Hood. I’m confused, do they really believe their BS, do they really think we can’t possibly recognise the lies they tell? Do they perhaps believe they’re invincible, untouchable, free to lie and dissemble at will? Do they really think an MD and a public persona of earnest goodwill will get them over the line forever?

  3. Thanks, as always, for speaking the truth, Dr. Hickey. And I will agree, “most psychologists, and I say this with a measure of professional embarrassment, have bought the psychiatric agenda lock, stock, and barrel.” I found this to be true in my case, since it was a psychologist, who I paid outside my health insurance group for a second opinion. Who DSM-IV-TR misdiagnosed the common symptoms of antidepressant discontinuation syndrome, worsened by the common adverse, mind altering effects of a “dirty” opioid and a NSAI, as “bipolar.” And I found psychologists buying into the DSM stigmatization system to be the case, also, when I was volunteering with a psychologist friend. And she wanted to cover up the fact that a child she and I were volunteering to help, was on a psychiatric drug cocktail with major drug interactions. She blamed all his problems on his DSM diagnosis instead.

    And, as one who was diagnosed with one of the “serious mental illnesses,” I do have some insight into them, and the recommended treatments of them. As to, “The implication being that only psychiatrists can understand the problems of ‘people with severe mental illness…schizophrenia or bipolar disorder.’ In working with the latter individuals, Dr. Frances tells us that ‘a broad biopsychosocial model is necessary to understand etiology …’ The implication here is that psychiatrists understand the biological etiology in those individuals that they label schizophrenic and bipolar. In reality, no such biological etiology has ever been discovered.”

    In my case, as mentioned, the etiology of my “bipolar” was a misdiagnosis, according to the DSM-IV-TR, of the adverse and withdrawal effects of an antidepressant, opioid, and a NSAI. And the psychiatric “professional” treatment for these adverse drug effects / “bipolar” was to put me on drug cocktail after drug cocktail, all of which were medically known to create “psychosis,” via anticholinergic toxidrome. Since today’s psychiatric “gold standard” treatment recommendations for “bipolar” – which include combining the antipsychotics, antidepressants, and benzos – is actually a recipe for how to create “psychosis” via anticholinergic toxidrome.

    Did all the psychiatrists, collectively, sleep through the day they taught about anticholinergic toxidrome in medical school? Or do you know why today’s psychiatric “gold standard” treatment recommendations for treating “bipolar” are a recipe for how to make a person “mad as a hatter,” via anticholinergic toxidrome poisoning?

    I’m quite certain “people with ‘severe psychiatric problems’ are experiencing great difficulties because of” the lack of wisdom behind, and lack of insight into, the psychiatric industries’ recommended drug treatment regimes, more than any other reason. Especially since the neuroleptics alone can create both the negative (via neuroleptic induced deficit syndrome) and positive (via anticholinergic toxidrome) symptoms of “schizophrenia,” all by themselves. But the psychiatrists believe these “torture” drugs, are “wonder drugs.”

    And I absolutely agree, “psychiatry is not something good that needs minor corrections. Rather, it is something fundamentally flawed and rotten, based irretrievably on spurious premises, and, in its practices, destructive, disempowering, and stigmatizing. No amount of rhetoric or spin can alter these realities….” No doubt, the reality is too difficult for Dr. Frances to admit to. We politely call this “cognitive dissidence,” despite the fact the psychiatrists stigmatize those who disagree with them as “delusional.”

    • “Someone Else”, above, speaks MY truth more eloquently than I could express it in words.
      The details differ, but the basic story line is the SAME. Thank-you, “Someone Else”.
      Let’s agree that the pseudoscience lies of the drug racket known as “biopsychiatry” are better described as “Mass Psychogenic Delusion”? Keep up the GOOD WORK, people!
      HUGS are STILL BETTER than DRUGS. Especially psych drugs…..

