A Brave New World – Somatic Psychiatry in the Spotlight

Robert Berezin, MD
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Somatic psychiatry has taken over psychiatry, and replaced an in-depth understanding of human nature. The fundamental and incorrect premise of somatic psychiatry is that the source of psychiatric problems come from defects in the brain. The false belief is that we are subject to brain diseases, and we need somatic treatments to fix them. This theory of psychiatry is now truly believed by most psychiatrists, as well as a lot of the general public at large. Its treatments have been lobotomies, ECT, and psychiatric drugs. (For a fuller exploration of Somatic psychiatry, read the appendix to my book, “Do No Harm: The Destructive History of Pharmaceutical Psychiatry and its Bedfellows – Electroshock, Insulin Shock, and Lobotomies.”)

Unlike neurology, psychiatry is not today, and has never been, about brain diseases. Neurology deals with literal organic brain damage or disease, either from anatomic malformations, death of brain cells from strokes or bleeds; damage from tumors, infections, seizures, concussions, dementias, toxic states etc. There is a clear distinction between organic diseases and functional conditions. Functional conditions refers not to the physical brain, but to the content of the consciousness it creates. Instead, psychiatry deals with the pains of life. This is manifest in the brain in a totally different fashion.

As I have shown in other blogs, the highest organization of the brain is the creation of the play of consciousness. We write our plays as we adapt to life. These plays are written through the emotional centers of the brain, the amygdala and the limbic system. Trauma — deprivation and abuse — especially in the early years, and continuing all the way through life, informs the writing of our plays.  As a result of trauma one adapts by writing darker plays. This the real source of psychiatric symptoms and suffering. The plays operate in keeping with the way the brain actually functions in consciousness. The play and its adaptations are what defines functional conditions.

Somatic psychiatry has usurped the idea of what is biological. Of course we are biological creatures. And yes, everything we know, think, and feel comes from the brain. But psychiatric symptoms do not come from brain lesions creating diseases — it’s not anatomic, structural connectivity, or the microbiology of synapses and neurotransmitters. Obsessions, compulsions, phobias, anxiety, depression, and even schizophrenia and manic-depression reflect the way our play gets written by our adaptation to trauma. This is the true level by which our biology operates psychiatrically.

The appropriate treatment is psychotherapy. Through psychotherapy one recovers from problematic plays by mourning them in the context of trust and caring in the therapeutic relationship. It specifically heals the trauma in the same way it formed in the first place.

Historically, psychiatric diagnoses were never intended to signify literal brain diseases. They used to be a shorthand and a guide to point to the psychological issues that presented. This is how it still should be today. The way diagnosis is now used is a travesty. Psychiatric patients  are being told they have a brain disease. And they really believe there is something genetic and biochemically wrong with them. Diagnoses were never intended to label and reduce our humanity. Psychiatric symptoms and suffering is purely a human problem. I do not use diagnosis at all. I attend to the person. Symptoms point to issues, which I deal with as they present themselves. Psychotherapy is the only practice that is humane, respectful, and caring. And it works.

Let’s take a brief review of somatic psychiatry, and the faulty science used to promulgate it. For lobotomies, the apparent locus in the brain for human problems was believed to be the prefrontal cortex. Since this part of the brain is the problem, let’s ream out the frontal lobe. In case there is confusion about the science, Antonio Egas Moniz, the inventor and promoter of this medieval horror, actually received the Nobel Prize for his great work. Thankfully this dark chapter in psychiatric history seems to have passed. But not so fast. It has now reappeared in different form — the promise of new drugs to erase traumatic memories. Life can be a happy dream. Let’s excise the bad and keep the good brain cells. Let’s control memory itself. This new improved model is actually chemical psychosurgery. A Brave New World indeed. Life is difficult. Trauma does leave scars. There is only one way to deal with trauma, loss, and pain, and that is to mourn it. It’s part of the human condition.

Shock treatment, whether electrical or chemical, goes back centuries. The purpose is to induce a grand mal seizure. The science was always bizarre. The theory was that seizures are the opposite of schizophrenia. Therefore a seizure will correct an imbalance in the brain — sound familiar? It’s like the Prozac theory of correcting chemical imbalances in the brain (a theory that has also been discredited). Many psychiatrists to this day still consider shock treatments the gold standard of psychiatry. Somatic psychiatry has now drifted over to neurostimulation therapeutics — Deep Brain Stimulation. We selectively pinpoint a small locus of brain cells. Zap them, and it fixes that damaged clump of brain cells, and the connected cells downstream. Now it begins. We are already on route, with ‘evidence based’ studies, to demonstrate the alleged effectiveness for DBS for the ‘diseases’ of depression, obsessive-compulsive disorder, phobias, post traumatic stress, anxiety, and schizophrenia. Millions of dollars will be spent to prove these ‘promising’ theories. And with good marketing they will soon turn into beliefs. In time, it will be shown that these treatments don’t do anything constructive, and somatic psychiatry will move on to something new.

