Psychiatry’s Current Greatest Controversy: Fraud, Bullsh*t or What?

Bruce Levine, PhD
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This article was recently published by AlterNet with the title Proven Wrong About Many of Its Assertions,
Is Psychiatry Bullsh*t?

In the current issue of the journal Ethical Human Psychology and Psychiatry, Australian dissident psychiatrist Niall McLaren titles his article, “Psychiatry as Bullshit” and makes a case for just that.

The great controversies in psychiatry are no longer about its chemical-imbalance theory of mental illness or its DSM diagnostic system, both of which have now been declared invalid even by the pillars of the psychiatry establishment.

In 2011, Ronald Pies, editor-in-chief emeritus of the Psychiatric Times, stated, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” And in 2013, Thomas Insel, then director of the National Institute of Mental Health (NIMH), offered a harsh rebuke of the DSM, announcing that because the DSM diagnostic system lacks validity, the “NIMH will be re-orienting its research away from DSM categories.”

So, the great controversy today has now become just how psychiatry can be most fairly characterized given its record of being proven wrong about virtually all of its assertions, most notably about its classifications of behaviors, theories of “mental illness,” and treatment effectiveness/adverse effects.

Among critics, one of the gentlest characterizations of psychiatry is a “false narrative,” the phrase used by investigative reporter Robert Whitaker (who won the 2010 Investigative Reporters and Editors Book Award for Anatomy of an Epidemic) to describe the story told by psychiatrists’ guild, the American Psychiatric Association (APA).

In “Psychiatry as Bullshit,”McClaren begins by considering several different categories of “nonscience with scientific pretensions” such as “pseudoscience” and “scientific fraud.”

“Pseudoscience” is commonly defined as a collection of beliefs and practices promulgated as scientific but in reality mistakenly regarded as being based on scientific method. The NIMH director ultimately rejected the DSM because of its lack of validity, which is crucial to the scientific method. In the DSM, psychiatric illnesses are created by an APA committee, 69 percent of whom have financial ties to Big Pharma. The criteria for DSM illness are not objective biological ones but non-scientific subjective ones (which is why homosexuality was a DSM mental illness until the early 1970s). Besides lack of scientific validity, the DSM lacks scientific reliability, as clinicians routinely disagree on diagnoses because patients act differently in different circumstance and because of the subjective nature of the criteria.

“Fraud” is a misrepresentation, a deception intended for personal gain, and implies an intention to deceive others of the truth—or “lying.” Drug companies, including those that manufacture psychiatric drugs, have been convicted of fraud; and high profile psychiatrists (as well as other doctors) have been convicted of fraud. Human rights activist and attorney Jim Gottstein offers an argument as to why the APA is a “fraudulent enterprise”; however, the APA has not been legally convicted of fraud.

To best characterize psychiatry, McClaren considers the category of “bullshit,” invoking philosopher Harry Frankfurt’s 1986 journal article “On Bullshit” (which became a New York Times best-selling book in 2005).

Defining Bullshit

What is the essence of bullshit? For Frankfurt, “This lack of connection to a concern with truth—this indifference to how things really are—that I regard as of the essence of bullshit.”

Frankfurt devotes a good deal of “On Bullshit” to differentiating between a liar and a bullshitter. Both the liar and the bullshitter misrepresent themselves, representing themselves as attempting to be honest and truthful. But there is a difference between the liar and the bullshitter.

The liar knows the truth, and the liar’s goal is to conceal it.

The goal of bullshitters is not necessarily to lie about the truth but to persuade their audience of a specific impression so as to advance their agenda. So, bullshitters are committed to neither truths nor untruths, uncommitted to neither facts nor fiction. It’s actually not in bullshitters’ interest to know what is true and what is false, as that knowledge can hinder their capacity to bullshit.

Frankfurt tells us that liars hides that they are “attempting to lead us away from a correct apprehension of reality.” In contrast, the bullshitters hide that “the truth-values of his statements are of no central interest to him.”

Are Psychiatrists Bullshitters?