      • You are far more correct than you seem to allow yourself to admit in public, Dr. Philip Hickey, PhD. (I’m being respectfully formal here) Anyway, to the point of your comment, there is FAR MORE IATROGENIC NEUROLEPSIS than anybody realizes.
        Look back to the 1950’s-60’s, with Thorazine. What was the state of knowledge of neuro-anatomy, neuro-chemistry, and neuro-biology back then? Nowhere what it is today, right? But what of the psych drugs? Not that much different. (Yes, there’s “SSRI’s”, and all the so-called “atypicals”, &etc., but again, that’s not exactly what I’m getting at here….) Regardless of what new drug is developed, the human brain still functions the same way. But, we need to look at true “evidence bases”, and true “outcomes”. I’ve been back in my hometown almost 30 years. I’ve seen MANY people cycled through the local “community mental health center”. There is NO doubt in my mind, that long-term use of psych drugs ALWAYS results in poor outcomes. More drugs, higher doses, longer time-on-drugs, ALWAYS does more harm than good. Yes, sometimes, some people DO do better – or at least *seem* to do better – on SOME drugs, for some short length of time. But that’s not what Pharma & biospychiatry do, is it? That’s not what make$ the mo$t MONEY. And, what protocol is there, for addressing those who were mis-diagnosed, and mis-drugged? The “evidence base” for use of psych drugs looks like a grade-school level pamphlet, when it should be a college textbook. Considering the many 100’s of BILLION$ wasted on psych drugs and Pharma, we have gotten VERY poor results. And, too many lives lost.
        I can think of several folks I know, who are walking, talking, barely functional DRUG ZOMBIES, from decades of psych drugs. Not trying to be nasty, but TRUTH is TRUTH, and FACTS are FACTS. Nobody can point to “psychiatry’s success stories”, because there are NONE! I’m willing to go farther than you are, Dr. Philip Hickey, PhD, but please accept my profound respect for the fact that you’re willing to go as far as you are, in exposing this “distributed holocaust”, to coin a neologism….(BTW, I’ve seen “psychiatric genocide” cited as early as the 1990’s….) Keep up the GOOD WORK….

  4. Frances just needs to stop and stop now. He was in cahoots with Johnson and Johnson, which Paula Kaplan documents so very well. Why he hasn’t been called to account for this makes me really wonder. And now, here he is trying to act like he’s some kind of hero, but he speaks out of both sides of his mouth.

  5. It is rewarding to me – very – to come on the Mad in America blog this week to see both Bob Whitaker and Phil Hickey holding the Kings of Psychiatry’s collective feet to the fire. While these kings may twist and turn with their spinning words, the patient logic of both Whitaker and Hickey applied against these same words represents the steady progress we need to eliminate their false (and so often devastating, if not fatal) practices and replace them with methods that are both humane and that don’t depend on a profit motive as their reason for being.

  6. Sure wish I had known about the Huff Post piece while it was still current. When people see stuff like this they should email Justin or Kermit about putting it in Around the Web or In the News so we can respond real time.

    So the fact that Frances continues to attack “anti-psychiatry” in print is the big news here I think. It means that our internal discussions about this have paid off, as Frances et al. are so unsettled by the term that they are giving anti-psychiatry more free and widespread publicity than we are currently organized enough to muster on our own.

    Typically, they [dissatisfied patients] have had a disastrous experience with psychiatric medication that was prescribed in too high a dose and/or for too long and/or in odd combinations and/or for a faulty indication. They are angry for a perfectly understandable reason- meds made them worse & going off meds made them better. Their natural conclusion is that medicine is bad stuff- for everyone.

    What an ignorant pompous asshole!

    What Frances has just revealed is his underlying contempt for all “survivors,” y’all. He has just reduced your anti-psychiatry analyses to cases of impulsive emotionalism. No matter that many of us here can, have and continue to precisely deconstruct the myths of psychiatry and “mental illness” in our sleep and can run logical circles around all of his pseudo-scientific, pseudo-medical babble.

  7. Terrific post. I had commented under the Allen Frances Huff Post article when it was current. The argument he makes is typical of some aspects of his thinking. He’s calling both bio-bio-bio, that is, biological reductionist, and psycho-social approaches, something he also sees as reductive, extremist. The last thing in the world these guys are ever going to do is to pay attention to the evidence rather than their own biases. The question is not whether it is biological, or psycho-social, or a little of both. The question is, given an impartial test, what would the science say. To say that it is biological, or psycho-social, or a little of both, is to draw a conclusion before you have all the facts. Once you have the facts, then you make a determination.The assumption today is that there has to be a biological basis to mental illness so-called because a biological basis supports all the medical school education that psychiatrists receive. Seeing biology in “mental disorders” is sort of fundamental to the profession. It justifies the whole business of seeing psycho-active substances, substances that otherwise damage the brain and body, as somehow medicinal. That a biological basis would help prop up their roles as medical doctors there can be little doubt. That there is, in each and every case, a biological basis, doesn’t even make legitimate sense, especially without evidence. There is, I would think, nothing extreme about basing your conclusion on the evidence rather than drawing the conclusion before you have the evidence. This conclusion drawn prior to research, that is, that leads to research conducted without an open mind, I call bias. Psycho-social, in itself, is no more extreme than biological, biological though, with or without psycho-social elements, props up the psychiatric profession in a way that the psycho-social doesn’t, thus it must be indispensable, and thus psychiatry can’t dispense with the biological when it finds a psycho-social causality. Pretty basic, isn’t it? Pretty scientific, it is not.

