Dr. Huda Has Written His Book: ‘The Medical Model in Mental Health’

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Samei Huda, MD, is a consultant psychiatrist with the British National Health Service. He has written a book called The Medical Model in Mental Health, An Explanation and Evaluation. It was published by Oxford University Press earlier this year.

BASIC THEME

In his preface, Dr. Huda tells us that he wrote the book to “explain the medical model and to evaluate its usefulness in mental health.” He also tells us that his inspiration was twofold:

Firstly:  “Having read many critical comments about the medical model in mental health, it struck me that many of these criticisms seem based on a lack of knowledge or misunderstanding of the medical model, not just in psychiatry but also in general medicine.” (p v)

Secondly:  “…many of the concerns about psychiatric diagnostic constructs and the effectiveness of treatments also occurred in general medicine.” (p v)

The central issue here is that anti-psychiatry writers, including myself, have devoted a good deal of time and energy to highlighting the distinction between general medicine, which I call real medicine, and psychiatry, which I call a hoax.

The basic theme of Dr. Huda’s book is that this distinction is not valid, and that psychiatry’s claim to medical status is as well-founded as any bona fide medical specialty. Dr. Huda pursues this goal, firstly by presenting a distortion of the term “medical model”; secondly, by selectively presenting areas and practices in which psychiatry and general medicine share some superficial similarities; and thirdly, by ignoring or downplaying those areas in which psychiatry and general medicine are essentially different.

The reason that we in the anti-psychiatry movement draw a sharp distinction between real illnesses and psychiatric “illnesses” is because they are fundamentally different. A real illness entails a biological or anatomical pathology which causes the symptoms, and which, although subject to a measure of individual variation, is essentially similar in all the individuals so afflicted. Psychiatric “illnesses,” in contrast, are nothing more than loose collections of vaguely-defined problems of thinking, feeling, perceiving, or behaving. Individuals who have been assigned a particular psychiatric “diagnosis” will inevitably have some features in common, but these similarities are almost always eclipsed by the degree of variation in both the sources of the problem and its presentation.

In this regard, it needs to be stressed that even in those medical diagnoses where the pathological process or structure is as yet unknown, there is always, at the very least, prima facie evidence that the underlying illness is a real disease: i.e. that the unknown pathology does exist and can be discovered through painstaking research and exploration.

In psychiatric “diagnoses,” this is simply not the case. Not only is there no formal evidence that depression, for instance, is an illness, there is not even a superficial indication of illness. There is nothing about depression that would lead a reasonable person to suspect an underlying, causative biological pathology. Indeed, the opposite is the case: depression is an adaptive mechanism that alerts us to the fact that something is wrong or missing in our lives, and encourages us to take appropriate action.

DR. HUDA’S METHODOLOGY

Dr. Huda pursues his quest by reducing the fundamental issue to a series of twenty questions, formulated to elucidate differences or similarities between psychiatry and real medicine. He then addresses each question in turn, citing numerous experts and references.

Here are some of Dr. Huda’s twenty questions, the full list of which appears on pages 307 and 308:

“What is the reliability of the diagnosis when compared to a relevant reference criterion?”

“Is the condition clearly separated from normality?”

“Is there little co-occurrence of conditions, i.e. conditions are separate clinical entities?”

“Is the condition clearly identified with a causal mechanism (aetiology)?”

“Is the condition clearly associated with a proven and detectable difference in structure or process?”

“Is the condition caused by social difficulties and/or traumatic events?”

Etc.

Note the question concerning causal mechanism and the question concerning proven and detectable difference in structure or process. These are the critical questions, but Dr. Huda has simply placed them in the list, essentially affording them equal status with the other items.

From all of these deliberations, Dr. Huda concludes that there is “some overlap” between psychiatric diagnoses and general medical diagnoses with regards to each question.