Recall establishment psychiatrist Pies assertion: “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” What Pies omits is the reality that the vast majority of psychiatrists have been promulgating this theory. Were they liars or simply not well-informed? And if not well-informed, were they purposely not well-informed?

If one wants to bullshit oneself and the general public that psychiatry is a genuinely scientific medical specialty, there’s a great incentive to be unconcerned with the truth or falseness of the chemical imbalance theory of depression. Bullshitters immediately recognize how powerful this chemical imbalance notion is in gaining prestige for their profession and themselves as well as making their job both more lucrative and easier, increasing patient volume by turning virtually all patient visits into quick prescribing ones.

Prior to the chemical imbalance bullshit campaign, most Americans were reluctant to take antidepressants—or to give them to their children. But the idea that depression is caused by a chemical imbalance which can be corrected with Prozac, Paxil, Zoloft and selective serotonin reuptake inhibitor (SSRI) antidepressants sounded like taking insulin for diabetes. Correcting a chemical imbalance seemed like a reasonable thing to do, and so the use of SSRI antidepressants skyrocketed.

In 2012, National Public Radio correspondent Alix Spiegel began her piece about the disproven chemical imbalance theory with the following personal story about being prescribed Prozac when she was a depressed teenager:

My parents took me to a psychiatrist at Johns Hopkins Hospital. She did an evaluation and then told me this story: “The problem with you, she explained, “is that you have a chemical imbalance. It’s biological, just like diabetes, but it’s in your brain. This chemical in your brain called serotonin is too, too low. There’s not enough of it, and that’s what’s causing the chemical imbalance. We need to give you medication to correct that.” Then she handed my mother a prescription for Prozac.

When NPR reporter Spiegel discovered that the chemical imbalance theory was untrue, she sought to discover why this truth had been covered up, and so she interviewed researchers who did know the truth. Alan Frazer, professor of pharmacology and psychiatry and chairman of the pharmacology department at the University of Texas Health Sciences Center, told Spiegel that by framing depression as a deficiency—something that needed to be returned to normal—patients felt more comfortable taking antidepressants. Frazer stated, “If there was this biological reason for them being depressed, some deficiency that the drug was correcting, then taking a drug was OK.” For Frazer, the story that depressed people have a chemical imbalance enabled many people to come out of the closet about being depressed.

Frazer’s rationale reminds us of Edward Herman and Noam Chomsky’s book Manufacturing Consent, the title deriving from presidential advisor and journalist Walter Lippmann’s phrase “the manufacture of consent”—a necessity for Lippmann, who believed that the general public is incompetent in discerning what’s truly best for them, and so their opinion must be molded by a benevolent elite who does know what’s best for them.

There are some psychiatrists who view the chemical imbalance is a well-meaning lie by a benevolent elite to ensure resistant patients do what is best for them, but my experience is that there are actually extremely few such “well-meaning liars.” Most simply don’t know the truth because they have put little effort in discerning it.

I believe that McClaren is correct in concluding that the vast majority of psychiatrists are bullshitters, uncommitted to either facts or fiction. Most psychiatrists would certainly have been happy if the chemical-imbalance theory was true but obviously have not needed it to be true in order to promulgate it. For truth seekers, the falseness of the chemical imbalance theory has been easily available, but most psychiatrists have not been truth seekers. It is not in the bullshitters’ interest to know what is true and what is false, as that knowledge of what is a fact and what is fiction hinders the capacity to use any and all powerful persuasion. Simply put, a commitment to the truth hinders the capacity to bullshit.

 

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37 COMMENTS

  1. Wow, bluntly put, and I believe it’s truth. Given that it is bullshit fraud that denies truth, when truth is exactly what people need in order to heal, I’d call it criminal, because it is harmful to the point of being lethal. At the very least, these practices are crippling and disabling for clients.

    I strongly feel these should be illegal practices, based exactly on the premise that, whether they are knowingly lying to clients or are making mistakes by following a corrupt protocol, either way they become aggressively defensive when criticized, then on the offensive with their gaslighting and mind-games, or worse yet, coercive and retaliating, and hurt their clients as a result. We tell them, they get nasty. Seems to be standard procedure. Illegal would be the adjective I’m seeking to represent the truth of this matter. Then, I’d be satisfied.