In the domain of pharmaceutical psychiatry, there haven’t been any new developments in years. We were told that ‘biological depression’ would finally be cured as we moved into the heyday of antidepressants. Get everybody on Prozac. In fact, the opposite occurred. Deaths from suicide have increased 24 percent from 1999 to 2014. It is now the 10th leading cause of death in the United States. The suicide rate for middle-aged women, ages 45 to 64, jumped by 63 percent over the period of the study, while it rose by 43 percent for men in that age range, according to the National Center for Health Statistics, as reported by the NY Times, April 22, 2016. In fact, black box warnings have been put on antidepressants for children and adolescents because antidepressants have been implicated as a cause of suicide. The real evidence is clearly mounting that the same danger applies to adults as well. Never mind the side effects — where people become estranged from their feelings, have no sexual feelings, and experience addiction and habituation. It is almost impossible to detox from these drugs without horrible and debilitating symptoms. Patients are now told they must take the antidepressants for life for their ‘disease.’ And when habituation takes place, new ones are added in.

Ben Goldacre is his illuminating Ted lecture, “What doctors don’t know about the drugs they prescribe” reveals the science behind ‘evidence-based studies,’ which are evidence-based in name only. A fifteen year review of antidepressant studies showed that 50% of the 76 studies were positive and 50% were negative. All of the positive studies were published and all but three of the negative studies were suppressed and not published. In 2004, approximately half of all studies that weren’t already suppressed by the pharmaceutical industry concluded that antidepressants are not significantly more effective than placebo alone. And two thirds of studies for children given antidepressants show the same. Even the standard for the positive studies by which effectiveness is scientifically accepted is that if antidepressants work 40% of the time and placebos work 30% of the time, it is deemed to be an effective drug. This means that the antidepressants apparently work 10% of the time in half the studies. In real science, the exception proves the rule. For a theory to be correct it has to be correct 100% of the time.

Somatic psychiatrists are now moving in new and bizarre directions, as the ineffectiveness of antidepressants shines through. Hallucinogenic drugs are being promoted as a cure for depression, alcoholism and the rest of psychiatry. The ‘evidence based studies’ are beginning, and not surprisingly, claim to be showing great promise. Here’s a good one: the bacteria in our gut is the cause for depression. The new theory is the microbial imbalance theory for depression — add it to the serotonin imbalance theory. Once again, the ‘evidence based’ studies claims it is showing great promise.

Somatic psychiatry has been so effectively marketed that most people believe in it. Belief is so very powerful. It is actually considered reasonable and constructive to be given a psychoactive pill for the human condition. Should we actually take seriously the idea that our gut bacteria cause depression? Do you think we all should drop acid and that’ll straighten out our lives? Perhaps we should zap our brains with DBS?  Hold onto your hats.

57 COMMENTS

  1. What happens when a person with no history of trauma is given a drug like accutane or Cipro or
    Prozac and develops psychiatric symptoms, agitation, anxiety, suicidal thoughts? These drugs have caused changes in the neurotransmitters and chemicals in the brain and they may be severe or irreversible. This is not something that can be ameliorated by psychotherapy.it has become a physiological problems.
    It has been stated that psych drugs cause and create “imbalances” that did not exist before the drug was taken. Like Chantix used as a smoking cessation drug causing psychosis or AKATHISIA or suicidality.
    Brain inflammation from immune disorders can cause psyvhiatric symptoms. What purpose does psychotherapy serve here?
    I do not believe all psychiatric disturbances are linked to trauma, although many may be.

    • truth,
      I agree with the idea that psychotropic drugs cause “mental illness”. I have experieced this myself – in the form of over whelming symptoms of “mental illness” that I had never experienced before – cropping up when I tried to stop taking these drugs.

      I believe that at least 50 percent of all longterm “schizophrenics” and “bi polars” are created by the drug trreatments.

      (I also experienced Acute Akathisia + years of extrapyramidal disability).

    • Having been forced to take the toxic poisons (“antipsychotics” and “antidepressants”) for a period, but coming off all of them over 7 years ago, I now find diet, exercise and gentle friends are the only ways to control the ongoing damage/residual effect of these dangerous drugs.