“Diagnostic constructs in both general medicine and psychiatry often identify areas of spectrums (e.g. of symptoms) rather than distinctive categorical entities (Chapters 3, 9, and 11) and are not always reliable in clinical practice (Chapter 8) or may have variable clinical pictures (Chapter 10)” (p 308)

And then the critical flaw:

“Biological mechanisms and/or causes are often  unknown in psychiatric diagnostic constructs but this can also occur in general medicine’s diagnostic constructs (Chapter 12), and social factors are particularly important causes for both psychiatric and general medicine conditions (Chapter 14).” (p 308)

There are three issues here. Firstly, biological cause is the defining feature of illness. This is the commonly accepted meaning of the word, and is fully endorsed by psychiatry itself in their avid promotion of the fiction that their “disorders” are real illnesses, just like diabetes. In this context, their phrase “just like diabetes” means having a biological cause, and by repeatedly using this phrase, psychiatry is essentially acknowledging that this is the acid test for an illness.

Secondly, some psychiatric “disorders” are indeed real illnesses. These include Alzheimer’s and other dementias; cognitive impairments due to brain injury/infections; etc. So when Dr. Huda compares psychiatric diagnoses with real diagnoses, from the perspective of cause and biomarkers, he will, of course, find “some overlap.” This is not contentious. But he will find no overlap in comparing psychiatry’s functional “diagnoses” with general medical diagnoses, and it is in this area that the contention arises.

Thirdly, the phrase “…social factors are particularly important causes for both psychiatric and general medical conditions…” is misleading. It might be argued, for instance, that both pneumonia and depression are caused by poverty. But in fact, pneumonia is caused by a germ. People who live in chronic poverty may have a higher risk of catching this disease, but drawing a straight comparison between this and the fact that poor people have a higher risk of becoming depressed is facile wordplay. And Dr. Huda is well aware of this:

“There is increased risk caused by social difficulties and/or childhood trauma for developing both general medical and mental health conditions with overlap in similarity of magnitude of some increased risks though intermediary mechanisms may differ.” (p 233) [Emphasis added]

The notion that in the etiology of pneumonia, for instance, the pneumococcal germ is an intermediary mechanism, and that the real cause of the disease is poverty or some other “social difficulty” is quite a stretch.

DR. HUDA’S CONCLUSIONS

Under the heading “Final Words,” Dr. Huda writes:

“The medical model as described in this book is one based on the practice of most doctors in clinical practice. It is the ethical use of knowledge and skills to benefit patients. The method of learning and applying this knowledge is based on learning about diagnostic constructs with attached useful probabilistic clinical information (e.g. range of likely prognosis and the chances of success with different treatments) and recognizing which diagnostic construct(s) best match the patient’s presenting problems.” (p 317)

Although superficially plausible, this statement is not an accurate description of general medical practice. Psychiatrists do indeed use this cookbook kind of approach to diagnosis and prescribing, but it is a far cry from what goes on in real medicine. The bedrock of real medicine is an understanding of the biological processes underlying normal human functioning, and those deviations from normality which we call illnesses.

It is well known, for instance, that many real illnesses are caused by tiny microorganisms called germs. This is by no means superficially obvious and represents a profound insight into the nature, course, and treatment of the diseases in question.

Real medicine is based on thousands of such insights. For instance, the pancreas responds to sugar in the bloodstream by secreting insulin into the blood. The insulin breaks down the sugar, allowing it to be eliminated safely. If the pancreas is damaged, or if the individual is consuming more sugar or carbs than the pancreas can deal with, diabetes results. Again, this is a profound insight, not superficially obvious, and extremely helpful in understanding and treating this illness.

The critical point here is that psychiatry has no such insights to support its long-contended assertion that its functional diagnoses are real illnesses just like diabetes. All they have is their unwarranted assertions, their PR, the ethically dubious financial support of pharma, and, of course, their nonexistent chemical imbalances.

Dr. Huda’s assertion that there is “some overlap” between psychiatry and general medicine is on a par with the assertion that airplanes and wheelbarrows have some things in common. Sure they do; they can both carry things from one place to another. But the differences outweigh any such similarities, and there is no evidence to support the notion that psychiatry’s functional diagnoses are caused by any kind of biological pathology.

Psychiatry plays with the medical model in cookbook style, but their endeavors in this regard bear as much resemblance to real medicine as the trundling of a wheelbarrow does to the flying of a jumbo jet.

FINALLY

It needs to be acknowledged that Dr. Huda himself recognizes this distinction.

“There is room for improvement in psychiatry’s often heterogeneous diagnostic constructs based usually on clinical picture not underlying mechanisms or causes; that is, they are often descriptive rather than explanatory. Better understanding of mechanisms and/or causes may lead to improvements in psychiatric treatments which currently often do not seem to affect the mechanisms or causes underlying the clinical picture directly. This better understanding may need to be achieved by research using more complex classification systems such as dimensional systems.” (p 317)

In other words: psychiatric “diagnoses” do not describe real illnesses, but “better understanding” will emerge from “more complex” classification systems such as dimensional systems. So it’s the same old stuff. We psychiatrists will have real diagnoses any decade now once we’ve discovered the real underlying causes of depression, childhood inattention, unconventional thinking, painful memories, etc. Meanwhile, the true causes of these human concerns are hiding in plain sight: loss; inadequate training; traumatic history; painful events; etc. But this is the reality that psychiatry has systematically repressed for the past fifty years or more.

And, incidentally, DSM-IV (1994) considered adopting a dimensional approach to classification but rejected the notion on the grounds that:

“Numerical dimensional descriptions are much less familiar and vivid than are the categorical names for mental disorders.” (p xxii)

Dimensional descriptions also de-entify the problem. “He scored seven out of ten on a battery of depression inventories” doesn’t have the same pathological ring as “He has major depressive disorder.” And pathological ring has been psychiatry’s primary agenda since the drugs began to come onstream in the 50’s and 60’s.

Dr. Huda closes on a conciliatory note:

“The different parties involved in mental healthcare — patients, their carers, and the various mental health professionals — should use whichever classification system (or no classification) that helps them best achieve patients’ treatment objectives and perform their roles and duties. They should also recognize that other parties may use different classification systems for good reasons.” (p 318)

And psychiatry’s “good reasons” for promoting a spurious pathological approach is to legitimize the pushing of dangerous drugs, which, by their own choosing, is their only stock-in-trade. It really is that simple.

AND BY THE WAY

Here are the top nine reasons for admissions to US general hospitals in 2015 (last year for which I could find data), with their causes:

  1. Septicemia:  Infection from elsewhere in the body entering the bloodstream
  2. Osteoarthritis:  Mechanical stress on a joint plus low-grade inflammation
  3. Congestive heart failure:  Impairment of heart’s pumping function, multiple specific causes
  4. Pneumonia:  Germs in the lungs
  5. Cardiac dysrhythmias:  Multiple causes, e.g., coronary artery disease; high blood pressure; valve disorders; electrolyte imbalances especially sodium and potassium, etc.
  6. Complication of device, implant or graft:  Self-explanatory
  7. Acute myocardial infarction:  Lack of blood flow to a part of the heart causing damage to the muscle
  8. Acute cerebrovascular disease:  Multiple causes:  e.g. arthrosclerosis, embolism, aneurysm, etc.
  9. Chronic obstructive pulmonary disease:  Long-term smoking, or exposure to air pollution, dust, etc.

And here are the top five reasons for US psychiatric admissions in 2012 (last year for which I could find data):

  1. Mood disorders:  Biological cause unknown
  2. Schizophrenia and other psychotic disorders:  Biological cause unknown
  3. Anxiety disorders:  Biological cause unknown
  4. Adjustment disorders:  Biological cause unknown
  5. Impulse disorders: Biological cause unknown

Degree of overlap:  zero

***

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.

***

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63 COMMENTS

  1. Pathology of any kind is a proper language of the psyche, our psyche does not create health. Our pathology is always present, in one way or another. Psychological meaning of illness is something more important than empty definition of utopian health. Health is just an empty claim toward psyche, life. Health does not exists, I am afraid. We are highly pathological beings, form the beginning of our life. Health is meaningless to psychological reality. We want to see us as healthy beings, but health does not exists in reality. Our cells are dying even now. The death and its pathology keeps us alive. The problem is that materialistic monotheism likes the utopian vision of health. Psyche creates pathology all the time, but heroic ego wants to believe in everlasting health. Which is utopia.

