No matter how clearly the scientific case is made that psychiatry is a pseudoscientific institution meriting no scientific authority, do you have that sinking feeling that psychiatry will continue to retain power and even grow in influence?
It doesn’t seem to matter that psychiatry’s “chemical imbalance theory of mental illness”—the major reason why people in mass began using psychiatric drugs—has long been discarded by science and is now being fled from even by members of the psychiatry establishment, notably Ronald Pies, editor-in-chief emeritus of the Psychiatric Times. Pies stated in 2011, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists”; and in 2019, Pies called the “chemical imbalance theory” a “myth.”
It doesn’t seem to matter that the National Institute of Mental Health (NIMH) in 2013 finally tossed the DSM—psychiatry’s diagnostic system—into the waste basket. Former NIMH director Thomas Insel stated that the DSM’s diagnostic categories lack validity, and he announced that “NIMH will be re-orienting its research away from DSM categories.”
It hasn’t mattered that numerous studies have found that so-called “antipsychotics”—especially in the long-term—are essentially pro-psychotics; and that so-called “antidepressants”—especially in the long-term—are essentially pro-depressants (see most recent study example of “Risk of Depressive Relapse Three Times Higher After Previous Antidepressant Use”).
So, why is the truth of psychiatry’s consistent record of getting it wrong and doing damage not setting society free to toss psychiatry on the garbage heap of history? There are obvious reasons having to do with the power of money and propaganda (Reasons 1 through 5); but there are darker reasons having to do with psychiatry’s political and societal role (Reasons 6 through 8); and perhaps the darkest reasons of all have to do with how psychiatry provides license to violate taboos and to exploit human desperations and vulnerabilities (Reasons 9 and 10).
1. Big Pharma Financial Power
This falls into the category of “Everybody Knows” in the sense of singer/songwriter Leonard Cohen. Damn near everybody knows that Big Pharma makes big money from psychiatric drugs, and that Big Pharma keeps this gravy train flowing by throwing cash at the American Psychiatric Association (APA), “thought-leader” psychiatrists, university psychiatry departments, psychiatry continuing education, psychiatry journals, and the mass media. This truth has been mainstream since 2004, following The Truth About the Drug Companies, published by Random House and authored by former editor in chief of The New England Journal of Medicine Marcia Angell, who includes chapters with titles such as “The Hard Sell . . . Lures, Bribes, and Kickbacks” and “Marketing Masquerading as Education.” As the song goes, “Everybody knows, that’s how it goes.”
2. Psychiatry Guild Influence
Everybody should know that institutions are going to fight for their survival and growth, and the American Psychiatric Association (APA), the guild of psychiatry, is no different than most other major institutions. Psychiatrists pay their dues to APA to promote the authority of psychiatry and its theories so psychiatrists can make money. Long after science had disproven the “chemical imbalance theory of mental illness,” APA presidents continued to publicly declare it as truth (e.g., in 2001, APA president Richard Harding, writing for the general public in Family Circle, stated: “We now know that mental illnesses—such as depression or schizophrenia—are not ‘moral weaknesses’ or ‘imagined’ but real diseases caused by abnormalities of brain structure and imbalances of chemicals in the brain”). While it is not surprising that a guild institution would act in the manner that the APA does, what enables its effectiveness is that (1) it is backed by Big Pharma money, and (2) its pseudoscientific proclamations are uncritically reported by the mainstream media.
3. Mainstream Media Failure
Most of the general public does not know that the “chemical imbalance theory” is untrue—or as Pies put it, “urban legend”/”myth”—because, with rare exceptions (such as a 2012 restrained NPR story), they don’t hear about this from the mainstream media, which also rarely reports on long-term studies that have found psychiatric drugs increase the risk of chronic impairment. In my 2019 Truthout interview of Robert Whitaker, “Why the Mainstream Media Has Failed to Tell Truths About Psychiatry,” he notes this obvious reason for the mainstream media’s failure: Big Pharma money for media advertising inhibits critical coverage of psychiatry and psychiatric drugs; but he also points out that this is not the only reason for the media’s failure.
