The Scientism of Attention Deficit Hyperactivity Disorder (ADHD)

Sami Timimi, MD

In my last blog I reviewed the scientific basis on which modern mainstream psychiatry rests and showed how a poor understanding of the basics of the scientific process was evident in mainstream academic and clinical frameworks that organise psychiatric research and practice. Modern psychiatry is built on scientism, not science. In this blog I start to illustrate how this scientism can be found in the literature on specific ‘conditions’.

As a practicing child psychiatrist, ADHD is one of the four common ‘diagnoses’ I encounter in my practice — the other three being autism, childhood depression, and generalised anxiety (diagnoses that are usually made by other doctors for patients I ‘inherit’). As mentioned in my last blog, it requires little intellectual effort to understand that calling ADHD a ‘diagnosis’ is not logical or accurate. In medicine, diagnoses are part of a system of classification based on explanation. What we are referring to as ‘diagnoses’ in psychiatry are descriptive classifications with no explanatory powers and therefore, strictly speaking, not a diagnosis. Calling ADHD a diagnosis, i.e., something with the capacity to explain the behaviours that it describes, is like saying the headache is causing the pain in my head or the inattention is caused by inattention.

My first ‘serious’ encounter with the phenomenon of ADHD was as a trainee in child psychiatry in the mid-1990s. ADHD was not being diagnosed in the UK at that time; in fact, child psychiatry was a largely systemically orientated profession that didn’t use diagnostic labels, and child psychiatrists rarely prescribed medications. We were aware of the growing medicalisation in the US and there were child psychiatrists in influential positions in the UK who were attracted by this. By the mid-1990s in the UK, their influence was beginning to tell. Thus one of my supervising consultants expressed an interest in carrying out a ‘project’ on ADHD and its relevance to the population we were serving in an ethnically diverse and deprived area of inner London. He asked me if I would like to join him. As an enthusiastic trainee eager to learn I jumped at the chance. My consultant hadn’t yet formulated a research question and so asked me to do a literature review summarising key data on ADHD (diagnosis, prevalence, causes, urban v rural etc.).

This proved to be an enlightening experience — just not in the way my supervisor imagined. I read studies and reviews but felt troubled by my inability to grasp what this concept was. The more I read the less certain I became. I couldn’t answer the basic question of “what is ADHD?” What is it, I kept thinking; surely it isn’t just ‘attention deficit’ and ‘hyperactivity’, just what it was called, followed by the word ‘disorder’. I found it incredibly frustrating that the literature I was reading wasn’t addressing this basic question. Instead there was an assumption that ADHD exists as a ‘thing’ and that this thing had a concrete reality that meant you could make authoritative statements about its features, implications, causes, prevalence, treatment and so on. I was astonished to realise that ADHD had been conjured into existence by a few people’s imaginations without evidential basis. The evidence then brought forward avoided the scientific methodology and ignored the ‘null hypothesis’ (the basic and starting assumption that ADHD does not represent a characteristic natural entity, which should be assumed until concrete evidence is presented that shows that this null hypothesis cannot be true). The papers I reviewed made me feel uneasy. How could this construct be taken at face value and treated as if it were a real entity? If the construct does not reflect a specific, measurable, identifiable, natural entity (as the null hypothesis presupposes), then all the data built using the idea that ADHD is a ‘thing’ is suspect. Castles built on sand.

This lack of foundational solidity has been confirmed for me in my subsequent years of examining various facets of the ADHD literature. As I will explain below, research in the name of showing ADHD to be a natural entity has provided convincing evidence of the opposite. Sadly, in an era in psychiatric thinking dominated by scientism, this is not the message that most people receive.

Instead, this is the sort of information you get from websites when you google “What is ADHD?”

ADHD stands for attention deficit hyperactivity disorder. It is a medical condition. A person with ADHD has differences in brain development and brain activity that affect attention, the ability to sit still, and self-control. ADHD can affect a child at school, at home, and in friendships.” (Kids health) Or “If you have attention deficit hyperactive disorder (ADHD), you may have lots of energy and find it difficult to concentrate. It can be hard to control your speech and actions. ADHD is the most common behavioural disorder in children. It usually starts at about 18 months old, but symptoms usually become noticeable between the ages of 3 and 7. We don’t know what causes ADHD but experts think it runs in families. It could also be caused by an imbalance in brain chemicals.” (Young Minds) Or “ADHD is characterised by periods of impulsiveness, hyperactivity and inattention, but it’s more than being a daydreamer or a fidget. ADHD affects about 2-5% of us, and it’s largely genetic – although environmental factors can make it worse.” (BBC advice).

If you google “What causes ADHD?” you get things like:

ADHD tends to run in families and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition… Research has identified a number of possible differences in the brains of people with ADHD compared to those who don’t have the condition… Other studies have suggested that people with ADHD may have an imbalance in the level of neurotransmitters in the brain.” (NHS choices) Or “Scientific research has found there is a strong genetic link in ADHD. It is not a disorder that is learnt or passed on socially… Many of the genes that experts have identified as potentially contributing to the development of ADHD are genes that control certain types of neurotransmitter… Scientific studies have shown that in people with ADHD some important parts of the brain are developing more slowly and communicating less well.” (Netdoctor)

If you google “ADHD treatment” you get things like:

Treatments range from behavioral intervention to prescription medication. In many cases, medication alone is an effective treatment for ADHD.” (Healthline) Or “Treatment of attention deficit hyperactivity disorder (ADHD) relies on a combination of medicines and behavior therapy. Treatment with medicine depends on the age of your child. The first step is an accurate diagnosis of ADHD and an understanding of your child’s strengths and weaknesses. Learning about ADHD will help you and your child’s siblings better understand how to help your child.” (Webmd)

Thus you can see that the views you will likely encounter in most searches on the subject bring up lots of scientific-sounding stuff that tells you that ADHD is something that exists as an identifiable ‘thing’ and that this thing has something to do with your genes and brain (chemicals and structure), and can be treated by medication alongside some behaviour therapy. Scientism has turned ADHD from a vague, difficult to pin down concept into a fact of culture masquerading as a fact of nature.

As ADHD does not reach the required evidence base to be considered a ‘diagnosis’, it is not surprising that there has been a failure to find any specific and/or characteristic biological abnormality such as characteristic neuroanatomical, genetic or neurotransmitter abnormalities. Unlike the myths that have been spread to spur an ADHD industry on, the scientific reality is that we have a cupboard empty of confirming evidence and full instead of ‘junk’ scientism.

Scientism in ADHD genetics

The claim that ADHD is ‘genetic’ has been extrapolated from twin studies. In the twin method it is assumed that when a higher percentage of identical than non-identical twins are diagnosed with the same disorder, this is due to genetics rather than environmental factors. This is because identical twin pairs will share 100% of the genes whereas non-identical twins will have, on average, 50% of their genes the same. However, for identical twins to have a greater likelihood of having a disorder because of sharing the same genes, you have to assume that the psychosocial environment is the same for identical and non-identical twins. This is known as the Equal Environment Assumption or EEA for short. It has been long established that EEA doesn’t hold when comparing identical and non-identical twins. Identical twins are often treated similarly (e.g. dressed in same clothes) and experience a unique psychological environment (e.g. swapping roles to confuse others). Being one of a set of identical twins is a different experience to being a non-identical twin and so the psychosocial environment could (as well as genes) by itself be responsible for greater behavioural or emotional similarity in identical compared to non-identical twins. This means the twin study method cannot disentangle genetic from environmental factors for ‘psychiatric’ presentations, and so estimates of the genetic contribution to ADHD cannot be arrived at from this method.

The only way to reliably evidence a specific genetic contribution to ADHD is through molecular genetic studies. Since faster and cheaper whole genome scans have become available the molecular genetic evidence has been accumulating. This increasingly large volume of ADHD genetic research is not showing any particular genetic findings, whether in relation to abnormal genes or consistent genetic associations. Yet this has not stopped unscrupulous researchers from making claims to the contrary.

In 2010, a study was published in the medical journal The Lancet claiming to have found concrete molecular genetic evidence that ADHD is a genetic disorder. This study has been, and continues to be, referenced as the preeminent study that demonstrates the certainty with which we can call ADHD genetic. In the press release at the time, the research team lead, Professor Anita Thapar, left little room for doubt, saying: “Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children.” This is what they really found:

The study involved the comparison of whole genome scans of 366 children ‘with ADHD’ with those of 1047 ‘non-ADHD’ control children, looking for something called Copy Number Variants (CNVs). CNVs are abnormal bits of genetic code that are repeated where they shouldn’t be or deleted where they should. Researchers found 15.5% (57) of the children with ADHD had CNVs compared with 7.5% (78) of the non-ADHD controls. This leaves an excess of 8% in the ADHD group, hardly a significant figure. If we are to accept standard ‘mainstream’ quoted prevalence for ADHD, it also means that if you come across a young person who has CNVs they are more likely to not be diagnosable with ADHD than diagnosable with it.

The deceit doesn’t end there, however. The average recorded IQ of the children with ADHD was 86, 14 points below the general population average of 100. Furthermore, when 33 intellectually impaired (IQ lower than 70) ‘ADHD children’ were excluded from the ADHD group, only 11.4% of the remaining 333 had CNVs (now only 4% above the ‘non-ADHD’ control group). 39% (13) of the 33 children with ADHD and an intellectual impairment had CNVs. This evidence is more suggestive of a relationship between the presence of CNVs and intellectual disability (39%) than ADHD (11.4%). The authors of this study should therefore have controlled for IQ given its disproportionate impact on CNV levels, but chose not to. As mentioned above the average IQ in the ADHD group was significantly lower than the control group (whom we can assume would have a population average IQ of 100). The authors should have chosen a subgroup from their ADHD patients who had an average IQ of 100. This would then have made for a more legitimate comparison group to their control group. I can’t help wondering whether someone in the group did that, because I suspect they may have been left with no or a tiny 1% or so difference and so chose not to publicise this.

This sort of high-profile and media attention grabbing publication is worse than junk science, as the authors have misled the medical community and general public in their conclusions. With genetics then, the cupboard is empty and the null hypothesis stands: There is no characteristic identifiable genetic abnormality/profile associated with ADHD.

Scientism in ADHD brain imaging studies

As with genetics, ADHD brain imaging studies have not uncovered any specific or characteristic abnormality. The picture that emerges is of consistently inconsistent findings, which are statistical deviations (the brains would not be recognised by radiologists as being clinically abnormal), come from small sample size studies, don’t always accurately match for age (and you’ll see why this important when I comment on birthdate research below) and typically don’t control for IQ level, or for the possible effects of medication. One research team finds one bit of the brain smaller than ‘healthy’ controls and the next one doesn’t, or even finds that bit is a little larger.

But, as I have been explaining, the science should not get in the way of the dedicated scientismist! In 2017, The Lancet Psychiatry published a study that the authors claimed provided definitive evidence that young people with ADHD have different and smaller brains compared to their healthy peers. As with the genetics junk science, the lead researcher, Dr Hoogman, made bold claims that do not stand up to scrutiny. In a press release that was covered by mainstream media, he stated that “The results from our study confirm that people with ADHD have differences in their brain structure and therefore suggest that ADHD is a disorder of the brain.” In an excellent analysis by Michael Corrigan and Robert Whitaker for Mad in America, they show how the research reveals more about the desperation of the authors to find something than their ability to conduct a scientifically careful analysis of their findings.

The authors call their study a ‘mega-analysis’ as they took data from a large number of previous research projects and ‘number crunched’ all the different sites findings as if they were all just one big study. This process is sometimes illuminating, but can also make incidental findings look more significant than they are. In total, they had data from the brain scans of 1713 patients diagnosed with ADHD and 1529 individuals who did not have this diagnosis, gathered from 23 different sites around the world. They claim what amounts to tiny differences in some (not all) particular brain structures that become statistically significant when they add all the available recorded volumes for a particular structure in the ADHD and non-ADHD groups. Using certain measures of statistical variance enables them to make this claim on differences that are so tiny they are of no clinical relevance. This method enables them to hide the consistently inconsistent findings.

For example, the largest difference was found for a tiny brain structure called the nucleus accumbens. This mega-analysis thus makes the claim that children with ADHD have a smaller nucleus accumbens (NA). However, if you look at the data by site you find 10 sites that found an on average smaller NA in the ADHD group, 4 sites that found a larger NA in the ADHD group, and 6 sites that found no difference. This is the picture for the structure with the largest difference in the study. Staying with NA, you can also see that there are major technical issues with interpreting the scans. For example, individuals in Bergen Norway have an average NA volume of 758 mm3 v 805 mm3 (ADHD v control), whereas in Wuzberg, Germany they have an average NA volume of 462 mm3 v 449 mm3 (ADHD v control). Perhaps Norwegian children have amazing NAs compared to German children, whom by this standard must all have raging ADHD to contend with. However, given that the Norwegian group is one of the groups where the controls have larger volumes, whereas the ADHD group has larger volumes in the German centre, this huge variation which is larger between centres than within further biases the findings if (as is the case) those with larger total volumes lay more in the group that had differences in favour of controls having larger structures.

Finally, here is yet another study that does not control for IQ differences. Associations between brain volume and IQ have been shown across a range of studies with adults and children. When the authors of this study published the correct IQ table (embarrassingly they had originally published an incorrect version), a separate group re-analysed their data, taking into account potential effects of IQ, and concluded that there was no significant difference between individuals with ADHD and those in the control group in any of the investigated areas of the brain when IQ difference is controlled for.

Here too then, as far as the science is concerned, the cupboard is also empty. No one has come near to finding a characteristic abnormality, and as a result there is no biological marker or brain scan used to diagnose ADHD. The null hypothesis stands — there is no characteristic brain abnormality associated with ADHD.

Scientism and ADHD as a chemical imbalance

There is no shortage of ‘experts’ prepared to claim that ADHD is related to a chemical lack or imbalance of the neurotransmitter ‘dopamine’. This idea is based solely on the perceived finding that drugs (like Ritalin) that act to stimulate the release of dopamine, and therefore increase its levels in brain synapses, appear to improve the ‘symptoms’ of ADHD (more on that later). Decades ago studies found that if you take stimulants, regardless of diagnosis, it improves your ability, in the short term at least, to maintain concentration on a task. However, as no one had yet demonstrated a lack or no lack of dopamine in individuals diagnosed with ADHD, the chemical imbalance theory was able to spread alongside aggressive marketing from manufacturers of drugs that increase the levels of these chemicals in the brain.

Every now and then a study comes along that challenges the received wisdom and so gets limited publicity. One such study was published in 2013. Its findings questioned “previous suggestions that attention deficit hyperactivity disorder (ADHD) is the result of fundamental abnormalities in dopamine transmission.” The researchers found that administering methylphenidate (more commonly known as Ritalin) to healthy adult volunteers as well as those who exhibit symptoms of ADHD led to similar increases of the chemical dopamine in their brain. Both groups also had equivalent levels of improvements as a result of the drug when tested on their ability to concentrate and pay attention.

Here too then the cupboard is also empty. The null hypothesis stands — there is no characteristic chemical imbalance associated with ADHD.

Scientism of ADHD revealed in diagnoses of young-for-class children

Several studies conducted in different countries have found that the youngest children in a class year have a significantly increased risk (compared to oldest children in a class year) of being diagnosed with ADHD and/or receiving medication for ADHD. These studies have found that whether you are in country that has high rates of diagnosing or prescribing (like USA) or low rates (like Finland), this pattern is still evident. Such a pattern of identifying ADHD is strongly suggestive that relative immaturity to your peers is a significant risk factor for receiving this label (i.e., for adults noting and problematizing the described behaviours associated with ADHD). Whether it’s over 6% of children (in Icelandic study) who get prescribed stimulants or less than 1% (in the Finnish study), the pattern still holds. Whatever the cultural norms for problematizing these behaviours are, relative immaturity in the class keeps emerging as a risk factor. Of course, children mature at different rates, raising an important question of whether a diagnosis of ADHD even for older-in-the-class children might also be reflective of their relative slower developmental trajectory. For a while now I have thought the growth of pseudo-diagnoses like ADHD to be a reflection of Western neoliberal intolerance of diversity amongst children, where from an early age children are given messages that they are valued for what they do (for their ‘performance’) rather than for just being. These findings lend further support to my concern that the prevalence of diagnoses like ADHD acts like a barometer of how intolerant of children and childishness we are.

Scientism in ADHD treatment

In 1999 a study of ‘treatment’ for ADHD was published. By then, prescribing of stimulant medication (the most famous name for a stimulant medication being ‘Ritalin’) was widespread. When this study was published it received extensive public and professional coverage. I remember attending our Faculty of Child and Adolescent Psychiatry (in the UK Royal College of Psychiatrists) annual conference in 2000, with the then chair of the faculty explaining to us that the implication of this study was that we would have to prescribe stimulants for anyone diagnosed with ADHD and probably (given resource limitations) that stimulants alone would be sufficient for most.

So what did this famous study find? This American study often referred to as the ‘MTA’ study (stands for Multimodal Treatment study of children with ADHD), was a 14 month multi-centre trial where young patients were randomised to four treatment groups: medication (stimulants) only, behaviour therapy only, combined medication and behaviour therapy, and routine community care. The authors concluded that after 14 months of treatment, there was more reduction of ADHD symptoms in the medication only and combined treatment groups than the behavioural therapy only group, who in turn had better outcomes than the routine community care group.

As you might predict by now, there were considerable problems associated with the study that make such a conclusion questionable. For example, two thirds of the routine community care group were also on the same medication as the medication arm of the study, yet had the poorest outcomes. Furthermore, the behavioural treatment arm consisted of an intensive 6 week course that was completed at any time during the 14 months, so that by the time of the 14 month evaluation, some of the families receiving the behavioural therapy intervention had completed it up to 9 months before the 14 month assessments, whilst the medication arm included appointments right up to 14 months. This raises the distinct possibility of a placebo response being the main reason for better outcomes in the medication and combined treatment arms at 14 months. At that time, conflict of interest statements were not mandatory in most journals. Predictably, when these were made known, many of the lead authors had long lists of pharmaceutical company connections.

The story of the MTA study doesn’t end there. By chance I ended up, at a conference in 2002, sitting next to a psychologist involved in the evaluations of the MTA trial. He told me they had just completed analysing the data for the 3 year follow up at his centre. I remember him saying to me “Once these findings are published no one will want to have their children take medication anymore.” I had to wait another 5 years before the 3 year follow up of the MTA was published. Unlike the original 1999 study, this publication, published 8 years later (allowing plenty of time for stimulant prescribing advocated by the 1999 paper to become the norm), had little accompanying press or professional coverage. The follow-up analysis of outcomes at 3 years of the MTA study patients could not find support for continuing superiority of medication regardless of initial severity of ADHD symptoms. Additionally, those who used more medication during the 3 years were more likely to experience a deterioration in ADHD symptoms, had higher rates of delinquency, and were significantly shorter (by an average of 4 cm) and lighter (by 3 kg) than those who had not taken medication.

This is typical of the findings in other long-term follow-up studies that are naturalistic rather than controlled trials (in other words, following people who attend usual services). These studies also fail to show that long-term use of stimulants is associated with any improved outcomes compared to those diagnosed with ADHD who don’t take them, and where there are differences it is often with children on stimulants having worse outcomes than those diagnosed with ADHD but not taking them (see for example the Western Australia and Canadian studies).

If these medications, which are used so widely now, had little evidence of harms associated with their use, perhaps we could tolerate the small initial improvement that is sometimes associated with their prescription, even if there is no evidence of improved longer term outcomes. However, the stimulants that are being prescribed have near identical pharmacological properties to street drugs such as ‘speed’ and ‘cocaine’ that we regularly warn others of the physical and mental dangers associated with their use. If these drugs were only prescribed to patients for a year or less it might be possible to put together evidence-based arguments for their use in this limited and controlled manner. Unfortunately, once started, a prescription is likely to continue being given for years. Given the considerable harms associated with the use of such powerful and addictive substances, you really need clear blue water in outcomes between those who receive such medications and those who don’t. I can’t think of a rational ethical argument (probably because there isn’t one) to justify the long-term prescribing of stimulants given the available evidence.

Conclusion: ADHD is an example of scientism

I hope I have convinced you that whatever the perceived merits of thinking of ADHD as a ‘diagnosis’ that has biological origins and can be ‘treated’ with medication, it cannot be thought of as a valid scientific entity, and the current recommendation for its treatment which usually prioritises medication without time limits is not evidence-based.

ADHD is an example of how academic psychiatry got infected with scientism that has likely led to untold harm. Imagining that ADHD is a diagnosis blinds children, parents, teachers, doctors and other practitioners to a whole variety of context-related factors such as immaturity, learning difficulties, exposure to violence, dietary factors, lifestyle, lack of family support, lack of confidence in parenting, and so on. It also blinds them to a whole variety of other approaches that may prove beneficial for such children. It’s time we stopped using ADHD as a label and scrapped any guideline attached to this scientism.

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  1. Sami:

    This is an excellent summary of the many ways in which “ADHD” is pure fraud. I have a metaphor to demonstrate its ridiculousness: Imagine if your car wouldn’t start, and your mechanic diagnosed it to be caused by “CNSD” (Car Not Starting Disorder), which, he confidently explained, makes it hard for cars to start up. Although it sounds pretty impressive, you would probably suspect that he is just covering up that he has no idea why your car won’t start up.

    We have more trust/respect for doctors, so we tend not to question their explanations, and thus are more easily fooled by their official/scientific-sounding labels. Perhaps some parents are easily fooled since they want an excuse to tranquilize rather than raise their kids, due to not having the time, energy, or patience for this. It’s justification for sedation. And it allows parents to evade any blame for their kid’s failing to become mature/responsible, since it wasn’t their fault, but merely “symptoms of brain disease”. Telling people what they want to hear has been very lucrative for psychiatry.


    • Just a word for the parents and carers you criticise. On the whole, they just want their child to be ok and happy and do well, and tend to rise up in passionate defence at the suggestion that if ADHD is not real, then they must be either lying, or their child’s “problem” is their fault. As parents tend to feel strongly about their children, this is a sh*tstorm you do not really want to walk into! After all, if the rest of the world (friends, family, other parents, other professionals, tv, social media) is telling them their child may have a disorder, then taking their child to the doctor must surely be the right and responsible thing to do. Schools have a massive part to play in perpetuating this by medicalising kids problems straight away and saying they can’t and won’t offer any kind of extra help without “medical evidence”. More drugs get sold, more doctors look clever, and schools get to be more exclusive and intolerant of diversity and the range of what is “normal” in child development gets narrower. What chance do parents have against this? They are left completely disempowered. When parents tell me they are thinking about getting a diagnosis for their child (ADHD or ASD mainly) I ask them, “how do you think this will help?” and they pretty much always say something like “I just want him to get everything he needs at school” or “I just want him to be understood and not get into trouble”. I’d say it is our society which lacks the time, energy or patience for children and childishness, not parents.

      • You are so right. Unfortunately, parents ARE sometimes responsible for at least not knowing what to do to help their kids, and sometimes really DO create these problems by abuse or neglect, and the ADHD label lets them off the hook. More significantly, though, it lets SCHOOLS off the hook for not knowing how to educate these kids. The fact that going to school a year later leads to a 30% reduction in ADHD diagnoses tells us that a lot of this is just development, expecting things from kids before they are ready. It’s also a well-kept secret that kids with “ADHD” diagnoses do immensely better in more child-centered classrooms (think Montessori) where they have more control of their time and activities, to the extent that they look quite “normal” in such circumstances. There are no doubt a small subset of kids who really DO have something physiologically wrong with them, but the ADHD label also obscures any attempt to understand about the real physical causes (such as sleep apnea, drug side effects, low iron, thyroid issues, etc.) On the whole, the main thing that ADHD does is let grownups off the hook. But I mainly hold the professionals responsible for misleading the parents into thinking this is a real thing. The behavior is real; the idea that all kids who act that way have something WRONG with them is a fantasy.

  2. I vividly recall my “work pills”. I was given, experimented on with, amphetamines in grade school in the late 60s. I recall the feeling of being “amped up” and REALLY wanting to be outside or anywhere but in a stodgy Catholic classroom. I hated that feeling of being trapped. In later years I found that same feeling later when I self-medicated with street speed. It seemed as if it was already condoned as a medication, begging the question: What are the roots of addiction?

  3. Good article. It is obvious, and it has been obvious for a long time, that ADHD is a fraud. Didn’t the inventor of ADHD admit as much?

    “Modern psychiatry is built on scientism, not science.” Excellent observation. The implications of this fact are even broader than can be addressed in one article. The wholesale drugging and brain damaging of almost an entire generation of children will not come without consequences, some of which we have already seen in the Las Vegas shootings and the more recent shootings in Parkland Florida.

    However, Mr. Timimi, there is one small problem with your concluding argument. Psychiatry did not get infected with scientism at some later stage in its development. Psychiatry has always been inherently bound up with scientism. It has been a pseudo-scientific endeavor from its inception, as anyone who has studied the history of psychiatry thoroughly will understand. But you are certainly right that psychiatric scientism has caused and will continue to cause untold harm to untold numbers of innocent people.

  4. In all this flap about “ADHD”, I notice that NONE of the “scientismists” mentioned in the article have paid a lick of attention to a known major cause of these symptoms- subclinical lead intoxication, which frequently manifests itself by inducing hyperactive behavior in the afflicted. I hope this isn’t because of some unwritten law that forbids psychiatrists from using non-psychiatric drugs for any disease, so that d-Pen or calcium EDTA are no-no’s for use in hyperactive individuals, even if indicated by laboratory means like hair sampling or using d-Pen challenges (to see if lead is being excreted in urine).

    • “around 90% of adults are undiagnosed and unaware they are living with it. 25% of the UK adult prison population have ADHD, and up to 45% of young offenders (studies have even shown that treatment with inexpensive medication can reduce re-offending by up to 41%)”

      And let’s remember the labour party brought us Community Treatment Orders, which for those who do not know, are people living in the community forced to take psychiatric drugs… usually antipsychotics.

  5. The things that come up when you google search “ADHD *and whatever else* ” make me vomit.

    It is one thing to say that a person is not attentive to certain things. Hell, even if people want to take methylphenidate if it’s helping them concentrate better, let them do it. Just don’t say “ADHD” is causing those behaviours.

    These statements about “brain differences and genetic findings” that get so much attention in the media are disastrous. Kids from abusive homes will display many of the behavioural features associated with terms like “ADHD” , and then be told that they are genetically defective.

      • Steve…I am one of those former kids, so let me add my two-cents to your excellent, prescient point:

        Being psychiatrically labeled-and drugged- in a good (enough) home as opposed to an abusive and unstable home have entirely different, even counter-psychosocial- consequences. Moreover, putting a child on psychiatric drugs (with their attendant labels) while leaving them in (that) environment, is tantamount to covert violence. In my own experience (even though I was removed from all psychiatric drugs by the psychiatrist at the State Hospital my parents dumped me, as well as legally removed from my violent kidhood home-by the hospital), it wasn’t until I began writing about that period of my life a decade ago, that I realized how invisibly insidious the psychiatric dynamic had been. I had to untangle the unconscious conflations of violent home from identified patient, save the repressed memories and what had been lost as a result. In fact… I had to do it twenty years after leaving psychotherapy, where my therapist never brought up my psychiatric kidhood (after its initial disclosure), nor it’s clear disjuncture to that of my adult life. So… my point here is, these ‘kids’ are angry because the betrayal is never broken, honored, or reified through a skilled, repairing relationship(s) I’m guessing the psychotherapy profession writ-large is dropping the ball big time in this area.

        • I think you are right. The majority of therapists are apologists for the status quo, and would consider your resentment or criticism of your past psychiatric “treatment” as either irrelevant or misguided. There are exceptions, fortunately. I know one foster care survivor who had a therapist start off by asking, “What have professionals like me said about you in the past?” The therapist spent the entire first session helping the young lady reject all of these historical labels and get ready to start over with real, client-focused therapy. It was the first time she realized that therapy was supposed to be for HER. It had always seemed more like a punishment for behaving badly.

          Thanks for sharing your story – it breaks my heart to hear, but I’m glad you are finding a new way forward!

          • I really appreciate your saying ‘thanks for sharing your story”! I spent several months writing about it for this website (personal stories, of course) and it was rejected last July. I felt devastated-and shocked- by both its rejection and indifference to it by editor-person. I am pleasantly surprised by the sense of being heard by you, despite only using my experience to illustrate my point. Maybe I’ll try again (fail better!) by taking another tract?


      • How difficult it is to stay
        between the tears and the blood,
        to listen to sounds that only
        with time and rarely
        become melody,
        to endure chaos
        that cannot be understood.
        You have numbers to erase the tears,
        medicines to cleanse the blood,
        protocols to silence the
        harrowing sounds,
        techniques to tame chaos.
        You have a science that like
        a skilled magician
        pulls out of the cylinder
        the wise rabbit
        and makes disappear the man
        that was inside

        P.S.: sorry for my awful English

  6. To all

    Once again Dr Sami Timimi has ruined a potentially good blog by repeatedly using the term “scientism” (even in the title) to describe psychiatry’s pseudoscience as it applies to the ADHD diagnosis.

    The term “scientism” is completely nonsensical and confusing in this context and undermines the goals of anyone who is trying to present a critical analysis of the oppressive disease/drug based model of Psychiatry.

    noun: scientism

    thought or expression regarded as characteristic of scientists.
    excessive belief in the power of scientific knowledge and techniques.”

    The term “scientism” is most often used as a way to criticize GENUINE scientists for over emphasizing the power and role of science in seeking truth and creating a more just and moral world.

    Modern Psychiatry is in NO WAY being TOO scientific in their efforts to convince people that human psychological distress is based in faulty genes and brain diseases, AND allegedly requires psychiatric drugs (not “medications”) to “fix” all these “chemical imbalances” in the brain.

    The reality here is the exact OPPOSITE of what Psychiatry has both posited, and executed in their theory and practice. They are NOT using a real scientific methodology in their psychiatric diagnoses, and they are guilty (in so many ways) of totally corrupting the scientific method throughout their entire efforts to promote their Medical Model.

    I am amazed and dumbfounded as to why most of the commenters here at MIA seem to suspend all their critical thinking skills and allow the use of the term “scientism” to go completely unchallenged. Using this term is not just utterly confusing, but also undermines our efforts to expose this oppressive Medical Model.

    Dr. Timimi says the following:

    “I was astonished to realise that ADHD had been conjured into existence by a few people’s imaginations without evidential basis. The evidence then brought forward avoided the scientific methodology and ignored the ‘null hypothesis’ (the basic and starting assumption that ADHD does not represent a characteristic natural entity, which should be assumed until concrete evidence is presented that shows that this null hypothesis cannot be true).”

    Using Dr. Timimi’s own words here, WHERE THE HELL is there even a USEFUL definition of the term “scientism” that has ever been used in either of his two blogs? And he has even placed this term in the title, as if it were somehow a negative critique of Psychiatry. He has, in no way, even attempted to prove that the word “scientism” has ANY legitimate meaning when critiquing what is wrong with the Medical Model.

    The word “scientism” is a highly contested and confusing term which leads ALL of us away from our goals of applying a consistent and accurate analysis of Psychiatry’s negative and oppressive role in the world.

    And as a secondary criticism, Dr. Timimi continues to use the word “medication” to describe psychiatric drugs. Once again, I will point out that both Psychiatry and Big Pharma has spent several hundred billion dollars on the the world’s largest PR campaign attempting (quite successfully) to convince people all over the world that their mind altering drugs are some form of “medication.” We should never concede them the ability and right to use this false terminology. Changing language is a critical part of any historical movement for social change. Let’s start NOW!

    I wanted to like Dr. Timimi’s blog; he does provide some very good critical analysis of the ADHD diagnosis. But his reckless and cavalier use of the term “scientism” sticks out like a sore thumb and undermines the essential content of a potentially good blog.


  7. The term “scientism” is most often used as a way to criticize GENUINE scientists for over emphasizing the power and role of science in seeking truth and creating a more just and moral world.

    What is “genuine” and what is “over” emphasizing something is at least partially subjective. On its face and without dictionary prompts, I would read the term as referring to the embracing of “science” as some embrace religion, i.e. as a dogma to believe in rather than as a tool to help understand the material world. I believe such a sublimated need for spiritual fulfillment (which is repressed so as not to be seen by their peers as superstitious) is why so many self-proclaimed “progressives” embrace psychiatry with an irrational fervor not borne out by objective evidence.

    Modern Psychiatry is in NO WAY being TOO scientific in their efforts to convince people that human psychological distress is based in faulty genes and brain diseases, AND allegedly requires psychiatric drugs (not “medications”) to “fix” all these “chemical imbalances” in the brain.

    Actually they are being very scientific (and successful) in their efforts to convince people of these falsehoods, and their efforts are succeeding. Mass deception is also a science, one at which the prison/psychiatric complex excels.

    We should remember that all this discussion should be unnecessary. Once it is recognized that “mental illness” is a linguistically absurd distortion and manipulation of language, and could not even exist in theory, it’s game over as far as “science” is concerned. Once it is understood that there not only isn’t but could never be such a thing, any further “research” should be recognized as unscientific in and of itself.

  8. Oldhead

    You described “scientism” as the following: “…I would read the term as referring to the embracing of “science” as some embrace religion, i.e. as a dogma to believe in rather than as a tool to help understand the material world…”

    Even your attempt at defining this highly misused and confusing term in NO WAY shows how it represents, or helps explain what is fundamentally wrong with Psychiatry’s approach to developing the disease/drug based Medical Model.

    They are not way using science in a “religious” way. That is, believing in science too strongly or with too much fervor etc. They are totally DEVIATING from the scientific method and using very distorted and corrupted methodology to arrive at their bogus conclusions. The only sense that your use of a religious analogy would be, is that they base all of their conclusions on FAITH, not real scientific evaluation of facts in the real world.

    And Psychiatry is NOT being “scientific,” or “TOO scientific,” when they deceive the public with their pseudo-scientific claims. They are instead being dishonest, manipulative, deceptive etc. etc. etc. and the list goes on.

    Oldhead, don’t forget that there is a whole segment of the population that is very much threatened by legitimate science (or TOO much science), and they need to place certain limits on its acceptance as an important way of analyzing the world around us. This is, because it seriously challenges and threatens those who place a great deal of dependence on faith based belief systems to determine behavioral and moral choices in life. More often than not, these same people will fall out on the “conservative” spectrum, that is, defending the status quo and criticizing those seeking Revolutionary change in the world.


    • They are not way using science in a “religious” way.

      Well, that’s why I put science in quotes; maybe saying the idea of science would be more accurate. I don’t think “they” (presumably meaning psychiatric ideologues) care whether or not there is a legitimately scientific basis for their pronouncements, only that they can fool the requisite number of people to prevail.

      They are instead being dishonest, manipulative, deceptive etc. etc. etc. and the list goes on.

      Exactly. And they have it down to a science.

      they need to place certain limits on its acceptance as an important way of analyzing the world around us. This is, because it seriously challenges and threatens those who place a great deal of dependence on faith based belief systems to determine behavioral and moral choices in life.

      “Certain” limits doesn’t sound crazy irrational, depending on what those limits are. I think finding a balance between intellectual and intuitive knowledge is an important consideration. Are you suggesting though that “science” should replace religion in determining what behavior is “moral”?

      • Oldhead

        First you quote me as follows:

        “They are instead being dishonest, manipulative, deceptive etc. etc. etc. and the list goes on.”

        Then you follow that up with a one liner that reads:

        “Exactly. And they have it down to a science.”

        You know damn well that YOUR USE of the word “science” here is NOT the meaning of “science” throughout the two blogs in question. Come on, let’s have a dialogue that reflects the essential meaning of these words.

        Then you ask me the question:

        “Are you suggesting though that “science” should replace religion in determining what behavior is “moral”?

        I would ask you: do we need religion to have morality? Were human beings acting in moral ways BEFORE the advent of religion? Can atheists be moral human beings?

        And if we look at the essential content of the Bible, we can hardly call this a bastion of morality. And if we look at a sizeable percentage of those who strictly follow religious teachings, can we call them people who act in moral ways, or even profess a set of behaviors that could be classified as consistently moral?

        You already know what my answers are to these questions.

        And since you threw the ultimate bate here, YES, if science was somehow used to help determine those behaviors and material conditions on earth that would afford human beings the very best opportunities to live a free, non exploitative, and just human existence, it would be FAR superior than what any so-called religion could offer.

        And any careful examination of the historical role of religion and its overall effect on human beings would bear out my above statement. And I have no reason to not think this will be the case in the future.


        • You seem determined to miss the forest for the trees. You actually think I’m making an argument in favor of religion as an arbiter of morality? I wouldn’t defer to religion OR science in that regard.

          But I am not using a different definition of science; figuring out the most efficient way of getting from point A to point B would be considered the “scientific” way in my book, no matter the goal.

    • I think you’re overreacting, Richard.

      Wikipedia defines scientism as follows…

      “Scientism is a term generally used to describe the facile application of science in unwarranted situations not covered by the scientific method.”

      …and that is exactly how I was seeing it.

      Google gives us…

      “thought or expression regarded as characteristic of scientists.”


      “excessive belief in the power of scientific knowledge and techniques.”

      Close enough.

      You’ve got me wondering whether or not it isn’t your own scientism that has you objecting to the term.

      • Frank

        I would truly like to plead guilty to “scientism,” but the nonsensical, contradictory, controversial, and inconsistent use of the term, prevents me from doing so.

        Even the defining type quotes you chose above make my case for why this term should never be used in these discussions.

        “excessive belief in the power of scientific knowledge and techniques.”

        We need MORE people being scientific, and thinking scientifically in this world, NOT LESS. Just look at the horrible crimes perpetrated against other human being by those who follow superstition.

        Let’s take the words “rational” and “logical,” can there really be such a [negative] thing as being “too rational” and/or “too logical”? You could only answer, yes, in instances where people somehow lacked an understanding of other people’s emotions. And even here we can draw “rational” and “logical ” conclusions about how such behavior may need to explore a deeper understanding of how humans are effected in these situations.

        Frank, what are those things in the world to which we cannot somehow apply some aspect of the scientific method? And for those things to which TODAY we cannot seemingly do this, who says that TOMORROW we may not find a way to explore these questions in a scientific way?

        And Frank, for those things that you do not think science is currently useful or helpful for, are you willing to trust religion, or some other faith based and/or superstitious belief system to provide the answer?


        • We don’t need more people applying the scientific method where it can’t, or shouldn’t, be applied. The view that everything comes under the umbrella of science, or that all problems will be solved by it, is, to my way of thinking, scientism.

          As for more people thinking scientifically, when it comes to soft science subjects such as psychiatry and psychology, that’s not what you get. What you get are more people thinking pseudo-scientifically. Astrology is science to the person who doesn’t know any better.

          Logic is not the truth. Logic is a method for determining what the truth actually is, and of distinguishing that truth from falsehood.

          Can there really be such a thing as being “too rational” and/or “too logical”? Yes. Anything can be taken too excess, even logic and rationality. The mental asylum building movement got a big boost from the enlightenment’s ostracization of viewpoints it felt to be unreasonable and non-rational and the people who held those views.

          Applying the scientific methods to all aspects of society is what I saw taking place in Walden Two, B. F. Skinner’s utopian/dystopian depiction of the future, depending on your perspective. Being more of a Walden One type of person, I’m no fan at all of behavioral mod. We’ve also got Orwell’s 1984 to show how science can go dreadfully wrong.

          I would never want to confuse science with so-called social engineering.

          • Frank

            You said: “We don’t need more people applying the scientific method where it can’t, or shouldn’t, be applied.”

            Once again, please tell me where are those places where it can’t or shouldn’t be applied?

            You said: “Logic is not the truth. Logic is a method for determining what the truth actually is, and of distinguishing that truth from falsehood.”

            Exactly Frank, and that is also exactly what science is suppose to do.

            And you can never be TOO good at either logic or science. And to say you can be, is a way (for some people) to diminish the importance of science, and thus leave the door open for superstition to guide one’s thinking. And we see all the dark places where that has led human beings in the past.

            And Frank, behaviorism denies the role and importance of consciousness. I would never deliberately do that. Please tell me where you think I might have done that in any of my writings.

            The use of the nonsensical “scientism” term is a backward step in ANY discussions critiquing Psychiatry and psychiatric oppression. It cannot be justified, and no one here has come close to making a legitimate case for its value in these discussions.


          • The humanities, social “science”, “metaphysics”, etc. If a person is going to step to the beat of their own drum, I don’t want to impose another person’s drum beat upon them.

            One could imply that a rapacious appetite for acquisition and exploitation was natural, but such an appetite is a threat to the environment (i.e. nature), too. Go with number one, and you’re in step with the drummer supplied, go along with number two, and you’re out of sync with the times. I’m not saying anybody should be in sync with the times.

            I don’t see scientism as a nonsensical backward term. I see it as a matter of applying science where science, for one reason or another, doesn’t apply, or, say, belong. Medicalization, for instance, where one is labeling non-medical problems, such as distraction or disobedience or misconduct, diseased, for social control purposes. Medicalization is an example of scientism in practice.

          • Oldhead

            I see intuition, and the feelings associated with it, as representing partial knowledge (little bits and pieces of knowledge combined with one’s past experience) that leads to embryonic forms of thought and conclusions about what may or may not happen, or be anticipated to occur in someone immediate future.

            I don’t think we can separate it from past experience or one’s logic about probable events in the real world based on that experience.


          • Frank

            You said: “Medicalization [of human thought, feelings, and behavior] is an example of scientism in practice.”

            This is nonsensical verbal gymnastics on your part to fit a specious argument.

            The “medicalization” that Psychiatry promotes and practices is *mythology* in practice. They have to distort and subvert scientific methodology in order to arrive at their wrong and harmful conclusions and practices. Why even give them (and it) any so-called scientific trappings by even using a word like “scientism.”

            I suggest you and Oldhead read some of the in depth debate about the history of this term, and how contentious, confusing, and politically charged many of the arguments are surrounding the use of this term.


  9. Oy, already! Does anyone else see this back and forth argument about a topic where there is quite a bit of agreement- with regard to the Mental Health counter narrative – as more than a little ridiculous? Is it necessary for each of us individually to speak using the exact same terms- sort of like the promotion and adoption of the lock step mythology of the “chemical” imbalance? Why so shrill and strident? If we cannot listen in this forum and be open to multiple perspectives, variation in expression and experience- why bother? Thank you, Sam for contributing this good and relevant article.