  2. As an example I’d like to point out that it’s perfectly acceptable for your doctor to make you into a ticcing spectacle with antipsychotic drugs, but he’d be in danger of losing his license were he to use Vitamins B3 and/or B6 instead of his “healing” meds.

  3. I’ve heard Robert Whitaker talk about this “false narrative” the psychiatric establishment is telling. He goes on to say we need to develop our own “counter narratives” to this “false narrative”. My thought was that a “false narrative” is a lie, a fiction. Your distinction between liars and bullsh**ters helps to further clarify the matter. In the context of a situation in which nearly everybody is lying, or bullsh**ting, I think telling the truth can be revolutionary. Seeking the truth, too, becomes revolutionary, especially when you have so many people seeking a rug to sweep it under, or going to great and contortionist lengths to evade it. There is another thing about not caring about the truth, I believe people call it “dishonesty”, and associate it with criminality, in other contexts. I believe Danish psychiatrist Patrick Goetzche has gone so far as to, aptly, compare the activities of pharmaceutical companies to those of racketeers. Great article, by the way. Thanks for drafting it. I hope the truth is beginning to sink into a few more noggins, some of which have been filled to overflowing with bullsh*t, out there.

  4. What Pies omits is the reality that the vast majority of psychiatrists have been promulgating this theory. Were they liars or simply not well-informed? And if not well-informed, were they purposely not well-informed?

    That should be rephrased in present tense. And it should be asked over and over.

  5. When I was going mental health services I would constantly tell my therapists about MIA or other alternatives to the current system and I only had one even bother to look at MIA. Her response was “I don’t understand it”, I imagine she probably didn’t read more than a few articles.

    What really bothers me is the lack of interest in looking at other alternatives because very few people at least from what I’ve seen never really get better in the current system. All they learn to do is manage their so-called “symptoms”. I find this lazy and it shows a real lack of caring about the vulnerable people your working with.

    I think I saw this quote once on MIA,
    “It is difficult to get a man to understand something, when his salary depends upon his not understanding it.”

    • Exactly; their entire lifestyles would have to change if they admitted that what they’ve been doing for years now is based on a lie. They wouldn’t make as much money for doing alternative treatments since insurance companies won’t pay for such things.

      I once read an article written by a husband and wife team who were psychiatrists. They admitted that they would rather do talk therapy with their clients than give drugs but stated that they wouldn’t be able to make a living without charging an arm and a leg for their time. They were old school and talked about how the change came about to using only drugs. Sadly they capitulated and went to giving drugs also, even though they didn’t believe in their usefulness. How do they sleep at night or look at themselves in the mirror each morning?

      Snake oil peddlers, plain and simple.

      • In the current system even just talk therapy can become abusive and lead to bullying, for a vulnerable client or I should say person, this can be devastating.

        As someone who has PTSD I know what it’s like to be treated this way and it can lead someone to believe there is now real help or safe place to open up and deal with the real issues. It can even lead to suicide.

        • This is sadly and maddeningly all too true. They get too comfortable, I think, and forget that this is a professional relationship. There should be a goal and a process to follow, not just random responses and opinions, which end up being judgments.

          People who have not sat in the client chair and experienced what can easily happen in these 1:1 meetings do not seem to get it, because it is hard to fathom. But so many clinicians do not think before they speak, and indeed, that can be dangerous to the point of causing despair and hopelessness. It often does.

  6. Hi Bruce, you write

    “a commitment to the truth hinders the capacity to bullshit”

    Personally I see the truth as being the Dung Beetle, that stops the spread of maggots and flies which then carry disease to what would otherwise be healthy cattle. The bullshit itself is just covering the known lie, and allowing doctor double think.

    Great article. But isn’t it McLaren and not McClaren? Anyway, nit picking insetead of dung beetleing lol.

    Take care

  7. True, psychiatry’s hypotheses have been regularly debunked over the decades (centuries). But the complexity of genetics invites psychiatry to just move on from one failed claim to other, less explored genetic hypotheses.