Whitaker notes: “In the early 1980s, the APA launched an effort to sell its DSM III ‘disease model’ to the public, and that meant telling its story through the media. It held media days, and gave out awards to reporters who best echoed the story that the APA wanted told, and so soon the public was learning that psychiatric researchers were making great advances in identifying the biological causes of major mental disorders.” Whitaker also points out that psychiatry/Big Pharma effectively convinced the media that the only critic of psychiatry is Scientology and, as Whitaker notes, “From the media’s perspective, you had academic psychiatrists on one side and cultists on the other, and who was the media going to believe? And going forward, this was a strategy that was bound to intimidate reporters, for their careers could be at risk if they were seen as lending credence to Scientologists. The Scientology card was psychiatry’s ace in the hole; it helped still media criticism for decades.” Another reason for the media’s failure is that the huge expansion of psychiatric drug use touched the media on a personal level and subverted their objectivity; Whitaker notes, “At any newspaper or magazine or publishing house of any size, there would be editors or reporters who were taking a psychiatric drug, or members of their family who were. That regularly made them personally invested in psychiatry’s narrative of progress, and resistant to criticisms of the drugs.”
4. Power of the Big Lie
Joseph Goebbels, Minister of Propaganda of Nazi Germany, infamously stated: “If you tell a lie big enough and keep repeating it, people will eventually come to believe it.” Big lies told by government leaders provide rationales for wars; and falsehoods told by institutions meet their needs for growth and profits. If these lies are heard often enough, they are believed, even after being disproven and retracted. In 2003, the Bush administration told Americans that the United States must invade Iraq because of proof that Saddam Hussein had “weapons of mass destruction”; such WMDs were never found, but since this initial claim was so loudly trumpeted and retractions so quietly whispered, many Americans continue to falsely believe that WMDS were discovered in Iraq; a 2015 poll reported that 42 percent of all Americans (51 percent of Republicans) continue to believe in the WMD rationale for invading Iraq. Similarly, a 2006 survey revealed that 80 percent of Americans believed that depression is caused by a chemical imbalance (87 percent believed so for schizophrenia). Despite the “chemical imbalance theory of mental illness” having been scientifically rejected by the 1990s—and now discarded even by the psychiatry establishment—because this theory was so loudly trumpeted and retractions so quietly whispered, not only do much of the general public continue to believe it, so too do many doctors.
5. Attachment to the “Bamboozle”
Astronomer Carl Sagan, a fierce advocate of scientific skeptical inquiry, noted: “One of the saddest lessons of history is this: if we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It’s simply too painful to acknowledge, even to ourselves, that we’ve been taken. Once you give a charlatan power over you, you almost never get it back.” When one combines this pain (of acknowledging that one has been bamboozled) with the mainstream media’s failure to report scientific truths, and add to this the power of placebos making anything at times appear to be effective, it makes it difficult for those captured to self-liberate; and thus, it is actually remarkable that so many Americans still don’t trust psychiatry or psychiatrists. A 2012 Gallup Poll on standards of honesty and ethics in various professions reported that only 41 percent of Americans felt that psychiatrists had “high” or “very high” standards of honesty and ethics (as compared to “high” or “very high” opinions of 52 percent for clergy, 70 percent for other medical doctors, and 85 percent for nurses). Given the onslaught of pro-psychiatry propaganda, the fact that the majority of Americans have a low opinion of psychiatrists stems perhaps from their personal experience with psychiatrists—their own, their family, or their friends’ direct experience with them.
6. Meeting the Needs of the Ruling Power Structure
Psychiatry has historically been supported by the ruling power structure in return for meeting the power structure’s need to maintain the societal hierarchy and political status quo. Most recently, many political leaders have sought to blame “mental illness” for mass shootings and have pushed for “mental illness screenings” and “treatments” rather than dealing with underlying societal causes. Psychiatry maintains the societal status quo by its attributions that emotional suffering is caused by defects in individual biochemistry and genetics rather than by trauma and societal defects created by the ruling elite. Psychiatry covers up the reality that the root of much of what is commonly labeled as “mental illness” is a dehumanizing society—one orchestrated to meet only the needs of the wealthy and powerful and not designed to meet the needs of everybody else for autonomy, meaningfulness, and genuine community.
