The Scientism of Autism

Sami Timimi, MD

In my last two blogs I reviewed the scientific basis on which modern mainstream psychiatry rests and then reviewed the science behind ADHD as a ‘diagnosis’. In both blogs I showed how a poor understanding of the basics of the scientific process was evident and how much of current practice arises out of what I am calling ‘scientism’ not science. I am aware that some think my use of the term ‘scientism’ as opposed to, say, ‘pseudoscience’ or ‘corrupt science’ is a mistake. I think scientism is a more useful term as it can cover many aspects: It can refer to an over-emphasis on the use of scientific knowledge and techniques, but can also refer to the corruption of science.

Use of the positivist, hypothesis-testing, measurement-focused pursuit of objective, value-free knowledge about the world ‘out there’ (beyond our imaginations) works great for systems and phenomena governed by ‘laws of nature’, but is not the most appropriate method for understanding subjective, meaning-generating conscious life. Kidneys don’t have dreams, intentions, or agonise over the meaning of their existence, and so we can use positivist, empirical methods to study them. Corruption of science can happen by methods such as the repetitive use of ‘science’ sounding language to provide an air of authority, whilst ignoring, not publishing, data fishing, and/or minimising facts or research that contradict the opinion expressed. So for me the term ‘scientism’ covers what I think has happened in psychiatry where the idea of being scientific and doing science trumps what the actual science finds and marginalises non-empirical approaches to understanding mental life.

Many are seduced by the idea that science will eventually answer the ‘why’ question that will lead us to be able to make diagnoses in mental health (i.e. a classification based on causal explanations) just as we do in the rest of medicine. For a whole host of reasons, such as financial, conflict of interest, guild and ideological allegiances, since these ‘scientists’ can’t establish anything definitive they resort to scientism. Over time the language and concepts associated with this ideology (for example the belief that we have psychiatric diagnoses and treatments that are specific for these diagnoses) become part of institutions, books, trainings, and of course our broader cultural ‘common sense’, so we think of them as if they were already established scientific facts, whilst the actual facts and uncertainties fade into smaller cultural spaces (such as this website). To me this is a classic example of the sort of dynamics associated with scientism.

I suspect my two previous blogs on scientism in psychiatry and ADHD were easier for readers of this site to agree with than this one will be. I have been aware of the divergences in critical views on autism, and I know that my view that autism as a concept is similar to other behavioural/psychiatric diagnoses and has no scientific basis is more likely to cause discomfort for some. However, like ADHD, I see Autism and Autism Spectrum Disorders (ASD) as facts of culture rather than a fact of nature.

I often feel conflicted when writing about autism as I am aware that there are many critics of the medicalisation of autism, who see autism through a story of ‘neurodiversity’ and have done many positive things to help empower some people who have been given the autism label, enabling them to accept and value who they are. I acknowledge and value the courage and insight these activists have and the contribution to the field they have made. But I struggle with the ‘neuro’ bit of ‘neurodiversity’ — the evidence just isn’t there. I feel this then leads straight back to bio-reductionism rather than freeing people from it. I had an interesting debate about this with Damian Milton, a sociologist and autistic activist coming from this neurodiversity critical autism perspective, which you can find here.

I think it has been harder to critique autism than labels like ADHD as autism has no specific pharmaceutical treatments attached to the label and hence the conflict of interest issue is not so easily apparent. Autism also has its origins as a rare condition diagnosed in children with significant learning difficulties and high rates of co-existent neurological disease such as epilepsy. This original cohort therefore had strong evidence of neurological abnormalities, but since the expansion into ASD we have a real mixed bag of presentations, problems, and levels of functioning. When I see such ‘diagnostic’ expansion, I get suspicious that we are not dealing with a diagnosis, but rather a branded commodity that has market appeal and so is vulnerable to what I call the ‘elastic band effect’ — where the boundaries can be stretched almost endlessly as the descriptions have ‘fuzzy boundaries’ that are open to subjective interpretation given that there are no physical markers to help accurately measure and categorise any one individual.

A very brief history

The word ‘autism’ was first used in psychiatry in 1911 by the psychiatrist Eugene Bleuler who used the term ‘autistic’ to denote the state of mind of psychotic individuals who showed extreme withdrawal from the fabric of social life. It is probably the most accurate use of the term as Blueler used the word to describe a state of mind rather than as a diagnosis. Then, in a paper published in 1943, the child psychiatrist Leo Kanner first proposed ‘autism’ as a diagnosis and used the term to label a group of 11 children, of middle class parents, who were emotionally and intellectually impaired and showing an ‘extreme aloneness’ from early life. It has been suggested that Kanner coined this new diagnosis in order to have a different word to use after pressure from some parents who did not wish their child to be labelled with the more stigmatising label of ‘Mental Retardation’ in use at the time. Autism then remained as a rare diagnosis given to young people who had considerable impairments in day-to-day functioning and often had moderate to severe learning difficulties with an estimated prevalence rate of 4 in 10,000 (0.04%).

The year after Kanner first proposed ‘autism’ as a diagnosis, Viennese psychiatrist Hans Asperger published a paper, largely ignored at the time, in which he described four children with no easily recognisable intellectual impairment, but with social communication problems. In the late 1970s, psychiatrist Lorna Wing saw a similarity in some people she was seeing and those described by Asperger. Dr Wing’s ideas intersected with another psychiatrist, Michael Rutter, and formed the basis for the expansion of the concept of autism into Autistic Spectrum Disorders (ASD). Revisiting the seminal papers by Wing and Rutter reveals the extent to which this expansion of the concept of autism was not the result of any new scientific discoveries, but rather new ideologies. For example, in her paper in 1981 proposing the ‘Asperger Syndrome’ diagnosis, Wing describes six case histories that appear to have little in common with the four cases Asperger described in his paper beyond sharing a lack of social reciprocity and a few other vague similarities. Four of Wing’s cases were adults, whereas all of Asperger’s were children; two had some degree of learning disability, whereas none of Asperger’s did; most of Wing’s cases spoke late whereas most of Asperger’s spoke early; most of Wing’s cases were described as having little capacity for analytical thought whereas Asperger’s cases were described as highly analytical; and none of Wing’s cases were described as manipulative, mendacious, cheeky, confrontational or vindictive (terms Asperger used about his cases) and so on.

Over the next couple of decades the concept of autism started to attract more professional and public interest, boosted by media coverage from events like the film Rain Man and the vaccine controversies. More people were talking about this ‘thing’ called autism. Soon there were courses, assessments tools, research, services, documentaries, experts and institutions all dedicated to furthering our knowledge and understanding of autism and how to treat or prevent it. Autism was now a fact of culture. Diagnosis rates continued to expand, leading to more services, research, talking about it (and so on). Now a group of adults who identified with the idea of autism but rejected the notion that this was a disorder emerged. These activists started talking about autism as a difference — a different but equally valid way of viewing and interacting with the world as a result of a different neurological ‘wiring’. Tensions have sometimes emerged between this latter group who spoke of themselves as part of the spectrum of ‘neurodiversity’ and those (often parents) who were struggling to cope with the behaviours of diagnosed children, who were often desperate to find ‘treatments’ and felt the ‘disorder’ side of things. Autism had become a visible and lively discourse, by now simply assumed to represent a real, tangible, identifiable ‘thing’ that could be differentiated from other potential problems (if you identified with the ‘disorder’ side) or meant that you were fundamentally different to ‘neurotypical’ subjects (if you identified with the difference perspective). No one, it seemed to me, was asking the obvious question: On what evidential basis can you conclude that autism represents a natural category that can be differentiated from other natural categories?

When I was training as a child psychiatrist in the early to mid 1990s, I came across two children diagnosed with autism in the whole of my four years of training placements. Both had marked functional impairments and had to attend specialist schools. According to some recent local data I have seen, 1.6% of school age children in my county now have a diagnosis of autism. This means that in the space of two or three decades prevalence has gone from 0.04 to 1.6%, a phenomenal increase of 4000%.

Nowadays I get the impression that any child who attends our Child and Adolescent Mental Health Services could end up getting a ‘diagnosis’ of ASD. Particularly when the young person is not responding to what is considered the ‘correct’ treatment, I often hear autism being suggested as a possible reason for the problems or lack of treatment response. So we end up in what I call ‘semantic games’, a kind of ‘what shall we call this’ rather than an understanding of what might be contributing to their presentation or what might make a difference to them. Naming is understandably popular with many, such as other professionals, teachers, parents, and some teenagers. But in my experience it can become a trap as people confuse (understandably) what has been sold to them as a ‘diagnosis’ with it actually being a diagnosis. In other words, they imagine that because they ‘have autism’ it helps them understand the reasons for their troubles and therefore professionals will now know how best to help them. My clinics have many people who have gone down this route, but where things have gotten bad again and now they think there must be another diagnosis and therefore another treatment and so they slip further onto the path of becoming a disempowered, helpless patient/parent at the mercy of being prescribed more, often useless, treatments (whether drugs or psychological) that further disempower. It’s a very hard cycle for all (professional, child and family) to step out of.

So what is the science supporting such a meteoric rise in prevalence?

Evidence to support the claim that autism is a ‘neurodevelopmental disorder’, in other words to do with the development of the brain, comes mainly from genetic and neuroimaging studies (for further details and further references for the discussion below, see chapter 2 in Re-Thinking Autism: Diagnosis, Identity and Equality).

Scientism in autism genetics

The argument that autism is a strongly genetic condition rests primarily upon twin studies. I explained in my last blog on Scientism in ADHD why estimating genetic heritability using the twin method does not give you reliable results. The only reliable way to establish the genetic component is through molecular genetic studies, of which there is a growing database involving whole genome scans of thousands of children with the autism label.

No specific, characteristic, rare, common or polygenetic genes for autism have been discovered, but not for want of looking. Thus various candidate genes, linkage studies, genome scans, and chromosome studies have all failed to produce and reliably replicate any particular genes for autism. The more failures that pile up, the more ‘complex’ autism genetics must be, according to advocates, whilst the most likely explanation for this finding — that there is no such thing as genes that cause autism — remains unmentionable. The continuing failure to identify specifics seems to have resulted in the majority of the human chromosome being identified as potentially harbouring autism genes, with major reviews typically concluding: “Many research teams have searched for genes that may be involved. They haven’t turned up any prime candidates yet, only dozens, maybe hundreds of bit players” (Hughes, 2012) and “With the advent of next generation sequencing techniques, the number of genes found that are associated with ASD is increasing to over 800 genes; consequently, it is becoming even more challenging to find unified explanations and functional associations between the genes involved” (Al-jawahiri and Milne, 2017). Instead of facing up to the possibility that genes are not revealing themselves because they are not there, we are instead moving into an era where multiple research teams come together to create banks of ‘big data’ in the hope that this can reveal tiny associations. It is hard to face the possibility that this mass of research money has led to a wasted endeavour.

The high ratio of males to females in ASD diagnoses also poses a problem for genetic theories. Genetic mechanisms need to account for this (such as autism being transmitted through the X chromosome) and thus far no molecular genetic studies have found an X or Y chromosome link.

Scientism in autism neuroimaging

An important consideration to take into account in any analysis of neuroimaging profiles is that of ‘neuroplasticity’. This refers to the remarkable ability of the nervous system (particularly in children) to grow and change in response to environmental stimuli. The remarkable plasticity of the human brain makes it difficult to determine precise cause and effect when individuals with differential life experiences subsequently show what appear to be differences in neurological structure or functioning. This inconvenience makes it difficult for researchers to ‘pin down’ behavioural aberrations into neurologically valid and clinically meaningful categories. Thus, neuroanatomical and functional differences could be the result of environmental factors affecting brain development (like psychological trauma), differential maturation rates and variations resulting from heterogeneity in the sample (for example, the effects of confounds such as intellectual ability).

However, the biggest problem for autism studies, as with ADHD, comes from the lack of consistently replicated findings. This consistent inconsistency plagues research in this area. For example, studies focusing on the cerebellum have documented an increase in cerebellar volume among children diagnosed with an ASD, while others have found smaller than average cerebellar volumes; yet others have reported no significant differences. Similarly, studies on the amygdala have found wide inconsistencies, including some studies that found significant differences in volume and others that found no differences. Similar inconsistencies have been found in cortical thickness with differences often becoming insignificant once intellectual ability level was controlled for. And so on.

The confused and contradictory reality of autism brain research was illustrated clearly for me when I participated in a debate about autism with a colleague at an academic event in March last year (2017). We each had to put forward papers supporting our view. The colleague I was debating with believes that autism is a ‘known’ disorder of the nervous system and that with sufficient research we will discover its neurological basis. These are the three papers he put forward:

  1. The emerging picture of autism spectrum disorder: genetics and pathology,” a 2015 paper by Chen and colleagues. This paper proposes that research points to a primary role in ASD for the limbic system and cerebellum.
  2. Neuroimaging in autism spectrum disorder: brain structure and function across the lifespan,” a 2015 paper by Ecker and colleagues. This paper focuses on frontal and temporal lobes and the cerebral cortex as the primary sites of interest.
  3. Autistic spectrum disorders: A review of clinical features, theories and diagnosis,” a 2015 paper by Fakhoury. This paper plumps for the primary issue in ASD being the balance of excitatory and inhibitory synapses.

It is a complete mess. No common theme emerged from these three ‘state of the art’ research reviews. Theories come and go and no one has a clue really what, how or where this apparent neurodevelopmental abnormality is. In none of the three papers was there evidence of a reasonable attempt to control for, or even mention, intellectual disability as a possible contributory factor to any differences found in studies. Recently some researchers are finally giving up on the notion that they will find anything. A 2016 paper entitled “ASD validity,” which includes the renowned autism researcher Christopher Gillberg amongst its authors, concludes, “The findings reviewed indicate that the ASD diagnosis lacks biological and construct validity,” and they recommend disbanding ASD diagnoses as a basis for research. Sadly, they go on to suggest a broader neurodevelopmental construct instead. None of this evidence (or rather lack of it) seems to have the slightest dent in the continuing expansion in the numbers receiving ASD labels or in the assumption that there exists a natural thing called autism.

Scientism defines what autism is

These days the same behaviourally defined syndrome (ASD) is applied to residents of institutions with little hope of living independently and a long list of the great and the good such as Mozart, Van Gogh, Edison, Darwin — all of whom, along with many others, have been retrospectively diagnosed as having an ASD (just type ‘famous people with autism’ into google). From an ‘impairment’ perspective, this is the entire human spectrum, suggesting that ASD, as it is currently defined, is too wide to have any meaningful features, beyond perhaps some degree of social awkwardness.

This problem of having a vast repertoire of presenting behaviours and levels of functioning that can lead to a diagnosis is referred to as the problem of ‘heterogeneity’. Not only do the ‘core’ features such as difficulties in social communication have a large cross-over with people who would not consider themselves as having a ‘disorder’, but autism as a mental state (referring back to Bleuler’s original use of the term autism to denote a state of social withdrawal) and elements of autism symptoms as traits are common in a variety of mental health diagnoses, from ADHD to depression and anxiety to psychosis. Heterogeneity is widely accepted as an issue in ‘mainstream’ publications about autism. However, far from seeing this as a major problem regarding the validity of the concept, it is often explained away as a reflection of the ‘complexity’ of autism. This leads to the ludicrous situation where a consultant at a conference was proudly talking about the first 100 patients they had diagnosed with ASD at their new national clinic and how “if you put those 100 people together in a room and talked to them you would struggle to see what they had in common.” This was put forward to explain how varied ASD presents in real people, but the pointlessness and bizarreness (just from a common sense, let alone scientific, point of view) of giving people who had little in common the same label seemed lost on this consultant (and sadly most professionals in the autism industry).

Wherever you look, what is evident is a heterogeneity and a lack of conceptual clarity about what autism is. This confusion is apparent when examining ‘diagnostic criteria’ for other common ‘diagnoses’. For example, in ‘conduct disorders’ you can find “inability to form bonds with peers and egocentrism, which is shown by a readiness to manipulate others for favours without any effort to reciprocate together with a general lack of feelings for others.” This description bears (arguably) a closer resemblance to the descriptions of the cases Hans Asperger wrote about than Lorna Wing’s cases (discussed above). One of the core features of the autistic spectrum is supposed to be a lack of empathy, a lack that is thought to cause enduring difficulties in social interactions. How is this type of ‘lack of empathy’ to be differentiated from the lack of empathy found in conduct disorder or indeed the ‘personality disordered’ criminal? Other ‘disorders’ such as ‘Attachment Disorder’ also describe children who lack empathy and have dysfunctional patterns of social interaction. Attachment disorder is described as often associated with some form of neglect, abuse, or trauma, however, in the absence of robust evidence on aetiology in autism, making the distinction between social dysfunction in the context of conduct disorder, attachment disorder or ASD becomes little more than a matter of the semantics carried by the subjective opinion of the diagnoser. This confusion of symptom crossover is not limited to conduct and attachment disorders, but spans potentially the entire spectrum of psychiatric diagnoses.

Take for example the ‘symptom’ of “Restricted and repetitive behaviours.” You will find versions of this in criteria describing Obsessive Compulsive Disorder, Obsessional Personality Disorder, Schizoid Personality Disorder, ADHD (such as with computer games), depression (morbid preoccupation with negative aspects), eating disorders (fixation with food and/or weight) and so on. Away from manuals and medicalised symptoms you can also find this with: most men (e.g. with football/soccer!), sportsmen and women (with their sport and training regimes), and humanity in general as an obsessive interest in a restricted sphere is characteristic not only of a depressed state of mind, but also of the application needed for discovery and exploration. Most high achievers thus have the capacity to ‘fixate’ on their area of interest/expertise.

What about the symptom of “lack of empathy”? You can see this in many formal diagnoses, such as depression, conduct disorder, psychosis, ADHD, personality disorders, attachment disorder and so on. It can also appear as a result of a lack of self-confidence in social situations. In fact, any experience connected to a preoccupation with one’s own problems tends to reduce interest in other people’s lives and interests. The extent to which one can feign interest in all subjects or empathise with all predicaments is limited. As expectations for social empathy (e.g. in school and in the workplace) increase, more may appear to lack this capacity. Perceived poor achievement or a sense of inferiority in a competitive culture may lead people to turn away from a range of common interests. And so on.

Thus what are considered primary symptoms of ASD like “lack of empathy” and “restricted and repetitive behaviours” cannot be thought of as isolated individual pathology/difference, without an understanding of the context in which they appear. When you start to dig around the undergrowth that constructs our idea of autism, it becomes apparent that it is so shallow; nothing can realistically take hold there. It is no surprise that all we have is scientism holding up autism as a concept. If we can’t find any boundary to hold the concept together, even a vague one, how on earth do we expect to find biological correlates or markers? The reason we can’t find any is thus obvious. According to the real science, then, autism should be seen as a fact of culture, not a fact of nature.

Autism is past its use-by date

I believe that the concept of autism and ASD, just like ADHD, is not just an example of the rampant scientism that has colonised the fields of psychiatry and psychology, but further, that we should stop using them. At the very least we have to stop calling them and thinking of them as ‘diagnoses’ (something with explanatory power).

I am pleased that a movement grew to reclaim some sense of the self-worth that was stolen by the ‘disorder’ paradigm of autism. However, I don’t believe the neurodiversity movement is likely to lead to the sort of shift I am thinking of. Whilst some might claim that the creation of the alternative categories of ‘neurotypical’ and ‘neurodiverse’ is a playful liberation from the pathologising medics, it still perpetuates the ‘us’ and ‘them’ dynamics and further solidifies the individualisation that feeds neoliberal politics. It replaces the marketization opened up by autism as a disorder with marketization in the sphere of neuro-identity. As I have discussed above, there is no measurable, characteristic ‘neuro’ bit here. Those who believe that we have found it have been sold a lie. We are all (humanity) simply neurodiverse.

Autism is part of the paradigm of medicalising, pathologising, and individualising that serves neoliberal politics and economics so well. The oppressive and insecure contexts that people, families, and communities must endure in the quest to make the ideal entrepreneurial, competitive, efficient, emotionally intelligent (to sell oneself or services, or cleverly manipulate others) qualities needed to be considered ‘normal’ means that when individuals can’t keep up, our societal constructs can blame this perceived failing on their interiority. Autism is one of those failings that can be branded, given a ‘scientific’ (scientism) badge and marketized. The focus then shifts onto the ‘failed’ person, who can be ‘supported/treated’, and the broader social context is freed from deeper examination. Further, politicians, bureaucrats, charities, and policymakers can look like they really care when they talk sympathetically about those blighted with this disability and how they are helping and supporting these people.

But at what cost do we continue to widen and widen the ASD net? Who has looked at the data of what happens to those caught in this net? Where is the evidence that a diagnosis improves the real world outcomes for those diagnosed? Why are we not researching this basic question? How many are warned about the potential negative outcomes associated with a diagnosis? I know, for example, that certain professions will not accept anyone who has an ASD diagnosis, but I don’t know how widespread this issue might be. In a recent report on ‘neurodevelopmental’ disorders and services in the county where I work, I read that “15% of adults with an autism spectrum disorder are in full time employment.” I don’t know what this means, but that seems like a worrying statistic to me. Labels carry associations and stereotypes few of us are able to see beyond. How many of us stop just seeing and trying to get to know “Jane” (or whoever) when we are told “she has autism”?

I understand that there are many who have found the act of ‘naming’ helpful. Parents may be enabled to have a new sympathy for their child and adults may feel that something about their life now makes sense. But at what price? How long do these initial feelings of relief last? What goes missing from that person’s narrative when a label that cannot explain is used to explain? I worry about these questions and why I never see them being asked in mainstream literature on the subject. I worry about the potential for a subtle kind of violence that can be inflicted on someone thus labelled that may limit their own, their family’s and a whole host of people’s beliefs about what they can and can’t do, what they need protection from and don’t. I worry about how having the label of autism provides a cruel kind of hope. Parents may feel now that something is understood, ‘experts’ will know what to do to help. As the days, months and years accrue with matters not improving, what does that do to parents’ feelings about their ‘disordered child’ and their ‘autism’? These are the types of dilemmas I regularly see in my consulting room.

In my practice I often meet families who have had a child diagnosed with autism, where matters haven’t improved, where parents feel disempowered because they believe that they cannot have the ‘expertise’ to know what to do and they can’t seem to find the ‘experts’ who do. I regularly meet young people whose own dilemmas are not given a full hearing, where the assumption is that they feel the way they do “because they are autistic.” For some people ASD is a ticket of entitlement, giving them access to learning supports (for example) that could be helpful for other children who are denied this support because they don’t have ‘autism’. But I also see regular examples where an autism label excludes kids who could find input helpful because, for example, their social anxiety is because they have autism and so there is nothing we can do about that.

So, my advice to all practitioners is to try not to give the diagnosis any privileged position in treatment. Keep in mind what those you are working with want to see change and work collaboratively on that, just as you would with any other person or family. Autism, like any other psychiatric ‘diagnosis’, is not a diagnosis. It has no explanatory power and so can’t tell you what will prove to be helpful or not with any particular individual, family, or community.

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  1. EXACTLY! Thank you Mr. Timimi. Finally someone is making the connection between the psychiatric myths of “mental illness” and the myth of “Autism.” Bleuler did not diagnose his “patients.” He invented a concept, a label. That invention, like the invention of “Schizophrenia,” has had disastrous consequences. This is a very well written and measured article. It may be that you concede too much to psychiatry. Even Kanner did not really “diagnose” his “patients.” Categorizations of behaviors do not constitute diagnoses of diseases. The resultant medicalization and proliferation of false diagnoses has terrible consequences in the lives of innocent children.

    The myth of “Autism” has rarely been investigated so well and so thoroughly. Well done. The so-called “twin studies,” genetic studies, and brain scans are all part of the pseudo-scientific charlatanry of psychiatry. The key, as Mr. Timimi has shown, is to go back to Bleuler to discover an answer to the question “What is Autism?” Even Bleuler didn’t know. That is the shocking truth of the matter. What does the term “Autism” even mean? Bleuler coined the term that he derived from the Greek “autos,” meaning self, as if to show that “Autism” is a disease of morbid self-admiration. What utter nonsense! Only a morbidly self-admiring psychiatrist could concoct such absurdities. Bleuler is also responsible for inventing the false diagnosis of “schizophrenia.” And wouldn’t you know it, Bleuler was a eugenicist. If we do a little research, it is easy to see the connection between Nazi eugenicism, which also included horrific “twin studies,” and modern psychiatry as it is traced through “Autism” and “Schizophrenia.”

    Mr. Timimi has made a major break through in this article. Szasz wrote extensively about the myth of mental illness, but who will expose the myth of Autism more particularly? Mr. Timimi has made a good start.

    • I’m going to have to say something about the false diagnosis of “schizophrenia”.

      When the “schizophrenic” comes off “his medication” he goes mad, and when he goes back on “his medication”, he eventually feels “better”. He’s then, still “care in the community” but he’s considered to be well.

      But if the “Schizophrenic” can come off his medication very carefully he probably won’t go mad. If he gets help with his “anxiety”, he’ll probably feel as good as the next person. He’ll also, be able to get back into life again because he’s not on very disabling drugs.

      Lots of people on Mad in America have overcome “schizophrenia” – through using effective non drug strategies – suitable for “Anxiety”. But nobody has ever genuinely recovered through the Psychiatric System.

      • How would you define the word “recovery?” In my opinion, this is a medical term and links to disease and the medical model of psychiatry. I would prefer words like “change” or “transformation.”

        In the early ex-mental patients’ movement, we used to day that “therapy is change not adjustment.”

        I stopped taking meds and seeing a therapist 40 years ago. Would you say I “recovered” or that I am “in remission?”

        • Alternatively Don,

          To claim MH benefit in the UK a person needs to pass themselves off as permanently Psychotic.

          Since the vast majority of people are not like this (though they might have different issues) ; there exists maybe 1% to 3% of the UK Population in the community that’s classified as ongoing completely mad.

          Which means MH Diagnosis in the UK cannot be relied upon.

    • For that matter what is a “Mental Illness?” Corner a shrink with this question and I’m sure he would need more than a minute to explain. Even more if he weren’t allowed to babble the usual tripe about unproven “chemical imbalances.”

      As a child I thought mentally ill people were unusually evil and eccentric villains. Psychiatrists actively promote this idea–using obscurantism to help the bologna pass for steak and make themselves sound like honest-to-gosh scientific ex-spurts.

      “Are the ‘mentally ill’ cognitively impaired with low IQs?”
      No. Any lowering in our IQs comes from the drugs and shocks.

      “Are the ‘mentally ill’ criminals?”
      No. The reason people wanted the Cures Act passed is they needed a loophole to lock up law abiding citizens. We already have places for law breakers.

      “Are the “mentally ill” morally depraved?
      This last comes closest to the Mythical Type of the Insane. In the Victorian times they realized many “mad” people were harmless. In this respect things have worsened for those of us who go nuts. We can no more reintegrate ourselves into society afterwards than a Victorian prostitute could become a respectable socialite.

      Oldhead calls psychiatric labels hate speech. I call them moral judgments. Unlike an annoying street preacher who says, “REPENT!” psychiatrists say you can’t become better. There can be no repentance or change since “Evil” is engraved on the DNA and brain chemicals of the “mentally ill” and taking crippling drugs is the only atonement possible for the crime of your existence. I was very suicidal when I thought I was hopelessly insane/evil btw.

        • Don’t feel that young anymore. But thanks. 😀

          I do think some social network for anxious, unhappy, and detached people should be in place. The lack of plain old TLC and compassion has led to psychiatry’s vast expansion. Interesting that Madhouses began around the Industrial Revolution when people started ignoring neighbors in distress. (Correct me if I’m wrong.)

          In Mary Shelley’s novel Frankenstein, the protagonist “loses it” twice. Both times he is not locked up or labeled but comes out of it. In The Last Man, one of the main characters loses it when a young woman “friend-zones” him but his friends love him back to sanity.

          There is a need Psychiatry is supposed to fill–but cannot. If I need food and only get meth, I may miss the food less for a while. But I will miss the nourishment soon enough.

          I am all for abolishing psychiatry–though I believe destroying the Big Pharma industry will hurt America–perhaps the Western World–severely in the economic area. The price is necessary however.

          First abolish involuntary psychiatry, then false advertising. Psychiatry will collapse on its own if stripped of authority and credibility. Sadly many long term psych “patients” can’t or won’t grow up after decades in the system. Most of my old friends fall into this category.

          We may need homes for these people like Szazs recommended. Not state “hospitals” but more like halfway houses only long term. Taking drugs would not be a requirement for living there.

          An economic system of cronyism that sustains itself in a circular fashion by producing unnecessary and harmful products, then bribing bureaucrats to force able citizens to buy said products that put them out of work and lead to other medical problems (costing tax payers as well as disabled victims) is unsustainable. We need to produce more useful things that don’t need Big Brother interference to sell.

          I believe Capitalism is a useful tool for producing food/clothes/etc. to provide for everybody including the few who honestly can’t work. (Not artificially crippled by Pharmapsychiatry with its bosom buddy Corrupt Bureaucracy.) What we have now is a grotesque mockery of the system. Selfishness and greed are at the root of Capitalism’s downfall in the West.

          Unlike many other commenters I agree with you politically and am openly religious. But because of my disgust with Tim Murphy and other “business as usual” Republicans I’m thinking of going Libertarian.

          • Rachel777, I agree with you that selfishness and lack of love and compassion from neighbors and family members is at the root of the problem. Thank you for your reply. What distinction do you make between “involuntary” and “voluntary” psychiatry? I’m not sure that there is a real distinction, but I would be interested to know what you think. Thanks again.

          • Just saw this:

            I believe Capitalism is a useful tool for producing food/clothes/etc. to provide for everybody including the few who honestly can’t work.

            Marx would have agreed with you that this was initially a positive function of capitalism, i.e. providing the infrastructure for feeding and housing the planet; however now that phase of history has been fulfilled, and people are in a position to exert collective power over how goods and services are produced and distributed.

          • Not all libertarians are right wing.

            “The anarcho-communist Joseph Déjacque was the first person to describe himself as “libertarian”. Unlike Proudhon, he argued that “it is not the product of his or her labour that the worker has a right to, but to the satisfaction of his or her needs, whatever may be their nature”…”


            If you’re thinking of “going libertarian”, as you put it, you don’t have to “join the party”, so to speak, and especially since it is a right wing party. Before the current trend of right libertarians there were plenty of libertarians of the left.

            “Left-libertarianism (or left-wing libertarianism) names several related, but distinct approaches to political and social theory which stress both individual freedom and social equality.”

            “In its classical usage, left-libertarianism is a synonym for anti-authoritarian varieties of left-wing politics, e.g. libertarian socialism, which includes anarchism and libertarian Marxism, among others”…


            I’m not prepared to sacrifice any hope of social justice to one form of “social Darwinism” or another.

  2. As it happens I looked up the symptoms of Aspergers and such like on google this very evening.

    I found a prestigious UK site and looked up it up. What I found was a list of vague symptoms that could apply to almost anyone and a lot of circular logic.

    Controversial though init, as a lot of people with the diagnosis like it and get really narked if you say it has no validity.

  3. This is a good critique, but the website easily could have published a similar critique coming from one of us who bears the autism diagnosis or deals with the processing/functioning differences that get labeled that way. Nothing personally against Dr. Timimi, but it’s frustrating that even critical platforms boost the voices of sane-classed professionals over the voices of the directly-affected.

    • There is one blog was by someone directly effected

      Whether anyone classes Timimi as sane is another matter. He does link to a debate between him and an autistic advocate early on in the article.

      Maybe someone answering Timimi would provide balance?

      Or maybe an article from someone who de diagnosed themselves from the diagnosis?

    • I agree with DannyTheWorld. Much easier said than done when it comes from a psychiatrist’s detached point of view, who does not have to deal with the plight of brain struggles (regardless of the label). We all know well Thomas Szasz’s theories (way too idealistic for our shortened lifespans daily life circumstances) and that DSM labels are changed from time to time mostly due to corporate/political reasons, but bottom line here those surviving with clear cognitive/emotional deficits (iatrogenic prescription drugs, neurodevelopmental patterns that do not conform to what society expects, brain tumors) need to have some sort of support to have a life as citizens in the society – with dignity, quality of life and respect. The world is not even ready to understand or to come off of the mass brainwashing they have been subject to on the myth of chemical imbalance, let alone having enough maturity to discuss autism as one can clearly see when the vaccine/antivaxx polemic comes up. Dr. Timimi, please come up with feasible, concrete propositions instead of blaming the victims and stripping them even more of their hard-won rights and needs. Maybe you need to have a grandchild with severe autism in order to experience the meaning of the word EMPATHY.

      • Hi – A lot of us actually don’t want to ‘use person-first language’ or functioning labels, and many of us have found our parents and grandparents to be the *least likely* people to empathize, and the most likely to subject us to ‘normalization’ in attempts to eradicate our differences. Thank you though.

        There *are* Autistic experiences and Autistic culture – as for instance there are Gay experiences and Gay culture. Sure, these groups are classed, maybe even categorically *produced*, by the era and culture we live in. Sure, there’s not one essential biological ‘thing’ that causes/defines our experience – and the search to find one has been lead largely by people who want to get rid of us.

        Still, we have shared experiences, shared needs/desires that are different from the ones dominant culture expects, shared subcultures, and a shared need to fight against abuse and oppression.

        All oppressed groups, in their struggles, have encountered this tension: Are we fighting for our rights *as* this group, or ultimately fighting to no longer be classed this way? The working-class anarchists and communists out for a classless society ran into tension with trade unions and political parties that wanted only ‘workers rights’. Monique Wittig contended, against more-conventional feminism, that lesbians could supercede womanhood itself. We will have this tension too, and hopefully we can come to talk about Autistic experience without the ‘scientism’.

        (I see a huge parallel between current neurodiversity activism and how early gay-rights groups took on a medical framing of their desires. I hope we can similarly develop beyond it.)

        Towards the anarcho-schizophrenic defense brigades,
        Towards gender-nihilist trans(&)womens’ liberation,
        Towards the end of whiteness and the end of wage-labor,
        – Danny

        • except that as a poofy woofter homosexulist I didn’t define my experience by a psychiatric label or definition. Autism is a Dr’s definition.

          Nuerodiverstiy sounds like science but has not scientific basis.

          Behavioural diversity I can understand.

          Queer Freaks I can understand.

          Nuerodiversity is still something that I don’t know what it refers to. Maybe i’ll look it up?

        • I think you frame the issue well – it is a social/political issue rather than a scientific one. That being said, I do see the author’s legitimate critique of the term “autism” being used, as it is both a pseudo-scientific label and a means of putting down a heterogeneous group of people based on their inconvenience to the status quo. It’s a difficult conflict to resolve – I don’t want to be disrespectful to those who choose to view themselves as “autistic” nor to disrespect the fact that this group does have different experiences based on how they are viewed and treated by society. At the same time, I definitely don’t want to do anything to reinforce the idea that diversity of behavior necessarily associates with diversity of neurology, because in the vast majority of cases, it does not. I’m interested in your views on how to resolve this conflict – any thoughts?

          Thanks so much for your thoughtful response!

          — Steve

    • The voices of the directly-affected does not need to be different than the voices of “sane-classed professionals”. With the harmful experiences from both the biomedical psychiatry and the neurodiversity movement fresh in mind, a direct consequence of once being labeled with autism, I support the effort of Sami Timimi. Because my challenges in life was, and is, what is to be expected of life to some extent. And the solution to this has not been to manage it with medical magic or to redefine myself as something too special for society to include in such a way that a dreamlike (as it felt when I was an activist in the neurodiversity movement) sub-culture must be created. Rather the solution for me has been to become aware of and accept 1) that a society, created by human beings, necessarily will inflict harm and violate some others as long as human beings themselves inflict harm and violate others, 2) that harm and violations done to me by human beings and society have created challenges in life, 3) that I, as a human being, has a political possibility and responsibility to contribute to a society free from the violence that excludes and create challenges in life.

  4. Yes, Autism is probably the strongest counter-example to the view that psychiatric/neurodevelopmental diagnostic invention and creep is primarily Pharma-driven. But as I pointed out in 2010 (“adult-autism-scan”-available-to-the-nhs-or-not/) there is plenty of potential money to be made from dodgy ‘diagnostic tools’.

    Sami Timimi’s critique of ‘scientistic’ diagnosis has improved since his submission (with Joanna Moncrieff) to the UK’s NICE panel on ADD / ADHD (“critical-psychiatry”/) but problems remain. Just one example: he tends to claim that proper (non-psychiatric) medical categories are always adequately grounded in biomedical fact, but what about ‘metabolic syndrome’, which has no specific biomedical test and apparently no clear cause(s): ? Surely ‘anti-neoliberal’ health practitioners like Timimi and Moncrieff should be denouncing this, with me (publicly, from now), for distracting from the well-established links between poverty (in ‘developed’ countries) and overweight/obesity?

    • Well said. I’d point out that “obesity” itself is now a medical diagnostic category. The tendency to look at symptoms or outcomes as “diseases” is most definitely not confined to psychiatry. There are profits to be made and power to be established by denying social determinants of health, all across the board. It’s just easier with psychiatry, as there has never been any slight requirement that the categories have anything to do with physical reality, and as the social benefits of being able to categorize people’s behavior as “diseased” far outweigh the related but far less powerful benefits of categorizing people’s cholesterol levels or BMI as unhealthy.

      — Steve

      • Cheers Steve …My position is that false claims about the ‘physical reality’ of psych conditions (and about medication) over decades have undermined the public’s faith in the ‘causal agnosticism’ approach of DSM 3-4, which I still support, I think.

        Consider epilepsy and migraine: often no definitive physical test, but we still diagnose them as brain disorders, and often use medication. . I get migraine myself, and find the fancy new meds very useful.

        Cholesterol/lipids is another good example of a ‘medical’ condition which seems to clearly fulfil Szasz’s ‘blood test’ criterion: the potential ‘scientism’ here is all about the risk/benefit ratio and misinformation. Near-identical issue about distracting from poverty as in overweight/obesity…which I do regard as ‘real’.

        • Personally, I think “causal agnosticism” is a BS cover for the true intentions of the DSM III+ series. It appears clear in hindsight that this approach was taken to specifically AVOID looking at cause so that the biological causation theories could be safely inferred. Grouping “disorders” without regard for cause, including things like high cholesterol and obesity, makes it easy to avoid bothering to look for one, which plays right into the hands of Big Pharma and professional guilds who want to create a “helping” industry and get paid for it. Because let’s be honest, if we start curing people, or providing free or low-cost home interventions, then we need to find more clients, which is a lot of work.

          So in my view, the DSM is a far more nefarious enterprise than you appear to give it credit for. If there were no “ADHD,” for instance, then we’d have to look at each individual kid and figure out what was going on. We might discover that some DO have something physiologically wrong (like low iron, heavy metal poisoning, sleep apnea, or just plain lack of sleep), or psychologically challenging (very anxious, angry, hopeless), or social oppression (child abuse, racism, bullying), OR, we may eventually conclude that our schools are not meeting the needs of a lot of kids and we might have to re-think how we run our classrooms (“ADHD” labeled kids do WAY better in open classrooms than in standard classrooms!)

          So in the end, creating the cause-free label undermines scientific inquiry and rewards lazy professionals for failure to look deeper into the real conditions behind the behavior they see.

  5. It sickens me to see ads like that of Google applauding themselves for hiring autistic people and encouraging other employers to do the same.

    I agree that the “neurodiverse” term smacks of the medical model.

    Here is what Sera Davidow (founder of WMass Recovery Learning Community and author for MIA) said about diagnostic labels:

    “I am suggesting that people struggle. Sometimes deeply. And that it leads us far down the wrong path to understand those *human* struggles by lumping them all into *medicalized* groupings that are largely artificial.

    Sure, *sometimes* people will speak to benefits… Helped them better connect with others with similar struggles and hear what’s worked for them, etc. But the benefits are far outweighed by the negative impacts, many of which I’ve already mentioned.

    We’d be far better off seeing struggle as struggle, and then being able to pick and choose from the array of supports that people have used to make their way through such struggles… Lumping the struggle into a man made category that does not objectively exist, narrows our view and our options and does harm to many of us.”

  6. Thank you for pointing out, “Autism, like any other psychiatric ‘diagnosis’, is not a diagnosis.” I remember driving down to Chicago, from the suburbs, with a bunch of friends in 2006, just after I’d been weaned off the psychiatric neurotoxins. We were headed to see Bono in concert. I remember looking at the car next to us, it had an autism bumper sticker on it. I remember knowing at that moment, in my heart of hearts, that autism was NOT a real disease “…just like diabetes.” How shameful our medical community is attacking and defaming little children with make believe diseases on a massive scale.

    When will the psychiatric and psychological industries actually get rid of the “invalid” DSM? It is a classification system of the iatrogenic illnesses that can be created with the psychiatric drugs, NOT a classification system of real “genetic” diseases. And when will the psychiatric and psychological industries get out of the business of turning millions of child abuse victims into the mentally ill with the psychiatric drugs for profit? That is the primary function of today’s “mental health professionals,” according to your own medical literature. Since the “mental health professionals” can not bill insurance companies for trying to help child abuse victims, you should not be make believing you are trying to help them. You’re harming the weakest in our society for profit. That’s sick.

  7. To All

    ONCE AGAIN, Sami Timimi ruins a potentially good blog on the pseudo-science related to the Autism diagnosis by continuing to use the nonsensical term “SCIENTISM.”

    He even has a subtitle, “Scientism Defines What Autism Is,” but NOWHERE” does he EVER really provide a workable definition of “scientism” that makes any sense. He is guilty of the very same criticism he makes of those that claim there is somehow legitimate science or a legitimate definition backing up the autism diagnosis.

    Dr.Timimi says the following in his first paragraph:

    “I am aware that some think my use of the term ‘scientism’ as opposed to, say, ‘pseudoscience’ or ‘corrupt science’ is a mistake. I think scientism is a more useful term as it can cover many aspects: It can refer to an over-emphasis on the use of scientific knowledge and techniques, but can also refer to the corruption of science.”

    Here he just makes up his own justification for why this term has some apparent meaning without providing ANY scientific evidence that it has ANY useful purpose or ANY clearly agreed upon acceptance within the scientific community.

    First, he continually shows how the pro autism crowd has NO definitive or useful science to back up their diagnosis, so I ask how is this an example of “… an over-emphasis on the use of scientific knowledge and techniques…” which Dr. Timimi claims is an example of “scientism.”???

    There are a dozen other words such as “pseudo-science,” “corrupt,” “unverifiable,” “half-baked,”etc. etc. that have far more useful meaning when criticizing the lack of a legitimate scientific model for describing autism.

    Once again I will say the following, any web search on the the meaning of “scientism” will provide MULTIPLE meanings of the term and hugely contested debates from all types of scientists and philosophers and other academics. There is NO accepted meaning OR agreement that this term has any validity.

    I will remind people that the term “scientism” is MORE often used by those who want to UNDERMINE the role of science in the world (including by Right Wing global warming deniers) and those that are particularly upset that almost all scientists challenge the fundamental basis of religious belief systems. Dr. Timimi’s insistence on using this term, without ANY clear definition, or useful purpose, makes me wonder if he is part of those academics who resent scientists (and the scientific method) from entering into theological discussions.

    Now on the issue of autism, I am not prepared to say that autism can ONLY be defined in a “cultural” sense as Dr. Timimi has implied. Until MORE LEGITIMATE SCIENCE is developed, I believe that we’d have to say it is most likely a combination of environmental and genetic factors. It is correct to be very critical of how the Medical Model has made a entire profitable industry of the autism diagnosis, and yes, millions of these children and adults are heavily drugged with mind altering chemicals.

    And I hope that in this blog, Dr. Timimi will actually participate in the discussion that he has provoked with such a controversial topic.


    • Maybe there are slight but significant US-UK differences in the meaning of ‘scientism’. The second OED definition can be paraphrased, a little provocatively perhaps, as ‘excessive faith in science’:

      I wrote (above) that Sami Timimi’s views have improved. He used to promote ‘Postmodernism’ as the answer to psychiatry’s problems: . Let us be thankful that he seems to have stopped!

      • Neil

        Thanks for that response. I notice in that definition you provided they use the word “faith,” which is ironically in major contradiction to the scientific method. It once again shows how confusing this term really is.

        And while you provided this confusing definition you ,as well, have offered no valid justification for using this term.

        Exposing and critiquing what is wrong with psychiatry and the medical Model is difficult enough without using controversial and nonsensical terms.


        • Wow. You sure have a hatred for this word, which is not a “nonsensical” word at all. It has a very real history in the western philosophical tradition. Some of the most famous philosophers I can think of discussed, debated, and used the term “scientism.” Habermas, Adorno, and Horkheimer all wrote about “scientism”—if it’s good enough for them, surely it’s good enough for us to use in our movement.

          You made me chuckle when you said that Mr.Timmimi gave “no valid justification” for using the term “scientism.” Speaking as if a writer using a word is a matter that can be “validated” or “invalidated” by science, is precisely the sort of silly action that the word “scientism” describes: the attempt to apply science to domains in which it is not relevant or appropriate!! ha!

          Again, just to repeat: not knowing when science applies and when it does not is absolutely textbook “scientism.”

          Is the reason you don’t like “scientism” because it includes a value-judgment? Because, yes, “scientism” is understood to mean *excessive,* *inappropriate*, or *unfounded* faith in or application of science.

          …Or is it because you’ve heard some conservative people use it?

          Please stop using all caps excessively… it is the equivalent of yelling at everyone.

    • My definition of “scientism” is accepting the pronouncements of credentialed “scientists” as infallible and having a religious commitment to following their dictates, whether they make sense or not. It suggests a dogmatic approach to “science,” and an unwillingness or inability to take personal responsibility to separate truth from propaganda. It also involves so-called “scientists” claiming such authority and attacking anyone who disagrees with them as “unqualified” or “hostile to science.” Within that definition, psychiatry fits quite securely. “Pseudoscience” covers some of that, but for me it doesn’t cover the religious commitment aspect as well. Not that I completely disagree with your concerns, because I do see “scientism” used to mean believing that science is a valid way to determine truth, as opposed to having faith in a spiritual reality. But I most definitely do see people who view anything with the trappings of “science” as an article of faith, and who accuse anyone who does their own thinking about it as “anti-science.” Most mainstream psychiatrists fit into the latter category, and they train their subordinates and “patients” to think (or not think) in the same way. Perhaps there is another term you can suggest that covers this unquestioning faith in the Scientific Authorities having special knowledge that we mere mortals are unable to attain?

      • Steve

        There is a much better term than “scientism” to describe people who blindly follow anything that has an alleged scientific label or credential behind it, and that is “BLIND FAITH.” These are people who don’t understand science, or know how to correctly use the scientific method. This is all closely very related to the phenomena of “blind faith” in authority. which we know is very dangerous in these times.

        I would also say that the terms such as “dogmatism,” pragmatism,” “reductionism,” and “mechanical materialism” are also useful terms to criticize poeple who distort the scientific method by using incomplete methodology, narrow interpretations, shortterm gathering of data, and the isololating of phenomena and components from their intrinsic whole. These are just a few of the distortions of the scientific method.
        The term “scientism” does nothing but sow confusion whem trying to correctly criticize psychiatry and the medical model, AND may actually lead to diminishing people’s belief in the importntance of genuine science.

        It is both funny and ironic that everyone here (including the author Dr. Timimi) who is criticizing the autism diagnosis (and promoting the use of the term “scientism) is actually using SCIENCE AND THEIR UNDESTANDING OF THE SCIENTIFIC METHOD to deconstruct what is wrong with those who are promoting the “autistism” and “Aspergers'” diagnosis. Friends, you can’t have it both ways.


        • Well, as I said in my definition, I would see “scientism” as a complete repudiation of science, the opposite, in fact, because science involves the absolute unwillingness to have faith in anything that is not supported by evidence. So clearly, believing scientific authorities without or even contrary to existing evidence is not scientific in the least. However, given the cooptation of this term to mean something different, I’m going to have to agree with you that the term is confusing and unclear (partly because most people don’t really understand what science is). I have to say, though, that none of your terms actually identifies a dogmatic belief in or blind faith in science as a specific term. It is really a lot more than reductionism – it is a religious faith based on the belief that there are some smart people called Scientists and these people are Smart and Know Things that the rest of us can’t know, and that if we simply follow them, then the world will be a good and happy place. It is a form of “blind faith,” but specifically blind faith in purported “SCIENTIFIC” AUTHORITIES rather than SCIENCE. Perhaps “authoritarian pseudoscience true believers” describes it, but really doesn’t provide a very catchy meme, does it?

        • You’re making a lot over a word, Richard, and, as you don’t own the English language, I don’t see it. According to a number of dictionaries, scientism is a term with a certain meaning. Were we to, in the interest of “political correctness”, perhaps, censor use of the word scientism, I would be seeing scientism in exactly that sort of reasoning. My point being that if there is a correct use of science, there must be an incorrect use of it as well.

          • Frank

            My belief is that if this word becomes accepted and more commonly used in these discussions that it would be a set back for our movement. This is why I have made a big deal out of the misuse of this term.

            There are many attacks going on against science in this world and I believe this is one of the less obvious and more subtle ways people undermine the belief in legitimate science.

            Dr. Timimi could have written all of his recent blogs without ever using this term and still made all of his political points very clear to everyone. We should ask WHY does he insist on using this term even in all the titles of his blogs as well as some subtitles and within the text?


          • There is a lot of bias in psychiatric research these days, not vigorous science, and so, respectfully, Richard, I have to disagree. I think this is also true of many other fields. In recent years we have had several scandals arising in the social psychology department in some colleges due to complete fabrications in what was presumed to be research. Of course, there’s good cause there when a career goes down the tubes because of forged statistics.

            I need a word for all the biased research I see taking place today, and I can’t think of a better one than scientism. I don’t think all our problems can, should, or will be settled by the scientific method. A “theory of everything”, to my way of thinking, would resemble religion too much to be of much good. Science, after all, is about disproving, not proving, presumption and theoretical speculation.

            Science is not the only thing that is under attack, pseudo-science is also under attack, and for that I say, so be it.

  8. Cheers Richard…I have faith in the scientific method, and I don’t agree that involves a ‘major contradiction’, because despite a lot of philosophical effort I don’t accept that the scientific method has been logically grounded. You previously mentioned ‘verifiability’, and part of my faith in science is Karl Popper’s pointing out that ‘verifiability’ is flawed. His ‘falsifiability’ is an improvement, but still not a wholly adequate grounding: (paywall…but I plan to Blog on this in the next few weeks).

    I agree that ‘scientism’ is still woolly, of course, as are ST’s recent articles, but he’s getting there.

  9. This article in a nutshell: “Autism doesn’t exist because it was discovered by scientists and science is bad and can’t account for individual subjective experience. Also, where’s the evidence? I need objective science to tell me that something exists before I can believe in it, because I don’t like science. Also, the merger of Asperger Syndrome into the autism spectrum is the fault of the person who created Asperger Syndrome in the first place and separated it from autism. I make perfect sense.”

    • All science worth its salt is objective.

      How would you define Autism Au Valencia? I thought it was like Dyslexia perhaps. Only instead of trouble processing the written word the person with Autism has trouble processing the world around them–especially human interactions?

      I dated two men on the Spectrum. They seemed like really smart, fun guys but very socially awkward. (One was abusive, but lots of “normals” abuse others.)

      I am asking because I am baffled myself.

    • I don’t really think that’s what the article says at all. I think it says that autism is not a scientific term because it’s not definable, and that we should not be prescribing “treatment” for entities that are not definable as different from “normal.” I think a lot of folks who identify as autistic would agree with this, based on my own experience. To say that autism was “discovered by science” is not really true, and that is the main point of the article. Autism was defined by agreement between professionals, but that’s not the same as being scientific, not at all.

      My experience of the author is that he is, in fact, deeply committed to the principles of science, and in fact he is stressing in this article is the need to be scientific in defining “mental disorders.” Sammi has been a stalwart defender of the basic principles of science despite being castigated by his own profession for his integrity. You may or may not agree with his conclusions, but to accuse him of “hating science” is an extreme misunderstanding of his viewpoint and principles.

      • Steve,

        You were supporting the phrase: “…autism is not a scientific term because it’s not definable…”

        Wouldn’t it be more correct to say that “autism” or its related phenomena “is not YET definable?”

        We may just not know enough about this phenomena or have the science and/or knowledge to describe what is going on here. There is so much we don’t know about how human beings and the human brain is affected by the environment and its related culture.

        I think we are both in agreement that all the so-called “treatment” for these labels is in most cases harmful and not advancing our understanding of how to help ALL people make progress in life.


        • Of course, I agree with you. I guess my two objections to the term being applied to people by professionals are 1) lumping all people with a certain set of behavioral characteristics together prevents any real analysis of whether it is a meaningful grouping of people with real similarities, or simply a social prejudice masquerading as a “diagnosis,” and 2) labeling a group is in and of itself a means to differentiate and “stigmatize” (aka be prejudiced against) the members of this group, which I find inherently dehumanizing. There may be, and perhaps likely is, a certain subset of such folks who actually DO have something physiologically malfunctioning, but we can never identify such situations if we lump all people together who act in similar ways without any understanding of the underlying mechanisms. So if it’s just a means of communicating about and between people who share some behavioral characteristics in common, no problem. But when applied by one person to another, I really have a problem with labels of this sort, as they make it way too easy to dehumanize them as a group instead of trying to understand.

          As for “neurodiversity,” as one of my old foster kid friends put it, “Maybe people should be allowed to have different chemical balances.” Viva la difference!

          — Steve

  10. Bottom line, again, I believe emphasis and efforts should be strongly directed to how people with different brain functioning should have the means to be part of a society that does not understand/accept how our brains are without stigma and discrimination instead of philosophical/epistemological/etiological discussions without any pragmatism. Just sick and tired of that – the real causes of “ASD” will most probably not be found out during our lifespans. Why don’t we just keep it simple and consider the possibility that “autism” is part of an evolutionary process of the brain as human species tend to evolve over time? Nowadays I don’t really care whether some people want to identify themselves with labels or not, if it is a real disease or not. Like I said before, sticking to Szasz’s tenets of “there is no mental illness” are too far fetched for 2018, for the here and now. As being originally from a “developing” country in which psychiatrical drug iatrogenesis is not even recognized as such, having to go through medication withdrawal on my own after lots of research has already been daunting enough for me. I have lost the best years of my youth (half of my life, more precisely) on being labeled, misdiagnosed, heavily medicated and not having much support and understanding from the anachronistic society where I came from. Now I just want to have dignity to LIVE with joy and quality of life the years ahead of me. It is counterproductive not only for me not to be pragmatic – please take this into account. Psychiatrists writing for Mad in America should be our allies and give constructive input instead of adding more obstacles for us to deal with this mad society. I also believe this website used to be better in the past, when its focus was only on psychiatric drug side effects/withdrawal/pharmaceutical corruption.

  11. Psychiatry is the unofficial unacknowledged religion of the state. “Mental illness” is the cardinal belief of this deceptively simple state sanctioned religion.

    Just as militarized cops shoot first and think later, medicalized “mental health” cops have been trained to label first and think later.

    Around this religion has grown an entire service industry (“mental health” enforcement clergy) that fuels it and feeds it.

    Liberation is merely a matter of demedicalizing the non-medical, or of retrieving the concept of “health” from the realm of the abstract.

  12. “One of the core features of the autistic spectrum is supposed to be a lack of empathy, a lack that is thought to cause enduring difficulties in social interactions”

    I haven’t had time yet to read this article as thoroughly as I would like, nor to read many of the comments. However I just wanted to comment on this particular comment as this seems different from what I have been taught about Autism. I thought “difficulties in social interactions” were thought to arise from difficulty in social understanding (e.g. understanding social situations, social cues etc.) rather than from a lack of empathy …(???) It seems that this would look very different from things described as conduct disorders.

  13. I had never thought much about Autism before I came to Mad In America.

    Before I came into contact with Psychiatry I would have thought “Schizophrenia” and “Manic Depression” were definitely beyond the scope of the talking treatments (or anything else) but now I realise that this is not true at all. The talking treatments are the only approach that works.

    Most people must have experienced the same “High Anxiety” as I did on withdrawal from “medication” and this must have been the main problem. But my “High Anxiety” definitely responded to the talking treatments.

    Dr Russel Razzaque featured right on MIA – his approach is useful; as well as Sarah Knutson on MIA right now; as well as Psychologist Rufus May’s; as well as Will Halls. And all theses approachs are similar.

  14. It makes sense we don’t know what causes autism. Now that I have read enough of Dr. Breggin’s writings it’s obvious how woefully ignorant even our smartest scientists are of the human brain.

    That’s why I say–even assuming a chemical imbalance existed–until there was actual proof that chemical X caused psychosis/depression–shrinks have no business messing around in our heads!

    “You must have cancer. As an Expert I don’t need to run tests. I’m going to put you under and remove random bodily organs for a few hours. Then force you to have daily rounds of chemo for the rest of your life.” Ha ha. Who would like to have that joker as a family doctor?

  15. Coincidentally, I was blogging about “autism” and have included a link to Dr. Timimi’s article in that blog. Check it out here:
    Sorry for being self-promotional, but in my book Self-Acceptance Psychology I go beyond complaining about psychiatry’s lack of scientific bases for their “diagnoses.” I offer a simple, but powerful new paradigm to describe and understand human behavior. It challenges the traditional ways of defining “mental disorders,” and reframes emotional and behavioral problems as adaptive and self-protective responses to fear, complex or chronic trauma, shame, and lack of secure attachment. These Five Causative Factors lead to an inability to handle shame in healthy ways. It identifies poor shame tolerance as a key factor in development of anxiety, depression, personality disorders and other supposed mental illnesses. People adopt one of three Blame-Shifting Strategies that define essentially all unhealthy behaviors in relationships with self and others. More at If you support my ideas, I’d appreciate your support on social media to get the word out.

  16. So many fucking treatments for autism are ineffective and teach nothing. I have autism and found that my therapist was just bullshit. I am 14. I saw through the bullshit years ago. The only thing autism induces is a bit of social anxiety and the urge to put things in front of your fucking face and swing them.

    • Good for you. Maybe to put things in front of your fucking face and swing them is your art form. Maybe it makes you feel good. I don’t see how that could be considered a disease any more than closing one’s jaws repeatedly on a wad of something mint-flavored and rubbery, except one is done inside the head and the other is outside it.

  17. In my school board, Risperdal, a toxic psychiatric drug, was often used to subdue children with developmental disorders. Studies show that it is common for children diagnosed with autism to be taking one or more prescribed psychiatric drugs. In one study which analysed medication use between 2001 and 2010 in children with autism, from birth to age twenty, two thirds of the children had been prescribed a psychotropic drug: with one third on a single drug, another third on two drugs, and 5 per cent were taking four or more medications. Unbelievably, a shocking 10 per cent of infants under the age of one year, who were later diagnosed with autism, had been prescribed multiple psychiatric medications.
    These vulnerable children need support, not brain disabling medications. The current practice is a form of child abuse.

  18. As a person who personally trips over the autism spectrum at times, I can appreciate the doctor’s words on the subject… especially around not getting hung up in labels for something as broad and undefined as autism. It seems to me that many of us struggle in processing information in our non native formats… for example, I’m very visual in my thinking. Much like Temple Grandin, I think in pictures… and in an auditory world, I have to translate everything into my own visual interpretation to make sense of it which can create lags and lead to overstimulation Even in conveying information, I’m far more effective in the written word than I am in simply speaking those same words aloud. Does that mean that I’m somehow less intelligent, not hardly… I can conceptualize ideas and projects in my mind’s eye, assemble and test them without even picking up a hammer or a soldering iron… create material lists and build my concept exactly as I’ve envisioned it. I don’t say that to blow my own horn, rather to illustrate that while my thought process may seem different, it most certainly has its advantages. Its taken me 54 trips around the sun to come to this realization, but it very much fits… and it presents unique opportunities to be effective in a foreign thinking climate. I would venture that others would probably share similar experiences.