    I’m satisfied with MIA’s response to the genetic “synaptic pruning” hypothesis. But there’s a lot of research activity re single nucleotide polymorphism (SNP), with some pretty grandiose claims. A Washington University publication claims that C. Robert Cloninger et al have shown specific SNP’s associated with 95% and 100% chances of being diagnosed with specific types of schizophrenia.

    And Joe Pierre M.D., in 3/23/16’s Psychology Today (“Schizophrenia Doesn’t Exist!?”) wrote that SNP researchers “…reported that 42 different sets of SNP’s sets account for 70% or more of the risk of schizophrenia, with certain genetic variations conferring as much as 100% risk of schizophrenia among those with specific types of psychotic symptoms.”

    I’d bet money that the SNP claims are overblown and/or manipulated (e.g., if they actually found these associations, they probably apply to only something like 1% of all people labeled “schizophrenic”). But if anyone has looked at these studies, can you comment on what’s right and wrong with them?

    • And what are the specific types? Are they the old humbug Bleuler/Kraepelin types? My forbidden literature mentions types, but they’re physical types, like vitamin dependencies, cerebral allergies, heavy metal poisoning, chemical sensitivities, thyroid deficiencies and excesses and such- things I never see in material coming from Big Time Psychiatry.

  8. Re my comment, I wonder if this claim, ” 42 different sets of SNP’s sets account for 70% or more of the risk of schizophrenia” means that 70% of all people labeled with schizophrenia have one of these 42 sets of SNP? That would be huge – meaning that 70% of all “schizophrenics” have these SNP’s. But it could also be trivial, if it only means that of the few people who have those SNP’s 70% are “schizophrenic.”
    Can anyone clarify this?

  9. Are Psychotherapists Bull Shitters? And is Recovery a Fraud?

    Yes to both questions. Survivors do not need healing or recovery. Those are a hoax. And they don’t need therapists knowing their personal affairs.

    What survivors need are comrades and attorneys, because this is how we fight back and restore our social and civil standing so that we can have a legitimate place in this world.

    Psychiatry, Psychiatric Meds, Discussions About the Effectiveness of Psych Meds, and Psychotherapy and Recovery ARE JUST MORE ABUSE!

    Nomadic

    • And how about today, where Social Darwinism and Eugenics are again on the rise. So rather than have low paid laborers as our scapegoats, we get our scapegoats from the middle-class family itself, and it is done with Psychiatry, Psychotherapy, and Recovery.

      So the scapegoats end up living completely marginalized lives, if not psych meds, then street drugs and alcohol. And all the while the White Coats are debating whether psych meds are effective, or if Psychotherapy and Recovery are enough to do the job.

      Nomadic

  10. I already mentioned in an MIA comment, that the gassing of German mental patients in the 1930’s was initiated by German psychiatrists and didn’t end until parents complained to Hitler(!), who stopped the procedure because it was causing domestic unrest he didn’t need while he was busy starting WW2.

      • Exactly. They no longer gassed the patients in the mental “hospitals”, they allowed them to starve to death. American soldiers who went into these places found starving “patients’ everywhere and numbers of dead who’d starved to death.

        The killing of “mental patients” was advocated by the keynote speaker at the 1941 American Psychiatric Association’s yearly meeting. there were very few psychiatrists attending who voiced a negative opinion of such an idea. Also, in 1942 there was an anonymous editorial in the APA’s Journal of Psychiatry advocating that what had been done in Germany should be done in America in reference to the “mentally ill”. In actuality this was not that long ago, only six years before I was born.

  11. One thing that the eugenicists of the 1920’s and 1930’s never understood was the high percentage of savant abilities among autistics (10% instead of a fraction of 1% among the general population), although I’m sure they had a gaseous explanation for it, as it contradicted one of the basic postulates of and rationale for the Eugenics Movement.

  12. From another perspective, a difficulty would be in determining who is a bullshitter and who is a liar. Bullshitter’s can rely on the lie, does that make them bullshitters, or liars?

    When economics become involved, is there any possible way to tell a difference… beyond that of interrogation and confession?