  8. Scary article that Allen wrote. To a general lay member of the public without this experience, this would be persuasive, I think.

    This paragraph from it really caught my attention:

    “Dissatisfied patients portray psychiatrists as power hungry bullies trying to control their lives and ply them with poisons. In contrast, psychiatrists often experience themselves as powerless cogs in an inadequately funded and disorganized mental health nonsystem, trying to do their best, under very difficult circumstances, to improve the lot of people suffering from terribly painful symptoms and terrible life circumstances.”

    First of all, yes, this is actually how I would categorize all of my treatment teams that led me straight to catastrophic illness and disability and gravely interrupted my life, from which I had to go to great and very creative lengths to heal.

    And then, he describes THEMSELVES as victims of the “non-system” system, while we who were seriously victimized are blowing hot delusional air. Yeah, right.

    At the end there, he sounds exactly like a knight in white shining armor, saving all those poor suffering people. Pure martyr.

    I’m afraid he’s invalidated my voice and story, that would be exactly his response to my experience, as it has been to other naysayers. Hmmm, what would be worth my while, here, then? I’m casting pearls before swine when I share my experience, and the response is unequivocal stigma. What would be the point of repeating that over and over again?

  9. I’m gonna call you Dr. Hickey, and the other guy “Frances”. OK, everybody else here calls you “Phil”, and that’s fine. But you, Dr. Hickey, write exactly what I WANT to say, but CAN’T. The only “illness” I “suffer” from, is iatrogenic stigma, and iatrogenic neurolepsis. After just over 20 years shrink-proof, and psych-DRUG free, I’m feeling better than ever! Gee, Frances, where did my imaginary “mental illness” go? What happened to all those quack shrinks who told me, from 1975 – 1995, that I had a “mental illness”, and would need these “meds” the REST OF MY LIFE? What explains the FACT that the longer I stay away from the pseudoscience lies of the drug racket known as “biopsychiatry”, the BETTER I FEEL? Today, I’m more whole, healthy, and happy than I was when I was in my 20’s, and TRULY SUFFERING from an iatrogenic pharaceutical disorder? Maybe, just maybe, some low dose of some “med” MIGHT have actually helped me back then, but that’s NOT what happened. From my first trip to that HELL HOLE State loony-bin in 1977, to the last time I required hospitalization in 1994, the worst of my sufferings were caused by the psych drugs. Thorazine. Mellaril. Navane. Cogentin. Imipramine. Triavil. Tofranil. Haldol. Depakote. Trazodone. There’s 2 or 3 dozen more, besides. Literally. That’s the legacy of people like Frances.
    I read Dr. Peter Breggins’ “Toxic Psychiatry” in the early 1990’s, and it literally saved my life. To the extent that I was at all “suicidal”, it was only to end the suffering inflicted on me by the DRUGS that I only *thought* I needed. As other commenters here have noted, some people still believe the lies that Frances spouts. But I prefer the TRUTH of Dr. Hickey. Dr. hickey, you say it better than I do. I know you care about us, Dr. Hickey, in a way that Frances doesn’t. Please accept my profound gratitude, and continued encouragement, Dr. Hickey. It’s getting hard to type. My eyes are filled with tears. What I’ve learned since I got away from the lies of Frances is that my tears are washing away the pain, and they are a part of my healing. And, yes, I cry for my friends who died too young – too soon – from the lies of Frances. What can I do to help you, Dr. Hickey?
    ______
    That’s MY TRUTH…..
    (HuffPo has become the go-to source for Frances style PROPAGANDA……I avoid HuffPo like the plague that it is. I’m not really angry, but I am madinamerica *GRIN /~Bradford

