A Psychiatrist Critiques Psychiatry, and Does a Great Job!

Philip Hickey, PhD
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Overland describes itself as Australia’s only radical literary magazine.  It was founded in 1954, and publishes a quarterly print journal (essays, stories, and poetry) and an online magazine (cultural commentary).

In the current issue, Winter 2020, there is an excellent article by Samuel Lieblich, a consultant psychiatrist working in the Greater Melbourne Area.  The essay is titled Ignorance is Bliss.

Here are the first two paragraphs:

“By now there is enough criticism of the mental health business out there that it seems to me most engaged readers have been informed about the problems: psychiatry makes a false equivalence of the brain and the person, psychiatry pathologises some of the normal problems of human life, psychiatrists enforce highly constrained norms of thought and behaviour, and psychiatrists don’t value patients’ autonomy. There is still however a lot of confusion about the status of the things that psychiatrists treat. These are by no means illnesses, and the medications doctors use to treat them are by no reasonable measure effective. I am going to have to risk setting up a straw man here, but the majority of people don’t believe the claims I’ve just made, even though they have been exposed to the same claims many times. Marcia Angell when she retired as head of the New England Journal of Medicine wrote a pair of scathing reports in the New York Review of Books to the effect that psychiatry is a pseudoscience; and these same claims are repeated in bestselling books like The Emperor’s New Drugs, and magazine articles too numerous to mention. If one moves carefully through the scientific evidence one finds too that a ‘chemical imbalance’ has never been substantiated for any of the things that have been called a ‘mental illness’, and that the prescription of medications for psychiatric problems is always tendentious. The abundance of scientific support for these claims is only equalled by the total absence of their accommodation in the practice of psychiatry and the lay discourse about mental health. Although science does not really support the use of many psychopharmaceuticals in the ways they are represented to be supported, and although there is no acceptable measure by which most of the things treated by psychiatrists qualify as illnesses, the cultural position of the medical profession and their medicines is such that even a scientific refutation of a medical claim appears unscientific. This position of the doctor as super-scientific is perpetuated and co-opted by pharma for profit, and by the state for the purposes of social control. Capital aggrandises the psychiatrist, whose job is to condition the citizens to their labour, or to excise a tax in the form of pharmaceuticals payments. Either way capital wins and we all play along because we have been so immiserated by budget austerity, social precarity and casualised over-employment that the only comfort we can afford is to indulge in a fantasy.

Around one in six Americans, and one in eight Australians is currently prescribed an ‘anti-depressant’; and what the profession calls ‘Major Depressive Disorder’ is one of the most common diagnoses today. This diagnosis in particular has grown to assimilate a large number of human experiences, and the drugs supposed to treat it have also proliferated, because patients are strung-out and desperate, and because there has been a determined marketing campaign – to the effect that all despair is an illness – by the pharmaceutical industry which has insinuated itself into the state and into academia so thoroughly that to find a research project or piece of regulation untouched by their money is almost impossible.”

Here’s the final paragraph:

“Mental Health is broken; it has been broken by psychiatrists who are not scientists but who have scientific pretensions; patients who are desperate, who for reasons of expediency may prefer not to confront the truth of their symptoms, and who have no-one more trustworthy to turn to; and corrupt businesses that have snake oil to sell. The diagnosis of ‘Major Depressive Disorder’ (as representative of many psychiatric diagnoses) has grown malignant and come to subsume myriad forms of human experience into a monolithic and compromised diagnosis.37 It happened because of covert drug-marketing and drug-boostering driven by the powerful but unscientific forces to be found on government committees, professional panels, and in other places of power, and because doctors and patient-consumers have turned a blind eye to this corruption despite it being quite obvious and well publicised. Each and every person will have their own reason for ignoring or accepting information about ‘anti-depressants’ and ‘Major Depressive Disorder’ but one can’t deny that these things have proven eminently marketable (by pharmaceutical companies), billable (by doctors), and their horoscope like inclusiveness has offered patients the illusion of an explanation for their distress.25, 26, 38 There is an emancipatory and compassionate potential within psychiatry, but it has not found its expression in the reification of certain culture bound states of distress as ‘illnesses’ nor in the prescription of toxic and useless ‘medications’; rather it finds its expression in listening to patients, and in providing patients with the opportunity, not much afforded them elsewhere, to listen to themselves.”

