The Psychoanalytic Struggle Against the DSM

Patrick Landman, MD
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The struggle waged by psychoanalysts for the last forty years, mainly in the field of mental health, is a paradigm of a certain development in Western culture and of what Freud called its “discontents.”

Let us go back to 1975: psychoanalytic psychiatry was then quasi-hegemonic, and psychopathological models were accepted and used by most practitioners; other behaviourist practices were of minor importance and psychoanalysts had learned to make use of the advances of pharmacology. And yet a shadow was already looming over the picture: the parents of autistic children were scandalised by the idea that their child’s autism could be causally related to the early mother-parent interaction or the question of the parents’ desire; they criticized the guilt-inducing effects of these unfounded hypotheses. They were convinced that the beginnings of autism should instead be situated in a biological dysfunction of a genetic origin, even though it was unclear how exactly it resulted in autism, and that the problems of interaction were secondary. History has since largely confirmed their beliefs.

Some Reasons for the Decline of Psychoanalysis Linked to the DSM

The Autism Wars

The “Autism war” turned out to be very costly for psychoanalysts, for a number of reasons:

Firstly, psychoanalysts did not wage this war against other professionals, but instead against the parents of disabled children. Having to deal with the effects of their child’s disability earned these parents a certain capital of sympathy and empathy, capital which these professionals lacked, thus damaging the image of psychoanalysis. In the United States, the beginnings of this “war” also coincided with the growth of the psychiatric service users’ movement, some strands of which were strongly anti-psychiatric. The struggle against authoritarian psychiatry and the struggle against psychoanalytic arguments became intertwined, which seemed particularly unfair, because throughout the country psychoanalysts had done a great deal to “open up psychiatric services” and give as much place as possible to the patients’ speech.

It is a historical paradox that psychoanalysts, who had worked so hard to humanize psychiatry, to give it a human face, almost in Levinas’ sense — to make it more dynamic in order to avoid chronicization — were accused of apathy or even therapeutic nihilism. Parents criticized them for neglecting educational methods and “waiting for the child’s desire to emerge,” thus allegedly wasting time and opportunities. Some parents tried to adopt and later impose educational methods that at times resembled animal training and whose supposed scientifically-proven efficacy turned out to be very much debatable. The DSM supported their claims: first, by providing a purely behaviourist definition of autism and, second, by increasing the prevalence of autism by grouping all or nearly all severe and invasive development pathologies under the category of Autistic Spectrum Disorders. However, because of its increased prevalence, autism became a public health problem, requiring political attention and funding, which opened up the way for dynamic lobbying or even the activism — so-called “evidence-based activism” — of the parents.

DSM III: pragmatic and a-theoretical

Starting from the 1970s, under the pressure from American insurance companies that wanted to streamline reimbursements, and given the general consensus that psychiatrists were unable to provide reliable diagnoses, the American Psychiatric Association (APA), the professional body of American psychiatrists, decided to modernize psychiatric nosography using operational criteria and choosing an a-theoretical approach. The different mental diseases became “disorders,” favouring utility and especially interrater reliability (the probability that two practitioners will issue the same diagnosis for the same clinical picture) over validity.

The creators of the DSM III were inspired by pharmacological research, in which drug testing tends to include the most homogeneous group of patients, i.e., those who present the same type of symptoms, in order to be able to compare efficacy using statistical tools. In the minds of the promoters of the DSM III, this breaking away from theory was not directed specifically against psychoanalysis; nonetheless, critics of psychoanalysis used it to assert the advantages of a psychiatry founded on observable symptoms, thus limiting ad maximum the subjectivity bias of the observer. They also denounced psychoanalytical concepts, which they considered too abstract, non-consensual and insufficiently discriminating, comparing them with the pragmatic advantages of an a-theoretical manual. The DSM, a statistical tool initially used for pharmacological and epidemiological research, has since gradually become a training manual and especially a reference book for establishing diagnosis. In less than thirty years, the “psychoanalytic” generation that received psychiatric training founded on the observation of behaviours has been replaced by the DSM generation which favours normative behaviourist and pharmacological methods as a first response.