  10. *Did anybody else notice that ALL the comments to Frances little HuffPo hissy-fit were basically in agreement, and ANTI-psychiatry….????….
    And, it would take a fair amount of statistic-digging, but MOST of Frances claims as to funding, and #of persons incarcerated, etc., *could**be* ascertained…. I can’t cite statistics off the top of my head, – obviously – but my gut feeling tells me that much of Frances claims about “mental health funding” are BOGUS…. The pseudo-science of biopsychiatry seems to me, to be the largest single, global-scale FINANCIAL FRAUD, and DRUG RACKET, ever…. BTW, considering how widely (supposedly), HuffPo is read, you’d think at least ONE comment would support Frances!…. ~Bradford.

    • Forgot to add: As for Frances “facts” about #of persons incarcerated, how many of them are in private, for-profit facilities run by either CCA, or GEO? Look into the financials for those 2 Corps., and I believe a case could easily be made, that private, for-profit “facilities”, including prisons, are in fact filled with so-called “mental patients”…. Maybe it’s the shrinks-office-to-prison-for-profit-pipeline?….Statistics *could* prove me wrong – or CORRECT….

  11. As other commenters have described, I really enjoy reading Dr. Hickey’s sound logical rebuttal to Frances’ writing. I share in the feeling that the HuffPo article is frightening and that the piece’s main interest is clearly to defend psychiatry and the status quo. The boogeymen “bad psychiatrists” and “bad GPs” do not exist. There is no good psychiatrists vs bad psychiatrists, there is only psychiatrists who believe that the human before them has a brain disease. Psychiatrists are also human, and humans are prone to the confirmation bias – thinking suffering is a “disorder” and that drugs are “good” except when prescribed “badly” will of course lead to a prescription for everyone who walks in the door. Frances’ “moderation” argument is no argument at all, if the system stayed the way it is I guarantee every psychiatrist could read it and come away agreeing with it and assured that they are not the “bad psychiatrist” prescribing antidepressants as a result of seeing the flattening effect of antipsychotics or what have you, but rather for “real” severe depression (happened to me). Humans also have a need for ego protection which is why cognitive dissonance occurs, and thus this article cannot possibly enact any real change. Like Dr. Hickey pointed out, he appears to be arguing for something good but upon any amount of close viewing, there is just very vague allusions to nameless “bad” doctors dispensing drugs like candy while the “good” doctors are helplessly, victims of the system, watching it happen. Despite my extreme harm at the hands of psychiatrists, I believe that the majority of psychiatrists *believe* they are doing something good and that their personal error rate is low or zero. If only they understood how much the DSM has been DESIGNED (by Frances!) to be difficult to use “correctly” to identify “real” mental patients, and to instead sweep up and harm massive amounts of people, for profit! If only each and every psychiatrist could take responsibility for being a part of a system that harms, similar to how members of dominant racial groups, etc must also acknowledge their place in our systematically racist society.

    If I could add to Dr. Hickey’s thoughts with my own, I want to point out how much it hurts that Dr. Frances and psychiatrists always seem to discuss the issue of iatrogenic harm/”over”prescribing/”mis”diagnosing as if it were some far off abstract dilemma existing only in theory, which can be solved by some kind of similarly vague abstraction and closer adherence to the vague theories of “real” psychiatry. Which presents the hurtful attitude that many psychiatrists seem to hold, that our lives as harmed patients are disposable given that other patients will benefit (at least in the short term). As if patients were objects, toys in a toybox to be taken out and played with, all fun and games until someone gets hurt… and when someone is hurt it’s the fault of some abstract reason apparently… in the sense that psychiatry is a belief system, it seems abstract and not specific to any one person but truly it IS personal, real and non-abstract. And what of the value of the lives who are now permanently crippled or traumatized? What I hear emotionally in Frances’ article apart from the logical flaws that Dr. Hickey has pointed out, is that the individual harmed lives have no value, and no credibility in the discussion.