This can be seen in psychiatry’s (and other mental health professionals’) explanations for high rates of suicide among indigenous peoples, detailed by psychologist Roland Chrisjohn and Shaunessy McKay in Dying to Please You: “Existing explanations blame the victim, finding that they suffer from personal adjustment problems or emotional deficiencies like ‘low self-esteem’ and ‘depression.’ None of the existing explanations alleviate the situation by acting or suggesting action against the forces of oppression; they don’t even recognize them.” As I detail in Commonsense Rebellion, there are many examples of leading psychiatrists attempting to curry favor with the ruling power structure, including the infamous MKUltra, the CIA program of experiments on human subjects in which leading psychiatrists used drugs and torturous procedures to assist the CIA’s efforts at mind control.
7. Psychiatric Diagnoses as Weaponry to Marginalize Dissent
As attorney and journalist Glenn Greenwald observed: “For guardians of the status quo, there is nothing genuinely or fundamentally wrong with the prevailing order and its dominant institutions, which are viewed as just. Therefore, anyone claiming otherwise—especially someone sufficiently motivated by that belief to take radical action—must, by definition, be emotionally unstable and psychologically disabled. Put another way, there are, broadly speaking, two choices: obedience to institutional authority or radical dissent from it. . . . Radical dissent is evidence, even proof, of a severe personality disorder.” The use of psychiatric diagnoses to discredit, dismiss, and marginalize those challenging and resisting societal authorities is common, utilized by many societies in recent history. Such marginalization routinely occurs in families, and it is also used by the media to marginalize well-known dissenters.
One recent example is Edward Snowden who, in 2013, leaked to the press information that revealed mass warrantless surveillance on U.S. citizens. To discredit and marginalize Snowden, Greenwald describes how the mass media psychopathologized Snowden: CBS News host Bob Schieffer called Snowden a “narcissistic young man”; The New Yorker’s Jeffrey Toobin also diagnosed Snowden as “a grandiose narcissist,” and the Washington Post’s Richard Cohen joined the choir, asserting that Snowden “is merely narcissistic.”
Another example is detailed by Jonathan Metzl in The Protest Psychosis: How Schizophrenia Became a Black Disease (2010), which describes the systemic racism that labels “threats to authority as mental illness,” and how this process increases the likelihood that black men will get diagnosed with schizophrenia. In Resisting Illegitimate Authority, I offer several other examples of how psychiatric diagnoses are used to marginalize dissent of the famous and non-famous.
8. Extra-Legal Police Function
Psychiatry meets the control needs of not only the ruling power structure, schools, and other institutions but also the control needs of families. A major reason that pseudoscientific psychiatry continues is that it can be legally used to control people who have done nothing illegal but who create tension for authorities (e.g., children not paying attention to boring teachers; teenagers mocking their hypocritical parents; adults so alienated from society that they stop participating in it).
David Cohen, professor of social welfare, wrote: “This coercive function is what society and most people actually appreciate most about psychiatry.” In his 2014 article, “It’s the Coercion, Stupid!” Cohen explains how the societal need for psychiatry’s “extra-legal police function” compels society to be blind to psychiatry’s complete lack of scientific validity: “Because of psychiatric coercion, society gives psychiatric theories a free pass. These theories never need to pass any rigorously devised tests (as we expect other important scientific theories to pass), they only need to be asserted.”
9. License for Punishment, Revenge, and Assault
Even for those who continue to buy into their psychiatric diagnoses, psychiatric treatment can feel like punishment. This is apparent in the series “Living Well with Schizophrenia” in which Lauren, an attractive young woman who self-identifies as having “schizoaffective disorder,” compares her psychiatric hospitalization to what she imagines “jail might be like.” In in her video “What a Psychiatric Hospital is Like,” Lauren reports that after being placed in isolation, “I was stripped naked of all my clothes and I was pinned to the ground by six hospital staff.” She notes how this and other such dehumanizations “fed my opinion of always wanting to get out as early as I could.”