The image of psychiatric diagnosis

Long considered as discriminatory because of its implied moral or political judgment and a risk of objectivization and ontologisation, the psychiatric diagnosis did not generally used to be announced by the clinicians to the patients or their families. It was useful to psychiatrists in order to determine whether psychotropic medication should be prescribed, but the same psychiatrists simultaneously denounced its low reliability. For example, it is not rare for the same patient and the same symptomatic picture to receive, over the course of his life, the diagnosis of bipolar disorder, later of schizophrenia and finally borderline disorder, which would be unthinkable or at least very rare in the case of a somatic disease.

The situation changed thanks to new laws: the duty of information practically obliged psychiatrists to give a patient a diagnosis, and, more importantly, service users started organising in order to demand a diagnosis in order to have more control or decision-making power, thanks to information found on the internet, over their course of treatment. Users tend to organize around a shared diagnosis, creating and using information websites and social networks. The psychiatric diagnosis has become a kind of claimed identity. It gives the patient the possibility to become an expert in oneself, to have a kind of expertise of experience which is valued just as much, if not more, as clinical or scientific expertise. The development of the DSM has also seen negotiations between stakeholders who wish to introduce such and such diagnosis into the diagnostic manual, given that it can also be a means of accessing welfare benefits and other support.

The consequences could be summed up as follows. Prior to DSM III, the subject supposed to know the diagnosis was the clinician; after DSM III, the subject supposed to know the diagnosis is the diagnostic manual, the result of negotiations between different stakeholders. The diagnosis has become democratised and is now widely accessible, so that is possible to self-diagnose.

Psychoanalysts, though not condoning the previous state of things, have overall struggled to rally behind this new regime, because their understanding of diagnosis is quite different from that of the DSM. Psychoanalysis works with a conception of diagnosis linked to the question of transference. Diagnosis is structural: neurosis, psychosis, perversion, borderline states, autism. The psychoanalyst is trying to understand the structure of the subject, which is understood as a predominant way of functioning, in order to adapt the framework of the treatment to the individual case. For example, when treating psychotic cases, one should avoid too much interpretation; in the cases of borderline patients the emphasis is on containing, and so on. This approach, though not necessarily contradictory to the DSM, has nothing in common with it. Yet psychoanalysts have suffered, together with others, from the decline of the clinician’s role.

The Psychoanalysts’ Response

The anti-liberalist reaction, the medical economy and Big Pharma

It is clear that the DSM was used by the medical economy because it is an epidemiological tool to determine the prevalence of a disorder, and evaluate the nature of the active file of consultations and hospitalisation centres, the activity of specialist centres and so on. Because we know that health, though it may be priceless, does have a cost, DSM psychiatry has been justly accused of encouraging public health policies that emphasize permanent evaluation and the profitability of reduced lengths of hospitalisations thanks to excessive medicalisation, while suppressing frameworks focusing on receiving and welcoming patients, providing a refuge and a place for life. These political choices have been attributed to “liberalism” and its concern with profitability, cost-cutting and favouring the private sector over the public.

The DSM is the result of a collective work of American psychiatrists. However, it has turned out that these psychiatrists had major conflicts of interests with pharmaceutical companies. This situation, denounced by the American press, rightly fuelled the idea that the DSM is a product of Big Pharma. This anti-liberalist response further politicised the struggle against the DSM. Its advocates tried in vain to present the struggle of psychoanalysts as part of the outraged reaction of “extremists,” or even dismiss the criticism of Big Pharma as conspiracy theories.

It is true that some psychoanalysts used the occasion of the fight against the DSM to convert their former anti-capitalist stance into a present-day anti-liberalist position, but others have pointed out that the DSM could also serve anti-liberalist policies; that it can easily become a tool of bureaucratic authoritarianism, etc. The DSM is simply a tool — what is problematic is the way it is used. As for the conflicts of interest, they are balanced by the influence of other lobbies such as insurance companies or user associations. These voices have warned against the debate becoming over-simplistic.

The humanistic response, the singular versus the general and the meaning of the symptom

As a result of the DSM and its various categories of mental disorders, each subject is asked to fit into a diagnostic “slot,” making it easier to enforce standardized guidelines and treatment protocols. Psychoanalysis has instead emphasized the need to look at each case individually, to focus on the singularity of each human subject. This is a strong objection, because symptoms are not simply a final common pathway — in the sense that all phobias or all compulsions resemble each other — but they are also correlated to the signifiers proper to the given individual and their history, and this dimension, which appears in the person’s speech, must be considered. This requires a diagnosis based not just on the observation of behaviour but also on listening to the patient. Unless this singular dimension is heard, we run the risk of dehumanising psychiatry completely. Psychoanalysts have been the defenders of a humanism threatened on all sides by DSM psychiatry. They are the guardians of a case-by-case practice which focuses on the individual’s difference, a practice that is always bespoke rather than reaching for ready-made solutions.

More and more patients feel a relief when their symptoms fit what Lacan called the “scientific universal,” in the sense that a diagnosis with a scientific allure gives a name to their mental pain. For some, the idea that science can actually do something is therapeutic in itself, just like the idea of finding the meaning of one’s depression, anxiety or even a delusion can be for others. Also, today, to speak about science and neurotransmitters rather than language and the signifier is considered epistemologically superior.

The anti-naturalist response, false science and the denial of psychic suffering

Faced with the advances in our knowledge about the brain, psychoanalysts at first remained in denial, then made certain attempts at collaboration. They now agree that the cognitivist sciences have brought many advances and their models have resulted in a number of applications that benefit the treatment of psychiatric users.

For example, in the field of autism, the new knowledge of the genetically-based sensory disorders has allowed the environment and framework of treating autists to be modified. Some hypotheses have also led to the creation of suitable educational strategies and so on.

And yet these advances remain very modest and cannot by any means justify the scientistic excesses, false science, the scientific fake news and orthodox naturalist positions. No genuine biological markers have been found for any mental disease; diagnosis remains a matter of clinical approach and the importance of neuro-imaging is largely overestimated. There is only a rhetoric of promise: biological psychiatry does not yet exist, what exists is a pharmacological psychiatry.

Let me give you a very specific example of an abusively naturalist approach: Attention deficit disorder, with or without hyperactivity, usually referred to as the ADHD, which has “replaced” hyperkinesia. This disorder had been considered a behavioural disorder until DSM IV-R, but in the most recent version it has become a neuro-developmental disorder, together with autism. However, in reality the large majority of children diagnosed with ADHD are in fact “difficult” or “unmanageable” children, impossible to “manage” by their parents, schools, society etc. By making ADHD a neurodevelopmental disorder — in other words, a disorder linked to a brain dysfunction, thus erasing social, educational or pedagogical issues — we naturalise this “impossibility of management,” which has potential political and ethical consequences. This naturalism is of course no longer presented as a rigid view of things, because the notion of brain plasticity is constantly being promoted and sometimes inappropriately expanded, but this naturalist tendency at times leads as far as to refuse the very existence of a psychic reality; the only thing that exists is the brain and its information processing, the rest is obscurantism and spiritualism founded on anachronistic cartesian dualism.

Psychoanalysts find it vital to take care of the individual’s psychic suffering and sustain a mind-brain dualism that is epistemological rather than metaphysical. The early 21st-century denial of suffering and the psychic reality thus replaces the denial of infantile sexuality of the early 20th century.

Questions of normativity, overdiagnosis and over-prescription

Freud argued that there is a healthy part in everyone, even the most insane. While psychoanalysts, as opposed to psychiatrists, do not take the non-existent “normal person” as their reference, they do nevertheless work with a certain reference to a norm. The subsequent editions of the DSM gradually reduced inclusion thresholds for a number of disorders and thus helped pathologize a number of behaviours, especially among children, leading to overdiagnosis and over-prescription. Psychoanalysts have entered into the struggle against excessive medicalisation, such as in the case of grieving (which now should only last two weeks or it becomes a depression) or more recently regarding the issue of screen time.

Paradoxically, this position against overdiagnosis and over-prescription finds an echo among the advocates of liberal economy, who understand it as a struggle against wastage and work absenteeism.

The alliance with service users

Psychoanalysts have become aware of the importance of user associations, not all of which are obviously serving Big Pharma. There are three reasons to justify the alliance of psychoanalysts and users:

First of all, before a psychoanalyst begins to practice, he must subject himself to the experience of analysis; he is a “user of psychoanalysis” and combines clinical expertise and experiential expertise in his own practice. Also, because in the analytic treatment it is the analysand who is speaking, a psychoanalyst should spontaneously find it quite easy to admit that users need to have their say. Finally, more and more psychoanalysts who are also psychiatrists have been connecting with psychiatric service users’ associations to support the latter’s struggle for their rights, fighting against segregation, denial of civil rights, abusive coercive methods, red tape, etc. Faithful to the traditional role of psychoanalysis and thanks to listening to the unconscious and handling transference, they have also provided support in more complex and subjective matters, for example in trying to find a new life project, rebuilding oneself, re-establishing one’s social life, emancipating oneself from diagnosis and so on.

Psychoanalysis and evaluation

Starting from the 1980s, evidence-based medicine (EBM) has become hegemonic in psychiatry, including a consensus over a strict hierarchisation of evidence. Clinical studies to evaluate psychoanalytic treatments have long existed, but psychoanalysts who published for the most part unique cases saw their publications being downgraded to the lowest rank in the evidence hierarchy. They faced a dilemma: either they would refuse the EBM system of evaluation using solid arguments, given that it is based on the model of randomised double-blind clinical trials used to demonstrate the efficacy of medication, and as a consequence psychoanalysis would become non-consensual, or they would adapt to the EBM system. Today the debate continues and the objections against entering into the EBM system are serious and well-argued. However, psychoanalytic researchers have also managed to demonstrate the efficacy of psychoanalytic treatments, especially in treating autism, without “betraying” the ethical foundations of this treatment.1

To conclude, the psychoanalytic struggle against the DSM has multiple forms and contains numerous paradoxes, contradictions and excesses; however, it is also a lucid work of culture and civilisation, faithful to the role Freud assigned to psychoanalysis in his more anthropologically-oriented texts.

Show 1 footnote

  1.  J. M. Thurin, M.Thurin , D.Cohen, B.Falissard ; Approches psychothérapiques de l’autisme. Résultats préliminaires à partir de 50 études intensives de cas. Neuropsychiatrie de l’enfance et l’adolescence, 62 52014 : 102-118.
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Patrick Landman, MD
Patrick Landman, MD, is a French psychiatrist, psychoanalyst, lawyer, and Chairman of STOP DSM. His interests include how institutions — such as Institutional Psychotherapy — can be helpful or harmful, the link between psychoanalysis and neuroscience, and the issue of diagnosis in psychiatry and in particular in ADHD.

42 COMMENTS

  1. In the so called autism wars, psychoanalysis was wrong and hurt people. The framework was unfalsifiable as is apparently the bio-medical model and the DSM.

    What you have written sounds more like a turf-war for market share and credibility. There is no serious challenge to the authoritarianism of psychiatry, just a dispute about which camp’s authority and interpretation of others’ experience should rule.

  2. Patrick, I appreciate your effort here, and the fact you are writing in a second language. You sounded like Lacan and possibly Levi- Strauss.
    Shades of Literary Criticism here which most American folks unless they have a grad or BA degree in Literature would miss and might not only find confusing but off putting.
    I think you were trying to say I am with you but too high flauntin’.
    And if not that you built a fourth wall with your use of the word Signifer.
    There are lots of gaps here but the history is expansive but we need the whole kitchen sink- dirty plates and all.
    So the torture that was considered treatment needs to be called out. Freud and his forced reversal with his first academic writings on sexual abuse of his female patients changed to hysteria.
    And although Anna Freud did some great work – what about her relationship with her father?
    I am glad to see your calling out of the issues with Autism.
    Have you read Sue Miller’s “ Family [email protected]? It is still one of my favorites though now it is dated but still.
    You by passed addiction and what was the real story on Freud and cocaine?
    And according to my memory bank in the nineties we as professionals were being to the DSM was bunk. We just we never told the truth about why.
    One of the things as a professional that I respected with a few of the psychiatrists I worked with was their ability to have compassion, empathy, and even as mutation to those thevwirked with or discussed. Some of them would talk about artists of all kinds and be in awe of their creative talent. A few. And in your Psychoanalytic journal one of them always had a section on artists and or creativity?

    I did not get this empathy in your writing. Next time maybe more Victor Hugo and less Satre.
    You cannot join with others if bridges are too walking.

  3. I am against capitalism, communism, nazism,because those systems and todays state is a product of destroying psyche by apollonian ego terrorism, their antihuman ideologies (scientism, theology) money.

    Only psychological socialism with hierarchisation of the psychological reality is something which could be a state with proper attitude toward human being. This is simple, after reading Szaszs books, Hillmans and many others, that those who are using DSM now – the inquisition should be those who will serve psyche tomorrow.
    There is no knowledge of what is psyche now, and there won’t bem without reading the Manufacture of madness and Re- visioning psychology.

    I do believie in dionisian Hitler, someone who will give back psyche its proper meaning and value, which was stolen by todays inquisition, I see the apollonian law and the psychiatry based on DSM as a form of usurpation of THE REAL HUMAN STATE which was destroyed long time ago by inquisition, so no one see it today.

    the first 60 pages of Re – visioning psychology is everything you need to wake up. There is no cure, there is only the truth.

    Blue or red pill, choice is yours, Neo.

  4. I find this article extremely weak, full of unsubstantiated, questionable, or completely false statements.

    > psychoanalysts had done a great deal to “open up psychiatric services”

    Ho, yes? Can you prove what you just said?

    Can you cite a single IPA’s or WAP’s document calling for the prohibition of forced treatments or the release of mental patients from psychiatric hospitals? Or is it historical revisionism designed to hide the real collaboration of psychoanalysis with psychiatry?

    And I’m not talking about some isolated psychoanalysts, but about the official position of psychoanalytical associations: where did they write that mad people should be free and have the same rights as other citizens?

    > DSM psychiatry has been justly accused of encouraging public health policies that emphasize permanent evaluation and the profitability of reduced lengths of hospitalisations thanks to excessive medicalisation

    Psychotropic drugs lengthen the duration of hospitalization:

    “In a study of 1413 first-episode male schizophrenics admitted to California hospitals in 1956 and 1957, researchers found that “drug-treated patients tend to have longer periods of hospitalization. . . furthermore, the hospitals wherein a higher percentage of first-admission schizophrenic patients are treated with these drugs tend to have somewhat higher retention rates for this group as a whole”. In short, the California investigators determined that neuroleptics, rather than speed patients’ return to the community, apparently hindered recovery [13].” (Whitaker, 2003)

    http://psychrights.org/research/digest/chronicity/50yearecord.pdf

    > while suppressing frameworks focusing on receiving and welcoming patients, providing a refuge and a place for life.

    But what are you talking about? Are you totally blind to the history of psychiatry? What you say is incredible.

    In addition, your position on drugs is very ambiguous. In 2015, you said at the Swiss Time:

    “Of course, taking amphetamines is like drinking alcohol, there may be temporary relief. Ritalin speed-up neurotransmitters, but it does not cure. I am not radically against drugs. I prescribe methylphenidates in a third of the cases I treat, when the suffering is too great.”

    https://www.letemps.ch/societe/lhyperactivite-nexistait

    The comparison is interesting. Will you advise children to drink alcohol, the time to set up psychotherapy? In fact, you are very favorable to ritalin, which you prescribe widely, and at the same time, you criticize the overmedication.

    https://stop-dsm.com/en/methylphenidate-mph-an-opportunity-to-waste-what-are-the-alternatives/

    • Freud, you know, like a lot of psychoanalysts, concentrated on treating so called hysterics, or neurosis. Loonies were beneath him. Kinda thrown under the bus one might say.

      I’ve done the talk therapy thing, too, but it wasn’t like the talk therapist didn’t use a prescription pad when it served him. The only question would be, did he use it with any less ardor and frequency than the purely bio-psychiatrist with his drug, drug, drug agenda. As far as I’m concerned, the two groups of theragoons are in cahoots, and so even the dynamic neo-Freudians can do better than plead their lily white innocense. It’s mostly a lie and a bluff.

      • My therapists were a confused and confusing bunch. The messages they sent were mixed.

        “You are hopelessly sick with a brain disease. This makes you helpless and powerless over your own actions. Your only hope is lots and lots of ‘medicines’ so you won’t think or do bad things.”

        “You really should have a better self esteem. You need to take responsibility for your actions and act like an adult.”

        “But always remember you are totally helpless. Your dreams will never come true because you’re rotten to the core with your diseased mind/soul which is actually a brain disease. Your only hope is to act like a child and always do exactly as you are told and never question doctor’s orders.”

        “You need to think more clearly. Make better decisions since you are an adult.”

        “Your brain is the enemy. Take some pills to kill it.”

        Are you confused? Me too.

        The more intelligent, open therapists–who cared–seemed to realize the conflicting messages they kept presenting and would get frustrated. 😛

    • It is almost never really bio-psycho-social. It has become bio-bio-bio for most psychiatrists, and a lot of psychologists, too, these days. And really, it should be the social-psycho-bio model if they’re serious about it, because if bio’s at the front, it will always dominate, especially when that’s where the financial rewards are.

      • Don’t even get me started on how useless and damaging I’ve found community mental health centers to be. I can’t believe that so much money is poured into places that work against helping people as much as they can. When I got my first taste of dealing with them it took me over six weeks fighting them tooth and nail just to get an appointment with them. And then they wanted all kinds of money and I didn’t have any money but got a scholarship because their financial person took an interest in my plight. As I was leaving her office after signing all the papers she said to me, “They will do everything that they can to keep from helping you and giving you what you’re entitled to. Don’t let them get away with it. Fight them and stand toe to toe with them and don’t budge an inch!” I couldn’t believe that a person that worked for them was giving advice about how to counteract their shenanigans.

        The money would be better spent setting up respite houses where people could go to get real help in time of need. These places are horrible and they’re harmful to people.

        • I wonder if the apartheid system of mental health is as obvious in the US as it is here in Australia. Don’t misunderstand me here I understand that people with a different world view and who have been subjected to generations of trauma quite possibly need separate services, but it really is bordering on signs saying “whites only”. I wish I had more time to look into this because with our “history” I can’t help but wonder about the unstated aims.
          Because nowhere is the failings of psychiatry more obvious when you try to introduce it into other culture. Their “standards” as to what constitutes a ‘mental illness’ are comperable to trying to introduce Christianity.

          • In America more whites get “treated” because we urge each other not to be afraid to seek out “services.”

            My African American friend says those in her subculture view psychiatry with suspicion. For what it’s worth, their churches and other social structures tend to help the poor and misfits.

            White churches tend to shun “weirdos” without plenty of green for the offering plate. Not all though. The one I attend now treats me kindly and encourages a developmentally delayed man to attend.

            Ideally churches would be interracial; not “black” or “white.” I’m hopeful that will happen soon. We need to unite.

          • Good that its a voluntary thing. Imagine the change if they were given the power to have police deliver people to them for exorcisms. Different ‘church’ officer lol.

            I can’t find the comments relating to psychs having proxy access to guns and tazers via police. Just a point of interest, our new MH Act has put a MH professional in every police station. They now have proxy access to chemical restraints and with the power to spike people before interviews?

            https://www.aljazeera.com/news/2018/08/bobi-wine-blocked-leaving-torture-treatment-180831053850755.html

            Interesting case in point. The wedding (MH and police) happened without the fussy of Harry and Megan. Bobi Wines lawyer needs to check the Convention against the use of Torture. Article 1.1 it is not torture if it is “inherent in or incidental to lawful sanction” . Thus as he has a doctor, he is being ‘treated’. Something which should be a concern for us all. Not only is it possible in Uganda, but in our own places of residence. And it interesting how effective the defense of “they wouldn’t do that” actually is.
            I was ‘spiked’ with benzos, jumped by police and handed over to a Community Nurse for a ‘verballing’, and with knowledge that I had been ‘spiked’ the Community Nurse then handed me over to police to be interviewed. Imagine being able to drug suspects without their knowledge before subjecting them to interrogation. No wonder they wanted the proof back.

          • Wtf, you get a lawyer in Uganda, but not in Australia?

            No wonder the lawyer at the Law Centre said “we’ve been getting a lot of these lately”. Their ‘throw you under a bus service’ makes them complicit in human rights abuses. They’re even turning up in Uganda. It just so easy to do. Drop em with benzos, plant a knife and some drugs, and tell police they are a ‘patient’. Police detain on s68e and hand em over to MH given they suspect on reasonable grounds that the person has a mental illness (the lie told by CN). He then ‘verbals’ and brings you under the MHA and authorises the spiking. Now without informing you that you have been spiked, he hands you back to police for interview. They interrogate and get what they want, and drop you off at the hospital for further treatment (ie massive injection of anti psychotics). Doctor now writes a script for the drugs you were spiked with post hoc. And it all appears lawful.
            Life deals you lemons, you make lemonade. I see a business opportunity.
            If the lawyers only accept documents minus the proof of the spiking, then they begin slandering you as a paranoid delusional. I like the new offices by the way.

  5. Thank you for your article and allowing me to comment. Freudians might want to re-visit this statement; “The “Autism war” turned out to be very costly for psychoanalysts.” The rate of “autism” was documented at 1:2000 before Freudian theory was abandoned by psychiatry; the rate is now documented at 1:59.

    I believe that psychiatry pathologizes emotional suffering (and coping styles deemed disabling) as a generally unrecognized tool of social control of the marginalized and disenfranchised. I believe that this is changing as criticism of psychiatry increases; consistently, I encourage Freudians to revisit the “autism wars” to address the epidemic of “autism.”

  6. back to bio/psy/soc model of causation….hello steve..
    there is a reason to put bio first…
    when you have a mind or emotional problem…
    the first thing a doctor is supposed to do…
    is to make sure there is not something bio
    causing the problem…like low thyroid…

    • Well, there is nothing wrong with checking someone’s thyroid or their vitamin levels or for actual medical problems. Unfortunately, I have not know many psychiatrists who bother with anything along those lines. Mostly, they ask people to list their “symptoms” and then “diagnose” them and prescribe something.

    • Little Turtle, I sort of agree with you.

      Go to a regular doctor to get tested for anemia, thyroid problems, or even diabetes. (Blood sugar affects our thinking.)
      Talk to a friend, trusted relative, clergy member, or life coach/guru type for possibly messed up thought patterns.
      Go to social functions for the social part.

      Notice who isn’t there and isn’t even missed? 🙂

  7. psychoanalysts had learned to make use of the advances of pharmacology

    Which of course made them revisionists and complicit with psychiatry/pharm, hence no longer of no use to anyone. (Such opportunism was/is not characteristic of all psychoanalysts in terms of squandered integrity.)

    Most of this article is a paean to eugenics and junk science.

    • Well said, Oldhead! Which is why I refuse to see any mainstream counselor again.

      They may help “normal” folks sometimes, but once they know you have an SMI label they keep reminding you of the “fact” that you are hopelessly insane/incompetent. Depressing!

      • So how do we go about combating this? I’ve dealt with my GP concerning this and made it very clear to her that it was junk science and I’d have nothing to do with her if she ever tried to push antidepressants or any of that stuff. But it must go farther than just dealing with your own personal doctor. We’ve got to begin combating all of this on a larger scale.

        • Stephen, I’m “coming out” as a psych survivor. Right now I’m fighting to start a career in my mid-forties.

          I’m fighting psychiatry with the Truth and educating the public.

          Oldhead sneered at my talking point that, “Psych drugs do not work.” He said they work perfectly since all people want to do is keep us passive and stupid.

          For abusive family members, the nasty shrinks, certain politicians, and others this is true.

          But many are convinced these drugs are life saving medicines that are good for you and slow brain degeneration. Why else would loving family members encourage others to “take their meds” while watching in horror and amazement as they grow crazier, sicken and die? Why do so many of us take these poisons religiously–scared of missing a dose?

          I didn’t WANT to take addictive drugs and rot my brain. Many family members love the “mentally ill” child or spouse. Even those who join NAMI often do so out of desperation. The friend who introduced me to NAMI left after her sister died and the organization seemed okay with it since she died “meds compliant.”

          The truth needs to be known. Some people are already seeing how worse than useless psychiatric remedies are. Hard to deny what you see with your own eyes. People get worse–not better. Crazier, not sane or able to care for themselves.

          People deserve to know the truth. I’m taking it to faith-based centers. I already have connections. And they are a form of social gathering folks still attend.