    • Both my new BFF “survivingthesystem”, and the VERY ESTEEMED Dr. Philip Hickey, PhD, express better in words the **TRUTH**, than I can. So let me agree 100% with what they BOTH are saying here. I like to be a bit more creative, and express my truth this way: So-called “mental illnesses” are exactly as real as presents from Santa Claus, but not more real. When I was a little kid, I received many different presents from Santa Claus, on many Christmas mornings. Just as later, starting in my teen years, I received many different, bogus “diagnoses”, and was on many different kinds of “psych meds”. We may have to live with *some* psychiatrists for the near future, but let’s hope they are like Dr. Kelly Brogan, MD, and not like the COGNITIVE DISSONATED Dr. Frances…… And, c’mon, “Dr.” Frances, I’m calling you out. Why don’t you come on here >personally<, and debate us? Or is your little propaganda platform HuffPo the only venue you dare speak in Public on? Yes. it is a "War On (*some*) DRUGS (*sometimes*), and we all benefit from this type of no-holds-barred open verbal combat. Again, Thank-you, Dr. Philip Hickey, PhD, Dr. Kelly Brogan, MD, my friend "survivingthesystem"……../

  12. If you think the Huff Post article the above piece is scrutinizing bad, you should see the most recent post by Allen Frances. It’s called Balancing Patient Freedom With Safety And Well Being, and it is certainly worth another critical analysis on the part of Phil Hickey, or anybody else on the Mad In America website who could tackle such a matter. It’s not really so much about Patient Freedom as it is about depriving some humans of liberty in the name of psychiatry. In it he justifies institutionalizing and drugging human beings, among other human rights violations, against their will and wishes. That people are often done irreparable damage by these actions is a matter that seems to escape his notice, more or less, entirely.

      • I thought about posting a comment from my own experience, but as a psychiatric survivor who has communicated these thoughts in meetings, in legal mediation, at City Hall, in a public service film, and online for years and years and years, I finally decided that this only keeps these toxic issues, as well as my personal issues, alive and active to continue to engage with this level of extreme narcissism. These are not healthy people.

        So I’m thinking at this point it is best to walk away and move on from all this. It’s a house of cards anyway, I don’t buy into all of that ‘power’ crap, that is their delusion, not mine. After all, what happens when there’s a tug of war, and one side lets go of the rope?

        • I don’t think it is as simple as all that. Were it actually “a house of cards”, as you put it, it would have tumbled long ago. Allen Frances here, with the obligato disclaimer, of course, shows his support for forced treatment. This is the same Allen Frances who chaired DSM-IV revision efforts, and who elected himself chief critic of the DSM-5, the media sucking up his word as if it were gospel. I wish we were dealing with “a house of cards”, in fact, and that it was only a matter of playing “tug of war” to topple it. How convenient of organized psychiatry to defend itself through criticizing itself in the person of Allen Frances. I imagine that his criticism is actually a covert defense all in all. He’s feigning critic all the better to make targets of the real critics, something he is not.

          • When a structure has no foundation (other than deceit and illusion), then it can fall at any time. That’s how I perceive psychiatry to be. A lot of society already knows that the mental health system and social services–especially child protective services–are toxic. I see these opinions all the time online, people are aware of this.

            I really don’t think that everyone will wake up to psychiatry as corrupt and incompetent all at once, and witnessing a debate or discussion about it is confusing for most people, there are way too many personal issues, egos, and subjective opinions and experiences flailing about. It’s just as hard to imagine cohesion within the resistance to psychiatry as it is to imagine substance in psychiatry.

            But one person at a time waking up to what this is all about will be its downfall. People have got to discover this on their own. And I do feel people are wising up about all sorts of corruption and power abuse these days, and are voicing and resisting it.

          • The house of cards is supported by money and guns. The money allows for replacing each card as it fails, before it becomes a threat to the entire structure; the guns for intimidating those who want to huff, puff and blow the house down.

          • Sounds like a wealthy cult militia, then, which yes, I think that’s a reasonable comparison in how it operates. And in this case it is government supported. That makes this especially challenging, because the beliefs of the government are the same as the beliefs of the psychiatry and the system. There seems to be no convincing either one otherwise, that this is all a huge scam, in every respect.

            However it occurs, I really do look forward to the day that it all comes to light, and everyone gets what they deserve–criminal punishment for some and restitution for others.

          • That makes this especially challenging, because the beliefs of the government are the same as the beliefs of the psychiatry and the system.

            Helluva coincidence, huh? 🙂

          • In my picture, they fall on their asses, that’s the answer which I was thinking. But I don’t know, been sitting with this see how it played out.

            All analogies aside, however, it seems that right now, everyone is losing in this particular arena of society.