    I recommend archetypal psychology to everyone.Because it is not naive. We are born to die. We are here, because we wanted to live for a while. We will suffer, we will be ill, and then we die. Hey ho let’s go.
    We need to revive the psychological meaning of pathology/suffering.

    James Hillman “Re- visioning psychology”.

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  2. Biological cause unknown? That’s strange- I can think of several possible causes for each of the above five symptom complexes. I can even treat some of them using off-the-shelf materials, despite being a psychiatric nobody. How am I supposed to be impressed by this psychiatric pretentiousness?

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  6. Hi Phil,
    Thank you for your article, thank you MIA. Obviously you do have the knowledge to shred any book to pieces.
    To me one thing is very clear, Any specialty that looks to help, heal, make better, would never ever be involved in staining people’s reputations, give harmful drugs, force, coerce, manipulate, take all power from them. And this is not an accidental bi-product. It is the product.

    Any lay person should be able to see that anyone with this power is not there to do good things, IF they were willing to be curious and peel back the layers. And really, there is very little peeling needed. You don’t even need a heart, empathy. You need logic, rational observation.

    To defend such a system or even part of that system is, well, being part of it.
    I am glad you take the time and concern to leave us your wonderful articles.

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  7. I also want to salute another articulate post by someone bringing clarity to the world. I especially appreciate the clarity of this comment: “Meanwhile, the true causes of these human concerns are hiding in plain sight: loss; inadequate training; traumatic history; painful events; etc.”

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  8. “When we are told what is healthy we are being told what is right to think and feel. When we are told what is mentally ill we are being told what ideas, behavior, and fantasies are wrong. […] The avenues of escape are blocked by the professional abuse of pathologizing. To refuse the mental health approach confirms one’s ‘sickness’. One needs ‘therapy’, […]

    How can we take back therapy […] from a system which must find illness in order to promote health and which, in order to increase the range of its helping, is obliged to extend the area of sickness. Ever deeper pockets of pathology to be analyzed, ever earlier traumata: primal, prenatal, into my astral body; ever more people into the ritual: the family, the office force, community mental health, analysis for everyone. […]
    Its practice may differ […] but the premise is the same. The work of making soul requires professional help. Soul-making has become restricted by therapy and to therapy. And psychopathology has become restricted to therapy’s negative definition of it, reduced to its role in the therapy game.”

    “The healer is the illness, and the illness is the healer. But as this ancient psychological idea has become translated into modern secular therapy, the”who” is none other than the professional therapist.
    By giving the pathologizing a clinical name, the professional therapist makes the first move in therapy game. The first move is not the pathologizing of the patient.
    —————————————————————————————–
    His complaints and oddities are not clinical psychopathology until so named. (They are psychological, and they are needed, because our psyche needs it, even if we, our ego is unable to cope)
    ——————————————————————————————

    On the one hand , I am protected from this “thing” by separation from it, it now has a name. But on the other hand, I now, have something…” Moreover the therapist has become the very god who by bringing the condition is the only one who can take it away.The patients tend to believe in his therapist: ” He alone can help me for only he knows really what is wrong.” What is “really” wrong means what is “literally” wrong, what has been literalized into wrongness by the professional therapy game.
    ———————————————————————————————————————–
    In this way the analyst and the patient become locked in a long -term therapy analysis, for the analyst is the one, the very God, who has seen into the patient incurable weak spot, his vulnerable heel, his ruinous secret. The analyst’s insight and the patient’s wound together embody the archetypal figure of Wounded -Healer, another ancient and psychological way of expressing that illness and its healing are one and the same. But again in modern secular therapy the Wounded Healer has been divided down the middle: illness is all one the patient side and health all with the therapist. The archetype is split, and the two halves are bound together compellingly in what is called transference and countertransference.
    Little wonder therapy speaks so much of “resistance” and that manuals are written explaining how to overcome or break through the patient’s “defense mechanism”.

    “Therapeutic analysis has side effects no less lethal than drugs”

    ————————————————————————————————————————————
    For the wrong pathologizing of the therapy game is killing.—————————————————— Levi -Strauss has noted that asymmetrical games, such as those between the unequal partners of therapy, end in killing one opponent. The killing of psychotherapy takes place on a psychological level:the neurosis, the problem, is supposedly “got rid of”, whereas actually it is soul that is being killed – again through a wrong pathologizing, a wrong understanding of the soul in the symptom.
    ——————————————————————————————————————-
    Wrong pathologizing has spread well beyond the games of the consulting room and clinic, becoming a covert political instrument of the state.Political heretics may be declared mentally ill in order to banish them – and this procedure is smoothly justified with assurances that it is for the “patient’s” good. We may not draw comfort from supposing that this goes on only in the Soviet union.

    James Hillman

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  9. I’m not overly organized here but I don’t think there’s much we haven’t heard before:

    Individuals who have been assigned a particular psychiatric “diagnosis” will inevitably have some features in common, but these similarities are almost always eclipsed by the degree of variation in both the sources of the problem and its presentation.

    Bonnie B calls this “decontextualizing behavior.” Superficial similarities in expression do not constitute any sort of legitimate “category”: To take a common stereotype, there could be any number of reasons a person might be running down the street naked and screaming in the middle of winter. I’m sure people can use their imaginations. There are likewise multiple, maybe infinite reasons for any outward expression of anything, depending on the individual’s specific circumstances.

    Secondly, some psychiatric “disorders” are indeed real illnesses. These include Alzheimer’s and other dementias; cognitive impairments due to brain injury/infections; etc.

    One of the few occasions I might ever have to challenge Phil’s semantics here. As per Szasz, I would say that if something has a physical cause and is a “real” illness, this should be considered a neurological disorder, not a psychiatric “disorder.” Maybe I’d just position the quotation marks and commas differently, i.e. some “psychiatric” disorders are indeed real illnesses. A fine distinction I know.

    This book seems pretty boring — is it supposed to be making waves or something with this platitudinous drivel? If so this highlights the continuing intellectual mediocrity of psychiatric self-justification and self-promotion.

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  10. Nice to read another one of your blogs, Dr. Hickey. I was missing your oft witty posts, as of late. I will point out, however, that some of the causes of these disorders are known.

    Mood disorders: the ADHD drugs and antidepressants can create the “bipolar” symptoms, as Whitaker pointed out; plus, the common non-biological issues such as child abuse, rape, bullying, distress caused by 9/11/2001 and the never ending wars, other injustices, medical malpractice, poverty, racism, etc.

    Schizophrenia and other psychotic disorders: The neuroleptics can create the negative symptoms of “schizophrenia” via neuroleptic induced deficit syndrome. The antipsychotics and antidepressants can also create “psychosis” and hallucinations, via anticholinergic toxidrome poisoning. Plus the non-biological causes listed above.

    Anxiety disorders: Probably the benzodiazepines, and/or benzodiazepine withdrawal. Plus the non-biological causes listed above.

    Adjustment disorders: Difficulty adjusting to repeatedly being treated in an ungodly disrespectful manner, defamed with make believe diseases, and force drugged with neurotoxins. Most of the time, so psychiatrists can profiteer off of covering up real life issues and crimes like child abuse, rape, bullying, distress caused by 9/11/2001 and the never ending wars, other injustices, medical malpractice, poverty, racism, etc.

    In Allen Frances’ words, psychiatry is “bullshit.” And psychiatry’s “bullshit” has destroyed the rule of law in our country.

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      • These are actually quite rare.

        The teen talking to non-existent people. The man going around calling himself Moses or Gandhi. The woman who imagines the CIA is spying on her.
        Very few people in the MI System I met ever experienced this pre-drugs.

        Most were nervous and unhappy from crap in their lives. Till the psych treatments sent them over the edge.
        Or they got a plea deal for shop lifting or assault.
        Or had a drinking problem that AA used to help with. Now they’re addicted to stuff far worse than booze.

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  11. Couldn’t we start having public debates between psychiatry and the anti psychiatry folks, such as Phil, Robert, and a myriad of members on here?
    Give people a choice of whether they want to go with dogma and lack of evidence.
    Since psychiatry infiltrates law, schools, people’s/users liberties, it should be presented to the public on a public platform along with their opposition. Countries that are supposedly free, are not supposed to tag their minions.
    Psychiatry uses anything and everything to try and convince the public. Now they are using crimes within society to try and make their stint seem logical. The public has to know the difference between crimes and what psychiatry calls the MI.
    How is a child a criminal, yet millions are drugged.
    Their drugs cause brain changes, and who is to know if these drugs eventually cause these kids to commit crimes? Definitely a crime has been committed against kids and adults alike.

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  12. SCHIZOPHRENIA $$$

    What does “has a Diagnosis of Schizophrenia” (in isolation) mean?

    https://drive.google.com/file/d/1s-mEHH5pLC5EzWpxjnOLKcylQOTJ-Kvw/view?usp=drivesdk

    Does it mean a person that can do nothing for themselves?

    Or

    Does it mean a person that is completely okay?

    WIKIPEDIA
    https://en.m.wikipedia.org/wiki/Schizophrenia

    “….Approximately three-fourths of people with schizophrenia have ongoing disability with relapses[35] and 16.7 million people globally are deemed to have moderate or severe disability from the condition.[169] Some people do recover completely and others function well in society….”

    UK NATIONAL HEALTH SERVICE
    https://www.nhs.uk/conditions/schizophrenia/

    “…Schizophrenia is a severe long-term mental health condition…”

    “…Doctors often describe schizophrenia as a type of psychosis. This means the person may not always be able to distinguish their own thoughts and ideas from reality…”

    “….Symptoms of schizophrenia include: hallucinations – hearing or seeing things that do not exist outside of the minddelusions – unusual beliefs not based on reality muddled thoughts based on hallucinations or delusions losing interest in everyday activitiesnot caring about your personal hygiene wanting to avoid people, including friends…”

    “…Schizophrenia does not cause someone to be violent and people with schizophrenia do not have a split personality….”

    Representation of Schizophrenia in Isolation is something Professionals in the UK do again and again. There’s Good Money in it.£££

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  13. Yes anomie, rotten to the core.

    I really think it is a true reflection of WHO and HOW we are. We easily talk about others, as lazy, a bum,
    crazy, weirdo, not motivated, won’t work, talks too much, too shy, etc.
    And we stare, we observe, from our vantage point, our post of judgment….psychiatry took it to an obsessional level, which in and of itself was the MI they speak of.
    There is NO medical or scientific model and none to be found. All it will ever explain is uniqueness in people. The illness part will still be pure judging on not fitting an ideal.
    Forever since history, people were killed for looking and being different. It is not new at all, and amazing that Philosophy does not take a bigger stance on this.
    It has always been about power, not anything realistic.
    They are nothing more than judgemental snobs and if I were them I would drop the absolutely insane ways of describing people in their reports. “she was dressed in an appropriate manner”.
    Obviously it’s HILARIOUS, but really? This passes grade? pffft

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  14. In case Dr Huda is reading this, seriously learn to relax, be flexible. You have no more than 100 years on this piece of land you are trying to control with your obsessions, and hurting people in your path. I have no clue how you can make peace with your part in this.
    It always makes me sad, for kids, for youth and even to a degree for shrinks. There is something very sad in being that convinced, that judgemental, that destructive.
    I have never seen your “ADHD” kids being so destructive that they maim others, You maim under the assumptions you hold.

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  15. I have read Dr Huda’s book and given a review, which can be read in full here: https://holeousia.com/2019/08/17/an-explanation/

    The author confirms in his introduction that this text book began with a specific starting point: to demonstrate that the approach taken to diagnosis, classification and therapeutic interventions in Psychiatry is no different to that taken in General Medicine. I would not fully disagree about this, as the Medical Model is the prevailing approach to mental health in the UK. However it is my view that any approach to Psychiatry, to be truly scientific, needs not to exclude consideration of the following:

    • the harms and benefits of any single Model
    • nominative and neurogenetic determinism and reductionism
    • social determinants of health and wellbeing
    • stigma, including iatrogenic stigma
    • learning from lived experience
    • where there are gaps in the evidence base (for example the limited evidence to support long term prescribing of psychotropic medications)
    • “Realistic Psychiatry” (also known as “Too much medicine” and in America “Saving Normal”)
    • biases introduced into biomedical research and medical education (for example the role of commercial vested interests)

    The author has argued on social media that my brief initial review was a “tacit admission” that his “argument is strong”. My difficulty as a reviewer is that I cannot consider and comment on what has not been included.

    The author of this text book has robustly argued that language, and how it is used, does not matter. I stand by my view that language is the basis of communications between human beings whether personally or professionally.

    I have written this longer explanation of my thoughts on this text book as I share the view of the philosopher Mary Midgley who died recently in her hundredth year. Mary Midgley often used metaphors in her writings and one of these was to talk about the windows that we each look through. In terms of our mental well-being, which can never be disembodied or separated from the life we live, we learn better when we share our window views. My blog hole ousia has no simple answers or over-arching framework but seeks to encourage shared learning. I am hopeful that the author of this book might write a second volume which considers how we might achieve this.

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      • The question I ask is this: is psychiatry really a “school of thought?” It purports to be a MEDICAL SCIENCE, with no actual support for that claim. It ignores its own research when it conflicts with the basic dogma of the belief system. People who don’t support those dogma are attacked and/or purged from the group. It seems a lot more like a RELIGION than a school of thought. A school of thought implies a philosophical viewpoint that is open to argumentation and new data. Psychiatry is unwilling to admit that it is promoting a philosophical viewpoint with which others may honestly disagree, and relies instead on having social power to enforce its dogma regardless of the truth. Which really prevents any kind of civil discourse with those who are unwilling to recognize the speculative and frankly dishonest nature of psychiatry as a “medical” field. For that reason, having a discussion about it feels like a big waste of time.

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        • Psychiatrists ignored me whenever I said anything negative about the pills they put me on. Either I was lying or it was my “illness” which (quite coincidentally) had never manifested in that form before I took their “100% safe, effective life-saving medicine.”

          Liar or inherent defectiveness. Can’t pill shame.

          So I decided two can play at this game. I lied and flattered shamelessly. As long as you kiss up and praise ye precious pills they’ll believe anything you say. It shows “good insight.” LOL

          Arrogant people are highly susceptible to flattery. Remember Colonel Klink in Hogan’s Heroes?

          It helped me escape.

          They hate the truth so you feed them the lies they prefer.

          Oh, they’ll easily believe you are “symptom” free. AKA no depression. Regardless of how you feel.

          What highly scientific method do they use to figure out your depression levels? Blood tests? Brain scans? Spinal taps?

          Nope.
          A quiz with 0-5 for negative feelings. They throw some physical symptoms that could be caused by real health issues, but it’s a trap. Just put 0 on everything and three 1’s so they won’t get suspicious.

          My joys and sorrows are my own business. I’l deal with them as I see fit. And calling my real life sorrows or griefs mere symptoms of some (unproven) brain disease is insulting the way I see it.

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  17. Well done once again Dr Hickey.

    I like the “cookbook” analogy, it reminded me of the mud pie my daughter once made me as a child. Shame she grew up and now has a gang of thugs at her disposal to force me to eat it because I was kidding when I said it looked like it would taste nice.

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    • Boans,
      It is a shame when stuff around us can change drastically,
      from what was good.
      Relationships can be wonderful but also sad.
      Although your comment made me smile, because you had the pleasure
      of being offered a mud pie. 🙂
      I find it difficult and I don’t think I’m alone in this, to remember
      the precious moments.

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  20. Thank you! I’m stuck on this constrictive view of “causes” ( what about the interaction of biopsychosocial factors?…) and then what I’ve seen, mood disorders and blood sugar related associations, schizophrenia and childhood trauma (manifest physically too) , parasites and mental illness symptoms etc.

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