And here are some gems from the body of the essay:

“Because by the 1970s validity in psychiatric diagnoses was already considered an unachievable dream, Robert Spitzer who led the production of the DSM-III10–12 said his aim was to improve the validity of mental health diagnosis by improving reliability.10, 13 To that end he gathered consensus from eminent clinicians and researchers in order to compose seemingly precise checklists of symptoms to define diagnoses. Notably in the checklist for ‘major depressive disorder’ there is no item that would require a psychiatrist to ask a patient ‘Why are you depressed?'”

“If you consider this abysmal reliability alongside the fact that no feature of the body has ever been shown to be awry in depression, that is no ‘chemical imbalance’ has ever been demonstrated even though people have been looking extremely hard for nearly a hundred years, how can a scientist set about determining whether the drug they are testing ‘cures depression’ when they have nearly no idea whether the people they are testing it on have ‘Major Depressive Disorder’ or whether that construct has any meaningful use in the first place?”

“It’s not clear to us exactly why ‘anti-depressants’ have so consistently been associated with an increase in suicidality. Some have proposed that it is to do with the common side-effect of severe restlessness, also known as ‘akathisia’, that – in combination with whatever got them prescribed the drug in the first place – drives people mad enough to kill themselves. I believe this is inflected by the fact that patients go to psychiatrists to have the singularity of their distress heard, understood and ministered to, and what they get instead is a mix of pharmaceutical salesmanship, cookie-cutter doctor-splaining about non-existent chemical imbalances, and a prescription for a useless chemical that demoralises them further. Patients are so saturated in advertising by ‘advocacy’ groups like Beyond Blue to the effect that only a doctor can help them that when they leave the doctor’s office with their hopes freshly dashed they are quite confused as to what has happened and promptly relocate the blame within themselves.”

“I would ask also: As a patient what is the use of having this or that diagnosis for whatever condition of sadness, distress, loneliness, loss, heart-ache, pain, weakness, guilt, demoralisation, degradation, destitution, unhappiness, balefulness, moodiness, irritation, frustration, powerlessness, imprisonment, hopelessness, or melancholy that you or a loved one is or was experiencing? Assimilating into the word ‘depression’ the infinity of ways the human being can find itself in darkness can only get in the way of understanding the unique experience of each new patient who deserves to be heard fully.”

“The so-called ‘anti-depressants’ should be re-classified as either poisons or research chemicals, and then people may do what they will with them, without believing them to be supported by medical science.”

COMMENTARY

Although Dr. Lieblich’s critique of psychiatry is precise, hard-hitting, and uncompromising, he closes his essay by pointing out that psychiatry has the potential to emancipate itself from its present indefensible position and to become a compassionate, listening profession.

In my view, however, this particular option was seriously compromised in the 1840s when Dorothea Dix’s “reforms” dehumanized and medicalized the American asylum system.  It was revived briefly by Adolf Meyer in the 1940’s, but was finally killed off by Robert Spitzer’s DSM-III (1980) and Allen Frances’ DSM-IV (1987).

Nevertheless, Dr. Lieblich’s article is a superb and compelling summary of the case against psychiatry.  The essay provides thirty-eight references for readers who want to pursue any of the topics in further detail.  Definitely a must-read piece.

 

 

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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.

34 COMMENTS

  1. “Although Dr. Lieblich’s critique of psychiatry is precise, hard-hitting, and uncompromising, he closes his essay by pointing out that psychiatry has the potential to emancipate itself from its present indefensible position and to become a compassionate, listening profession.”

    This is how I see it. No they can not. They are not counselors. If they want to be counselors, then they went to school for the wrong thing. Psychiatry should be abolished, upon being seen for what it is; a form of social control, that while it may have helped bring us out of the dark ages and into the “age of reason”, is no longer “needed”, and that if it is going to continue, must be seen for what it is and treated accordingly.

    • Thank you, Philip, for pointing out this relevant, and truthful, critic of psychiatry. And I agree, Jeffery, that since a primary actual societal function of psychiatry, psychology, and their many DSM deluded “mental health” and social worker minion today, is attacking children, and covering up child abuse.

      https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
      https://www.madinamerica.com/2016/04/heal-for-life/

      And since all this systemic child abuse covering up by the psychiatric – and their many non-medically trained psychological and other DSM deluded “mental health” and social worker minion – is by DSM design.

      https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1

      “Psychiatry should be abolished, upon being seen for what it is; a form of social control …[it] is no longer ