Has Psychiatry Gone Uniquely Astray?

Henry Bauer
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Science, medical science included, and their applications in technology and in medical practices, have seen huge progress in recent decades. Those needing medical care have experienced much benefit. Robert Gallo, a well-known public hero of HIV and AIDS research, credits this to “an increased understanding of and reliance upon the scientific method” (p. 2 in Gallo’s memoir, Virus Hunting, Basic Books 1991). The scientific method consists, of course, of going where the evidence leads, accepting explanations and theories only when they have been tested against what happens in the real world. That’s why science and science-based medicine have offered such reliable understanding and guidance.

Followers of the Mad in America website and its blogs know, however, that these encomiums do not extend to contemporary psychiatry, neither its theory nor the associated practice. Against mountains of evidence, the reigning “consensus” blames all mental or emotional dysfunction on physicochemical circumstances in the brain and prescribes drug treatment accordingly. And that consensus remains impervious to the wealth of contrary evidence fully documented in many books and other works by highly competent, even distinguished individual psychiatrists, as well as investigative science writers, journalists, and personal testimonials from patients.

Evidently psychiatry has not benefited from the scientific method in the manner that medicine generally, and science itself, have benefited. Science is supposed to be evidence-respecting and thereby open-minded; psychiatry is presently not.

But is psychiatry really unique in this respect? Is it the only field of medicine where dogmatically held theories contrary to evidence have held sway for long periods?

Not at all. But that fact is known only to handfuls of academic specialists in such fields as the history of science, the sociology of science, or the umbrella discipline of Science & Technology Studies (STS). The insights gained in these specialties have made little impression even on the overall discipline of history, let alone on what most students or the general public learn about how science has worked and changed over the decades and centuries. Popular beliefs about science, shared by most of the public, the media, pundits, even science writers and journalists, are sorely mistaken about contemporary science.

The fact is, it’s commonplace for dogmatically held theories contrary to evidence to hold sway for sometimes long periods, in medicine but also in science generally.

For one example, in 1976 a Nobel Prize was awarded for the discovery that the degenerative brain disease kuru, akin to mad-cow diseases, is caused by a “slow virus” that remains somehow dormant for years before wreaking its harm. Some two decades later, though, a Nobel Prize was awarded (in 1997) for demonstrating that the cause is not a virus at all, be it a slow one or a fast one, but rather by a misshaped protein given the designation of “prion.” Medical science and the associated practices were dogmatically wrong for a couple of decades, and during that time the proponents of the prion hypothesis were largely ignored, and laughed at and denigrated when not ignored.

Again, medical science and associated practices were quite certain that stomach ulcers are caused by stress and stomach acid. For several decades, the Australian doctors who had observed in the early 1980s the presence of Helicobacter pylori bacteria in stomach ulcers were ignored, dismissed, or actively denigrated. Belatedly, in 2005, Marshall and Warren were awarded the Nobel Prize for discovering the role of H. pylori in gastric disease including ulcers.

It is not only ignorance of the real histories of science and medicine that conspires to maintain a general belief in the great reliability of the consensus in those fields, it is also that the repudiation of earlier dogmatically held theories is not emphasized when Nobel Prizes are awarded with respect to prions or ulcer-causing bacteria or other major advances. Rather, the good news of discovery and progress is hyped: Stanley Prusiner accomplished a scientific revolution by showing that prions could be responsible for infectious disease; Marshall and Warren brought revolutionary progress in medicine by indicting bacteria for many gastric ailments.

Much popular and much technical discourse cites Thomas Kuhn’s description of progress in science via scientific revolutions, emphasizing the progress, the advance. But every such revolution deserves its naming because it overturns earlier beliefs. Scientific revolutions are not only milestones on the road of progress, they are also gravestones of earlier theories that, more often than not, were held dogmatically and were defended vigorously against dissenters who were ignored, dismissed, or actively persecuted.

By emphasizing progress and not the repudiation of previous belief, the impression of science as certifiably reliable at any given time becomes reinforced.

The alternative viewpoint makes for a very different attitude, namely, that every contemporary belief in medicine and in science is reliable only insofar as it has not yet been overturned in a scientific revolution. History obviously cannot provide any example of a belief that will never be overturned, it can only offer instances of beliefs that have not yet been found wanting.

More instructively, the history of science and of medicine teach that in the run-ups to scientific revolutions, any researchers who foreshadow the future revolution by drawing attention to the flaws in current beliefs, the evidence against current theory, are treated shabbily, to put it in the mildest possible terms.

Here, then, is the prime insight to be drawn from the fact that the practices of contemporary psychiatry are at odds with popular ideas about the reliability and progress of science and science-based medicine:

Popular ideas about how science works are highly misleading. The so-called scientific method does not produce immediately reliable findings. Competent dissenters from current theories may in the future turn out to have been right — or at least more right than the current theories — even as these dissenters may at present be called crackpots, cranks, denialists, Flat-Earthers, ignoramuses, and the like.

So where did popular ideas about science come from, that I assert to be misleading?

They came from how science used to be, by contrast to what it is like nowadays. One would be hard put to overemphasize the sea change in scientific activities that is apparent when contrasting contemporary science with science before World War II.

In a drastically oversimplified nutshell, one might describe pre-WWII science as a cottage industry carried on by independent intellectual entrepreneurs motivated primarily by curiosity in seeking truths about the natural world, not beholden to patrons and subsisting typically in ivory towers undisturbed by social, political, commercial interference; science was free to be its own thing.

By contrast, contemporary science is at the mercy of those who provide the enormous resources now needed to penetrate further into Nature’s mysteries. Modern-day science is competitively cutthroat and subject to pervasive conflicts of interest, beholden to the providers of resources: governments, businesses, industries, foundations, all of which aim to harness science to their own benefit.

These assertions are described and documented more fully in my new book, Science Is Not What You Think—How it has changed, Why we can’t trust it, How it can be fixed. The book addresses common misunderstandings about the scientific method, replicability of scientific findings, peer review, and more. The “fix” it suggests is the possible establishment of a Science Court to adjudicate expert differences over technical issues. That was first suggested more than half a century ago when the experts were at loggerheads and arguing publicly over whether power could be generated safely using nuclear reactors. More recently, some legal scholars have pointed out that such an institution could help the legal system to cope with cases where technical issues play an important role.

Beyond that, I suggest that a Science Court is needed to force the prevailing “scientific consensus” to respond substantively to substantive critiques from dissenters. If, for example, a Science Court were to adjudicate over the benefits and costs of antidepressant drugs, there would be an open, public display of all the relevant data from all trials, and expert witnesses would need to defend their views under cross-examination. The Court’s independent, disinterested weighing of all the evidence would indirectly benefit society as a whole by being directly helpful to psychiatrists, their patients, and policy makers concerned with health care overall.

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Henry Bauer
Henry Bauer is Professor Emeritus of Chemistry & Science Studies and Dean Emeritus of Arts & Sciences at Virginia Tech; he had earlier served at the Universities of Sydney, Michigan, Southampton, and Kentucky. He is Austrian by birth, Australian by education, and American (since 1969) by choice. His publications, chiefly in chemistry and science studies, include more than a hundred articles and twelve books.

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55 COMMENTS

  1. Thanks for the blog, Henry. A science court is an interesting idea, and I do agree it might be able to speed up the process of change, as one who is frustrated by the lack of timely reform in today’s “mental health system,” even after the head of NIMH confessed that the DSM is invalid. And it’s been pointed out that the psychiatric drugs can create the DSM disorder symptoms. Although, judges are easy to buy, unfortunately we must remember.

    I do agree, the love of money is the root of all of the fraud within the sciences. True competition brings about amazing innovations and truth. What we have today is too few financially directing research in such a way as to financially benefit themselves only, as opposed to society as a whole. And truth is the last thing they want coming to light. It’s a shame the wrong financiers have taken over the US, and destroyed our once great nation.

  2. Henry

    Thank you for this very interesting analysis of the historical forces influencing the critically important role of science in our society.

    I want to pose some provocative differences with some of your conclusions regarding both the problem and the solution to having true and unbiased science as a liberating force for human progress.

    You said: “In a drastically oversimplified nutshell, one might describe pre-WWII science as a cottage industry carried on by independent intellectual entrepreneurs motivated primarily by curiosity in seeking truths about the natural world, not beholden to patrons and subsisting typically in ivory towers undisturbed by social, political, commercial interference; science was free to be its own thing.”

    This above statement leaves out the very important history of the role of religion as a distorting influence holding back human progress and sometimes viciously punishing, any and all, those whose scientific endeavors somehow threatened religious doctrine. Political power in society usually benefited from these religious pogroms because, religion itself, has historically reinforced acceptance of both slave and class based forms of oppression.

    And looking at the situation today, Psychiatry and its Diseased/Drug Based paradigm of so-called “treatment” (with all its “genetic theories of original sin”) very much shifts the focus in society AWAY from any critical appraisal of the inherent problems with both the economic and corresponding political system. It’s all about bad genes and brain chemical/PERSONAL DEFICIENCIES rather than the defects in our particular economic or political institutions.

    And I would argue that over the past 4 decades Psychiatry and Big Pharma (as an institutions in society) have become too big and essential to the status quo to be allowed “to fail.” Especially looking at the role that these backward forces play as institutions of “social control,” drugging and incarcerating (in penal and psych hospital jails) those sectors in society who are potentially the most radical creative agents of social change and possibly a force for revolutionary change.

    As for your idea of a “science court,” in theory this sounds good, but without any FUNDAMENTAL CHANGES away from this profit based economic and political system, this would ultimately be corrupted and fail. Just as we are suppose to have a true democracy in this country, is it not a total and complete sham and illusion, controlled and manipulated by the 1% percenter/ruling class?

    The political and social role of Psychiatry as an instrument of “social control,” and the role of Big Pharma (with their enormous profit levels) are now such an essential part of the U.S. economy, that they both stand (along with the capitalist system that both sustains and depends on them) as major impediments to the liberating role of science and of ALL human progress.

    Richard

  3. My favorite story of scientific obtuseness comes from the Incident of the Broad Street Pump, back in the 19th century, just before running water and Pasteur introducing the germ theory of disease proliferation.
    London’s public health officer (yes, they had one, back then), noticed a concentration of cholera cases surrounding one of the public pumps that dotted the city in those days, so he used his authority to pull the pump handle, stirring great outrage in the city’s medical community. Not only was the pump handle put back on, but one of the medical community’s bigwigs pumped himself, and drank, a glass of water from it to prove “that good English water never hurt anyone,” whereupon he died of cholera within 24 hours. Around 20 years later, when the pump was dug up, it was discovered a nearby line in the sanitary sewer had cracked, and was leaking effluent into the ground water.

  4. Your article brings up some really good points. And dogma is extremely hard to prove wrong once it’s been ingrained into whatever political system that exists whether it be in an industry, public policy, our court system, or in our social system. The thing about psychiatry is that they are not following the scientific method of true science. They have developed their own and it has a major flaw. It cannot be proven invalid. There is no way to prove a hypothesis wrong by following the new rules which they have set out. I did not come up with this theory but another scientist did. I wish I could give you the link but I didn’t bookmark it. It’s too vague. Look at Stephen Hawkins work, his doctoral thesis was the big bang theory. His next project was to prove himself wrong. That’s true science. It’s repetition.

    One of the leading scientist from Ely Lilly was interviewed and actually stated that you have to leave the scientific method behind in pharmaceuticals and what you learned in school, is no longer valid. And I personally think McClaren’s medical journal published paper, Psychiatry is Bull$!&$ where it proves that psychiatry is not pseudoscience at all, is I think, in essence, an expose to how ridiculous the scientific method of psychology and psychiatry is. It’s basically calling out, “prove me wrong” but given the method, it’s too vague and can never be debunked.

    Psychiatry is not science in the mental health field. It’s called marketing.

  5. Marketing: I would go so far as to say it’s not just psychiatry, but pharmaceuticals.

    There are pharmaceutical cascades that are killing people which have nothing to do with opoids or psych drugs.

    It often starts with a statin. Then, muscle pain – add NSAID. Stomach trouble, add PPI. This might cascade into heart drugs, or it might cascade into psych drugs, as depression sets in and sleep gets worse. Someone who was feeling fine, but had a blood test run & came back with “hypercholestemia” ends up very sick in a few short months by just listening to their doctor, who listens to Pharma.

    What about the 50 years of fluoride in the water? When will the science court decide that there is no one dose for all people, determined by levels in water?

    I think that psychiatry is an extreme symptom of a very sick system. Decisions are made for the benefit of share price, not for the benefit of anyone’s health or well-being.

    The innocent who “go along” with what they are told – are participating in a huge social and chemical experiment. For share price.

  6. Obstetrics is an area with similar ignoring of evidence in order to maintain the status quo. The national Caesarian rate is around 30% or higher and no one bats an eyelash, while midwives have as good or better of a safety record with rates under 10%.

    Another great example is Semmelweis. He introduced handwashing into labor and delivery wards and reduced the childbed fever rates from very high to almost nothing. He was fired because the doctors were insulted he thought their hands were dirty, and his successor eliminated the practice and rates soared again, sending Semmelweis to the mental ward with frustration.