      I stayed with therapy for 5 years after coming off the drugs believing that there must be some underlying problem, but that only kept me believing there was something quite fundamentally deficient in my character, when the damage was iatrogenic.

      For the past two years I have been totally free of psychiatry AND therapy and am gradually rebuilding the life that psychiatry had been so intent on destroying.

      I have residual trauma and iatrogenic damage…both from psychiatric “help”, (being locked up and forcibly drugged with highly toxic substances and treated like a cockroach IS traumatic), and thinking more psychiatry/therapy could help me was totally wrong headed..sort of a variant on the Stockholm Syndrome, perhaps?

      Being free of the psychiatry and understanding that the drugs and treatments (including traumatic “therapy”) have caused physical changes that mean I will need to be careful with my diet and environment and making new social contacts, friends and interests have probably been the greatest contributors to my ongoing wellbeing.

  2. Robert:

    Do you think that it is possible that recent epidemics of “ADHD”, “bipolar disorder”, “depression”, etc. may be due partially to the false medical model having become so ingrained in American culture, that: 1). Parents are now less likely to raise their children sufficiently due to being tricked to think that normal childhood immaturity is a “brain illness” that a child is incapable of overcoming, which prevents their children from learning mature coping tools, and 2). Adults are also being tricked into viewing their own normal feelings of sadness in response to normal life events like loss/disappointment/failure, as a “brain illness” that they are powerless to cope with. This would then cause them to not use their resourceful, adaptive capacities to understand and address their own problems, which then worsen over time as a result.

    Lawrence

  3. Hello, you say:

    “A fifteen year review of antidepressant studies showed that 50% of the 76 studies were positive and 50% were negative. All of the positive studies were published and all but three of the negative studies were suppressed and not published.”

    What is this review, please? I don’t find it.

  4. Helping gut bacteria in unhappy people would be preferable to putting them on SSRIs. For one thing you can check what grows in the gut to determine if the bacteria is right and how to fix it if it’s not.

    I have no problem with using proper nutrition (sleep or exercise) to help people feel better emotionally. This is different from putting people on mind-altering drugs.

    A few times I wound up on the psych ward from intense fatigue/depression I was found to have a low thyroid level. Anemia also causes those feelings–though I believe my pernicious anemia stemmed from my drug cocktail. Now it’s no longer an issue.

  5. Dear Dr Berezin, Thank you for telling the truth.

    “…Hallucinogenic drugs are being promoted as a cure for depression, alcoholism and the rest of psychiatry….”

    I related in a 12 step fellowship that ecstasy had now become a “wonder drug” :- “…when people took it they could confide in a therapist and overcome trauma..” –

    …and Everyone in the room started laughing.

    (.. people freely confide “cringe inducing” personal details in these groups all the time…).

  6. I agree with the majority of your article, but I believe the hallucinogens hold promise. Of course they are not a ‘cure.’ But neither is psychotherapy a ‘cure.’ It is but a means to assist one to be with reality, relationship, emotion and life, in a more skillful and loving way. The hallucinogens, if used with that intent, by people of skillful means, hold the potential of accelerating the process of healing. Of course they are not a cure, but a tool that some find to be helpful, and others not.

  7. I believe that people can be severely damaged by toxic psychiatric drugs, but some of this is reversible given time, proper diet, nutrients, exercise. That is not the case with the brain damage caused by ECT. Why are there so few psychiatrists that condemn this barbaric, brain damaging, lunatic torture?

  8. Excellent article. Do you see the pendulum swinging back towards a more psychosocial psychiatry in the coming years, or do you believe the biopsychiatric approach will predominate indefinitely? I teach young psychiatry residents and supervise them on their psychotherapy cases, and many (but not all) seem to recognize the limitations of the reductionistic somatic approach and yearn for instruction on the basics of psychodynamics and psychotherapy. Some even recognize the utility of psychotherapy in working with so-called schizophrenic patients. The history of the field is marked by major paradigmatic changes. Could we see one occurring in the next thirty or fifty years?

    • Mark L. Ruffalo, LCSW,

      “….psychotherapy in working with so-called schizophrenic patients….”

      “…in the next thirty or fifty years?…”

      34 years ago when I ended up in hospital following an attempt to withdraw from ‘medication’ ; I was told by a psychologist that all consumers could recover without drugs.

      I did eventually manage to withdraw very carefully from the ‘medication’, and to Recover as a result.