Beyond psychiatric “treatment” being so miserable that it can serve as a deterrent, it can also be used for revenge. One of the darker aspects of human nature is the capacity for a perverse pleasure through revenge; this includes getting back at people who have created unpleasant tensions by their altered states or suicidality. Of course, it is taboo to admit this desire for revenge; and it is even more taboo to admit that such revenge can be tinged with perverse pleasure and sadism; and it is shameful to admit that society allows for legalized assault. But if you doubt all this can occur, I’d suggest you watch Lauren telling how “I was stripped naked of all my clothes and I was pinned to the ground by six hospital staff.”
Tellingly, even though Lauren has embraced her schizoaffective diagnosis, YouTube has recently demonetized her videos which have been flagged for not being “advertiser friendly.” This penalty is likely due to Lauren’s lack of sufficient enthusiasm for her own psychiatric hospitalization, electroshock (ECT), and psychiatric drugs, which likely flags her videos as “controversial”—even though she repeatedly states that other people have positive experiences with these procedures. Thus, even though Lauren embraces her schizoaffective diagnosis and does not condemn any psychiatric treatment, because she is not totally compliant with psychiatry’s dogma, she is being punished via her videos being demonetized. In contrast, not being flagged for being “controversial” and not being demonetized by YouTube are videos that promote the biochemical brain imbalance theory of mental illness (YouTube is a subsidiary of Google, part of the ruling power structure).
10. The Empty Promise of Compassion and Love
Human beings want compassion and love, which is often difficult to find in a contemporary Western society which prioritizes efficiency and productivity. And people who are extremely depressed, anxious, alienated, and dissociating often find it even more difficult to receive genuine compassion and love because they behave in tension-producing manners, throwing “monkey wrenches” in family/school/workplace assembly lines. And so, tragically, this group who needs compassion and love the most because it is crucial to healing, receives the least. This results in such people being highly vulnerable to empty promises of how they may get compassion and love.
The false promise of psychiatry and its apologists is that if one accepts one’s psychiatric illness and the idea of biochemical causality, one can gain compassion and love from “enlightened members of society.” The false promise is that compassion and love will be gained with “medicalization parity”; e.g., if society is compelled to say, “People with delusions and hallucinations have the biochemical-genetic illness of schizophrenia, and they deserve the same compassion as anyone with a medical illness.” However, in reality this biochemical/medical parity stigmatizes even more.
The Canadian Health Services Research Foundation (CHSRF), in “Myth: Reframing Mental Illness as a ‘Brain Disease’ Reduces Stigma,” reported in 2012: “Evidence actually shows that anti-stigma campaigns emphasizing the biological nature of mental illness have not been effective, and have often made the problem worse.” One example is a 2010 study in Psychiatry Research that reported that for the general public, the acceptance of the “biogenetic model of mental illness” was associated with a desire for a greater social distance from the mentally ill. The CHSRF review states: “The evidence shows us that while the public may assign less blame to individuals for their biologically-determined mental illness, the very idea that their actions may be beyond their conscious control can create fear of their unpredictability and thus the perception that those with mental illnesses are dangerous. . . . leading to avoidance.”
Attempting to exact compassion and love through compelling the belief in “mental illness as biochemical medical illnesses” has not only failed but has created more stigmatization. Furthermore, coerced compassion from “enlightened members of society” routinely results in fake compassion, and such incongruent reactions can be “crazy making” for those experiencing it. Yet, people are so desperate for compassion and love, they cling to empty promises.
Because of the above 10 reasons, no matter how clearly the scientific case is made that psychiatry is a pseudoscientific institution meriting no scientific authority, psychiatry will continue to retain power. When we recognize that scientific truths alone are not setting society free, we begin to shift our energy to strategies that take into consideration the above reasons.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.