    Freud himself was intimidated away from his original finding that many adult women had been sexually molested, and completely changed his “trauma theory” and developed the “drive theory” in order to accommodate the community’s need not to admit what was going on. A hundred years later, it was shown that his observations were absolutely correct, but psychiatry remains committed not to look at abuse and trauma as the main cause of “mental disorders.” Not much money in trauma, I guess.

  7. The big hoax must promise a growing bag of gold as a carrot for all that get involved and needs people with titles to provide the veneer to fool the majority of themselves and then the population, then it grows along with their true belief like a snowball that doesn’t seem like it could ever melt. The AMA is from it’s inception such a hoax . (Read if you wish the book “Sick And Tired” by Robert Young ) So is ADA dentistry (who would dare put mercury in even children’s mouths ,when mercury is the 2nd most deadly element on periodic table ? ) There is much precedent for the psychiatry hoax and for the power of the pharma poison cartel . Just look to history that became available to the public after 2003 concerning the horrific IG Farben , the chemical and pharmaceutical industry conglomerate . Can’t make the link to the info work . If you could google to this you’ll see something interesting .
    The Laws of the Pharmaceutical…The Dr. Rath Health Foundation

  8. Thank you for such a thoughtful article. I agree with every point except the idea of a science court. I am cynical that it would easily be corrupted and misused by the money and power of the prevailing doctrines. A good idea that would not work in the real world. I fear it would veer away from your good purposes and be used to vilify the very opinions you wish to protect. On the other hand there needs to be a real education about the scientific method. Very few people, including many scientists, do not actually understand science. When followed correctly real science is a beautiful thing. Gone are the days when one searches mightily for counter evidence, the absence of which fosters a theory. Instead, people who question are called all sorts of viscous names.

    • A Science Court for psychiatry would have to be staffed by totally disinterested citizens. Best to select people from totally different professional backgrounds, like a sociologist or ecologist or computer scientist, and an equal number of consumers, selected by random or from consumer-based (NOT parent-based) support organizations. No psychiatrists or psychologists allowed!

  9. What is science? What is medicine? What is progress? We need to think a little more deeply and articulate more precisely the meaning of these words. This isn’t just an exercise in semantics. There are fundamental differences between that which the word “science” originally signified, and it’s modern counterpart. And medicine? What is that? I suggest that it is something different than that which it is commonly supposed to be. Monsieur Jean-Jacques Rousseau had some great insights on medicine, for example. https://psychiatricsurvivors.wordpress.com/2017/02/14/the-lying-art-of-medicine/

    As far as “progress,” it may be the most misunderstood and misused term of all. In fact, as David Wootton has suggested, the boasted “progress” of medicine is much less significant than is commonly supposed. https://psychiatricsurvivors.wordpress.com/2017/06/28/bad-medicine-doctors-doing-harm-since-hippocrates/

    Is Thomas Szasz right? Is medicine, like science, actually a form of false religion? https://psychiatricsurvivors.wordpress.com/2017/01/06/the-theology-of-medicine/

    In any case, one thing is clear. Psychiatry has nothing to do with healing. It has even less to do with truth. Heck, it’s not even what it’s name implies, namely, the medical treatment of the soul. What is psychiatry? Consult the following website in order to better understand the truth about psychiatry: https://psychiatricsurvivors.wordpress.com/2016/05/10/the-truth-about-psychiatry/

  10. It is not just the private interests that block the scientific progress, but the “systems” of private interests.

    The Sakel cure was used for decades without any scientific proof, because it corresponded to a system of interests: those of physicians, nurses … They did not begin to take an interest in the effectiveness of the method before laying the foundations for a new system: neuroleptics. Yet the resistance of the old system was severe: nurses and nursing aides who had acquired an “expertise” in this field (and therefore privileges) were resolutely opposed to abandoning the method, the scientific evidences against them.

    A system of interests, unlike private interests, has no precise limits. The system of interests of neuroleptics affect for example the psychiatrists, the families, the pharmaceutical industry…

    That is why the struggle for science is also a political struggle for a new system. It is by changing the system that you change its ideology, although the ideological struggle can have its share in the system change.

  11. Welcome to Mad in America, Dr. Bauer, and thanks for an intersting article.

    While I generally agree with what you wrote, there is an important thing to remember: unlike other branches of medicine, psychiatry is entitled with a right to use violence to make people follow its demands. In non-psychiatric medicine, you can learn the different positions concerning a therapy and make a choice. In psychiatry, you are deprived of choice from the start.

    And, unlike the misguided therapists from other branches of medicine, psychiartists won’t just harm you. They can literally devastate you mentality and personhood. In fact, oftentimes it is, effectively, a goal of their actions, even if psychiartists themselves might quite sincerely believe that that they are helping.

    And don’t forget that while the actual dominant social power-structures and cultural prejudices are negatively affecting any scientific and medical field and process – natural sciences and non-psychiatric biomedicine are very often severy twisted and badly damaged by conflict of interests and enforcement of ideals, as you know well yourself – they still affect human-related areas of study, and practices based on them, even stronger. So, in psychiatry, virtually any mental activity that upset the dominant social forces and cultural mores are extremely likely to be medicalised, pathologised and repressed under guise of “treatment”.

  12. this is my theory of psychiatry and most of medicine:

    1. The doctor and medical institution does whatever is in their best interest financially, including diagnosing the patient.
    2. In the process, the goal is to maintain as many patients on the patient roster as possible, “keeping the numbers up” rather than curing inductees.
    3. In the process, patients may be harmed by the procedures or “treatments.”
    4. After medical harm, re-diagnosis to a more complex or more severe diagnosis, or add a diagnosis, and send patient to a higher level of “care” or more intensive or restrictive “care.” This may harm further. Repeat.
    5. In the event of inevitable patient death, blame the patient’s condition, which you have already given to cover your ass.

    Very scientific.

  13. Mr. Henry Bauer,

    Wikipedia describes you as “HH Bauer is the author of several books and articles on fringe science, arguing in favor of the existence of the Loch Ness Monster and against Immanuel Velikovsky, and is an AIDS denialist”.

    Many blogs and websites of people who term themselves as skeptics or science-writers will not give you any space on their websites to write anything as they will dismiss everything you say based on the fact that you deny that HIV causes AIDS. Mad In America will also be defamed for giving you space to write anything. That is expected. Guilt by association tactics will be used to cast this website away. You would be hard pressed to find people here (including myself) who deny that HIV causes AIDS. Hell, even Robert Whitaker has been compared to AIDS denialists in the past for criticising psychiatry. Thomas Szasz is still defamed as a Scientologist, even though he was an atheist.

    However, naturally that does not mean everything you say is false, and perhaps some interesting insights can be gained from a “fringe science writer”. Just wanted to put that out there.

    • The so-called “skeptical movement” is a bunch of militant defenders of mainsteam dogma who will dismiss and attack ANYTHING that deviates from the mainstream, including antipsychiatry / critical psychiatry. You’re on their “hit list” (or “ridicule list”, to be more precise) already, whether you want it or not: if you haven’t noticed it yet, your views are as unacceptable within the mainstream discourse as the ones of Dr. Bauer. For “skeptics”, as well as “respectable” society in general, you’re effectively “anti-science crackpot psychiatry denialist”. This negative characterisation may be used for everyone else here as well, INCLUDING ME. We’re all “fringe types” here – we have to understand it.

      So, to reject Dr. Bauer’s views because of their current “fringe” status would be hypocritical. Everyone can and should form his or her opinion on his positions by inquring into them rationally, not by reacting to them emotionally. I invite everyone to think by themselves, not only about psychiarty, but about all issues, including all branches of science and medicine.

  14. “Shine on you crazy diamond ” is the title of a song by the group “Pink Floyd” .” Another brick in the wall ” is another one of their songs. It’s late and I’m too tired to find the links.

    Psychiatry is such an exasperating pile of shit .

  15. I’m glad it made you laugh Julie , but this heaping mound has been building for hundreds of years and I just recently realized it’s also part of the military industrial complex. It’s also part of the pseudo scientific tower of babel which crosses into all areas affecting quality of life and survival of human beings .It may be the best way to toss the pile is through actively joining the Movement for Health Freedom and making sure that within their guidelines are clear stipulations about the right to be free from any and all things reeking of the pile . Of course we know the pile has nothing to do with health care but this way we get to use their false words against them. Health Freedom it seems, do to prevailing propaganda might be the fastest way to get the most people the option of freeing themselves from the stench. Hopefully this way there would be way more people that could show up at demonstrations . I know you’ve seen it before but many others have not. Google World HealthFreedom_Assembly.pdf ) Then open the 2006 International Declaration of Health Freedom ) Of course I take an anti -pile position at the same time .