      • Steve McCrea: I read your reply to “Dr.” Frances, but I don’t do facebook, so I couldn’t log in to comment there directly. And, by now, you’ve read enough of my comments to know we’re on the same team. So you’ll understand that, and why, I’m going to challenge you here. You’re wrong, you’re *WRONG* when you say that a person needs to actually commit a crime, and be charged with a crime, and to be considered innocent until proven guilty. Yes, that might be the *ideal*, the *dream*, the *goal*, but that is NOT the REALITY. I am not the only victim, but I’m willing to go Public here, and tell my TRUTH. I was fraudulently charged with a bogus, fabricated “criminal charge, here in New Hampshire. More than once. Each time, it was *believed* – that is, I was *perceived”, to have a “mental illness”. I have been speaking out publicly against the lies of the pseudoscience of biopsychiatry, and the abuses of the so-called “mental health system” for over 2 decades now. And, yes, I have been RETALIATED against. I narrowly escaped being turned over to the State Department of CORRECTIONS, and hauled off in handcuffs and shackles, to the State PRISON. “SPU” – the “Secure Psychiatric Unit”, is literally a prison-within-a-prison. It’s a SuperMax level facility, run by the Dept. of Corrections, and it is literally PRISON. there’s nothing “therapeutic” about it. It’s not under the same budget as the Dept. of Health and Human Services. So, yes, some of the statements you made are blatantly incorrect, at least here in New Hampshire, and I’m sure in many other States. Also, especially look at what’s happening in the State of Ohio, where POTUS candidate John Kasich is from. Basically, he “balanced” Ohio’s State budget with $Billion$ in Federal “funny money”, much of it going to *private*, *for-profit* “psychiatric care facilities”. And yes, “CPS” – Child Protective Services, or “DCYF” – Division of Children, Youth & Families as it’s known here, is every bit as criminal, inhumane, and out-of-control as is the larger “mental health system”. As a CASA worker, you should know that. Thank-you for accepting my strong words here in the spirit of support and friendship which I offer them to you, my friend. But so-called “mental patients” are daily locked up and forced-drugged on bogus “criminal” charges….without due process, or the Constitutional protections the rest of us (supposedly) still enjoy……..~B./

      • That concept of “danger to society” is part of the Hegelian Dialectic, as I *think* it’s called. Correct me if I’m wrong. Anyway, it’s the idea that a bogeyman is set up, that poses a “threat”, or “danger”, and that fear is exploited to benefit TPTB (The Powers That Be ), at the people’s expense. It’s exactly the way “terrorism” is used to justify all kinds of Gov’t taxations & expenditures. There has to be SOME excuse to keep selling dangerous drugs at great profit. Which, sadly, leads to completely fabricated “reports” – and very real, if irrational fears. Again, I have to report from my own case. Because I’m known here in my hometown as “anti-psychiatry”, and “anti-drug”, it’s a fairly regular occurrence that I’m ACCUSED of being “threatening”, or “inappropriate”, or some such nonsense.
        So this whole “danger to society” is vastly overblown, and prevents us ALL from responding better to ACTUAL violence, and whatever causes that violence in the first place. When it’s seen that way, not only does “biopsychiatry” NOT make us safer, it in fact makes us all more at risk. And, it doesn’t address the factors which create actual serious crime and violence. The worst “crimes” I ever committed, were when I was on psych drugs. THAT is the BIG LIE that scares biopsychiatry, and what they have to keep censored, hidden, and covered up. Psychiatric drugs induce criminal behavior in a significant percentage of those so drugged. That is the LIVED TRUTH I KNOW…. I suspect Dr. Frances knows that truth, too. He can’t be *that* intellectually dishonest, can he?…………..?

  13. Thanks Frank, very timely. I read it and it’s truly unbelievable in light of Frances’ recent pretensions about being compassionate and enlightened (and worthy of “dialogue”). He makes it clear in the above article that he is our straight-up enemy. And while I don’t recall the name “Murphy” being mentioned, he’s gung-ho for “assisted outpatient treatment.” Rather than arguing with him we should be calling out Huffington for promulgating this stuff. Maybe everyone should go there and register.