      The Psychotherapy that worked for me, involved compensating for the Severe Anxiety I experienced despite carefully withdrawing from the drugs (and this approach still works for me today).

      But if I didn’t make the Move away from Psychiatry 30+ years ago, I would still be “Psychiatric” today (or Dead).

      • How Does a Person Compensate for Neuroleptic Withdrawal Severe Anxiety?

        When I attempted to withdraw from Strong Psychiatric Drugs I could spot straight away that I was worrrying a lot, and had difficulty making simple decisions.

        At the same time through trial and error I was able to see, that if I could distance myself mentally from my problems – they wouldn’t seem like much, and decisions would became easy to make.

        So that’s what I did with Great Great difficulty, and it worked in the Long-term. This was my “Cure for Severe Mental Illness”.

  9. The attempt to salvage respect for psychiatry by dividing it into “somatic” psychiatry and psychotherapeutic psychiatry is clever, but it doesn’t hold water. From its inception, psychiatry has been, as Thomas Szasz has so clearly shown, the science of lies. But that deception is not limited to the lobotomies, electroshock, drugs, insulin shock, or other horrific practices. It is inherent in the endeavor itself. It is difficult for those who are invested in the field to recognize these realities (although some have managed to do it very well, namely Thomas Szasz and Peter Breggin). Why? Upton Sinclair’s astute observation is relevant: “It is difficult to get a man to understand something, when his salary depends on his not understanding it.” Szasz and Breggin still managed to make good salaries while telling the truth. Other psychiatrists and “professionals” should follow their good examples. It is wonderful that there are a few people who are willing to point out the conundrums of biological psychiatry, but it is well past time for those same people, and the general public, to understand that psychiatry is by its very nature a dangerous conundrum. The attempt to criticize, reform, or rethink psychiatry is a major part of the problem that will not be resolved until the truth about psychiatry becomes more widely known.

    To discover the truth about psychiatry, see here:
    https://psychiatricsurvivors.wordpress.com/2016/05/10/the-truth-about-psychiatry/

    Is psychiatry really the science of lies? Yes, see here:
    https://psychiatricsurvivors.wordpress.com/2015/02/05/psychiatry-the-science-of-lies/

    For those who wish to better understand the Brave New World reference to Soma, see here:
    https://psychiatricsurvivors.wordpress.com/2016/07/26/christianity-without-tears/

      • The success of ‘the science of lies’ I believe is achieved through the non acknowledgement of Recovery.

        Last time I saw my GP he recorded in Block Capitals “..I can see no reason why Mr X could not work on a Building Site..”

        On another sheet of paper from his ‘Legal Adviser’ given to me during the interview the last paragraph (unaware to the GP, I believe) stated “..this patient has a diagnosis of schizophrenia ..”.

        A person “..with a diagnosis of schizophrenia..” would not be suitable anywhere near a building site.

        But a person that made Recovery as a result of stopping treatment, and had remained well for many years would probably be suitable to work on a building site (If qualified).

        The diagnosis was not “Schizophrenia” – my GP had this wrong as well.

    • I have no real quibbles with psychotherapy as such. However, just because someone has a license to practice therapy does not necessarily mean that said person is a perfect fit for each and every person coming to them. Therapy only works if the person listening and asking the questions and the person doing the processing are a good fit. And simply having a license doesn’t mean that you know what in the hell you’re doing. A person seeking therapy may have to try numerous therapists before she or he finds the correct fit. And of course, to be a good therapist you must first respect people and believe that each and every person is of infinite worth and value in the world. I’ve gone to three therapists and one of the three was absolutely great. One was mediocre and the third was abusive. The one who was great was new at the work and he obviously liked it and liked people. He didn’t think too highly of himself just because he was the one sitting in the seat of power. I still use many of the things that he shared with me even after twelve years.

  10. I wouldn’t worry about hallucinogens having too much of a role in big-time psychiatry- you’ve got to spend 8-12 hours one to one per tripping patient, during which time the shrink could see 96 to 144 patients @ 5 minutes/visit. Or- they’d have to pay someone else to do the sitting in their place- not good for the old income.

    • Bcharris, when I went on my first SSRI (anafranil) I was tripping for 3 weeks. Slept maybe 20 hours the whole time. The shrink didn’t care I was losing it or going bonkers. He claimed ANAFRANIL NEVER caused HALLUCINATIONS. Either he lied or was too busy golfing to check the list of side effects in the pill manual.

      I never threatened anyone but I was terribly frightened. Dr. Quack said that meant I had classic schizophrenia without bothering to see or talk to me on the phone.

      Shrinks like him are behind most of these mass shootings! They should be publicly held accountable to the families of victims.

      • Well, I’d have to get you off the anafranil and start you on mega B3, probably niacinamide to avoid having you freak out from the flushing niacin frequently induces, because I know that (A) any antidepressant can induce hallucinations in the susceptible and (B) letting anyone hallucinate for prolonged periods seldom results in them having psychedelic experiences that they’ll benefit from.

        • Been off the anafranil for 24 years. The psychiatrist let me quit cold turkey. I spent 16 hours in bed sleeping. He told Mom since I was still detached I needed to be hospitalized immediately or become permanently insane. When Mom relayed this message I wept and trembled in terror. I went to the psych ward willingly-desperate for help. What I got was a mega-dose of seizure inducing Haldol. 🙁

          Now that I have weened myself off those toxins after 25+ years I wouldn’t mind the kind of therapy you offer, Bcharris. I feel horribly dry and itchy with a chronic cough and symptoms similar to the worst kind of fibromyalgia. My body keeps giving off weird odors those around me can smell (not just my imagination.) My thinking seems clearer for the most part though.

    • They should definitely be held accountable for drug induced suicide and homicide. My own Psychiatrist (and Psychiatric Researcher) hid my adverse reactions on the records, even when I requested they be recorded for my safety.

      Many many years later my GP Surgery is attempting to do the same.

  11. If it’s common medical policy to hide Adverse Psychiatric Drug Reaction (Akathisia) – then its not surprising that the average person is unaware of the dangers.

    I’ve had 4 male first cousins that have died on “medication”. They didn’t have too much wrong with them to begin with, I believe its possible that they were just ‘victims’ of bad medical advice.

  12. Right now there is zero solidarity among survivors. Everyone looks to psychiatry, psychotherapy, recovery, motivationalism, life coaching, and religion, to somehow fix them. Survivors seem not to understand that all of this is nothing less than subjecting say a rape victim, to additional rapes.

    Survivors do not understand that all of these healers are absolutely powerless because they have not faced their own pain. They have made zero attempts to redress the wrongs committed against themselves. Rather, they have found that if they preach dissociation and feel good, then they can not only propagate their denial systems, they can also rake in money.

    No amount of confessing in the psychiatrist’s or psychotherapist’s office can ever restore your social standing. Same thing for the recovery circle, nothing could ever restore your social standing.

    So of course you will continue to feel distress. Anyone who tells you that you should not be feeling distress is just another abuser.

    The only way any of us will ever be able to do anything to restore our social and civil standing is to act publicly, usually with close allies, to bring about justice. That means penalties for the perpetrators and reparations for the survivors.

    • Don’t beat yourself up over the matter, littleturtle. If you did, we’d probably have to call it “mental suffering”. You can throw out the biology there because there is none. However, if we beat you up, that’s a different ball game. Physical abuse, more often than not, especially if intensely rendered, can easily result in physical injury. Ditto: long term drug (“medication”) use, electrically induced grand mal seizures, and radical brain surgery.

    • Abusive relationships, extreme poverty, homelessness, and social ostracism are some very real causes of mental suffering, Littleturtle. These can all be helped without drugs. Leaving the abuser, gainful employment, shelter…these are real solutions to mental suffering.

      Brain tumors and certain forms of epilepsy may require surgery. Brain scans will show if something really is wrong with the physical brain. And a neuro-surgeon is needed. Not a psychiatrist!

      • Agreed, and in this day and age it should be impossible that a Psychiatrist doesn’t start there.

        They don’t look for jaw misalignments. They don’t look for toxins. They just hand you a bottle of pills based on behavior. Modern medicine is lazy. Sad thing is every diagnosis has a counter point.

        If you disagree but don’t voice your opinion too loudly you’re “Passive-Aggressive.” If you strongly disagree, you’re oppositional defiant. IF you do agree, congradulations you have a bottle of pills!

  13. “Abusive relationships, extreme poverty, homelessness, and social ostracism are some very real causes of mental suffering”

    Yes, these are causes of suffering. Really, its anytime your survival is being threatened because you are being marginalized. Its an evolutionary response.

    The remedy is to fight back, usually with comrades to restore your social and civil standing.

    MIA does a great job of exposing the harm causes by psychiatric medications. But psychotherapy, the recovery movement, life-coaching, and self-improvement are also very harmful too. They are another layer of abuse that survivors get subjected to, rather than being encourage to fight back and restore their social and civil standing, their honor.

    Familial abuses should be handled in a court of law, not a psychotherapist’s office.