    • Speaking of dialoguing, Allen Frances here talks about being in agreement with Eleanor Longden but, of course, he’s been talking to E. Fuller Torrey and D.J. Jaffe, too, and those are the folks he seems to be taking his cue from, although he doesn’t drop their names, read between the lines, it’s the message of Torrey’s Treatment Advocacy Center and Jaffe’s Mental Illness Policy Org. that you’re getting here, that is, America’s top lobbyist for more forced drugging. Neither Torrey nor Jaffe are friends of psych-survivors, nor are they friends, when it comes to psychiatric abuse, of human rights.

      • Don’t people generally consider Torrey to be our #1 menace? I think we need to emply some Alinsky-like tactics, i.e. make him the personified symbol of the things we most oppose and then focus on his “professional” contradictions, hypocrisies, about-faces, etc., and identifying him as a rogue shrink even within the context of the profession at large. We should learn to deconstruct his main arguments and understand the “studies” he uses to argue his points.

  14. I find the technique of blaming the disserved, abused and angry former “patients” on misdiagnosis or poor treatment protocols particularly rich. Where is his evidence of that? Or are we supposed to take his word for it? As I’m sure he is well aware, and even documents above in his own blog, the current treatment protocols are pretty primitive and are almost always followed to the letter: interview the “patient,” get a list of current symptoms, come up with a diagnosis that justifies your intended prescription, and send them away with a drug to “reduce the symptoms of his/her disorder.” These angry patients are not the results of outside the norm doctoring – they are the results of your standard of care, and blaming them for your failures or suggesting that a few crazy outlier docs doing bad work caused millions of former “patients” to be critical of your lame efforts at peacekeeping is just plain lame.

    —- Steve

  15. Great work as usual Dr Hickey. This guy should go into politics he is so good with the spin doctoring. Mind you stepping outside the protections of his chosen profession might have consequences, and politics can get ugly.
    Hey, I see Radovan Karadzic got 40 years. Be a bit of distancing from that ‘colleague’ I guess. Vulpes pilum mutat non mores.
    keep at em.

  16. Despite the severity of my condition having also caused me to loose 27 pounds in just 2 1/2 weeks, my psychiatrist would do nothing but prescribe drugs, and so ridiculously so that the maximum session I could obtain was still less than just five minutes. Yet other of his patients, who he seemed to regard of as being friends, obtained sessions lasting up to an hour, and were often given their session prior to me receiving mine, even though the appointment schedule placed them after me, not before. So I would have to sit there in the office waiting an extra bloody hour.

    My condition, was drug induced. The drug given to me was given to me by a previous psychiatrist. This psychiatrist then dumped me on the streets by saying that he no longer saw people of my age bracket. In truth, he knew that I could sue him. Thus he removed all data from my file that related to the drug induced condition, and then he basically told me to get lost. This psychiatrist also relayed this info about the “drug induced condition” to my GP.

    So I then went on the hunt and found another psychiatrist and he said that he was familiar with my condition and that there were plenty of drugs available, old and new, to apply to this condition. He said that once he received my file from my GP, that an appointment date would be set. It never was ! Due to the info passed on to him from my GP, he knew that if he put the name of my condition on paper, that once again I had a chance of suing the previous psychiatrist. But weeks later I managed to get into his office and he instantly said that he had no experience dealing with my particular condition, even though he had said the exact opposite before hand, and he had also previously said that he had many other patients with the same condition.

    So I found a new new psychiatrist, and the same results occurred.
    So I found a new new new psychiatrist, and the same results occurred.

    So, now that I was getting closer and closer to heading toward death, therefore my hair was falling out, and I was getting very little sleep( After several years had passed by, I had lost a total of 1 years worth of nights sleep.), and my pants were occasionally falling down due to me now having been reduced to a very skinny body, etc., I went back to my GP. He then set me up with another psychiatrist who would proscribe the appropriate drugs, but do so only if I agreed that I was not suffering from the “drug induced condition”. In other words, as long as the “drug induced condition” was not confirmed and put on paper, thus I could not sue the original psychiatrist.

    Due to all of this I was surviving on only $4,500 per year, being unemployed now and such. But it could be bumped up to $9,000 if I got onto a disability program, but that required my psychiatrist to put the “drug induced condition” on paper, along with his signature. It was a tough battle, but my social worker managed to get it done.

    So, thanks to the lovely people known as GP doctors and psychiatrists, the last 20 years of my life have been a living hell with me being confined within my apartment 24/7, and only going outside when needing to purchase clothes and/or food. Plus, with no sunlight over the many many years, I ended up with vitamin “d” deficiency problems as well.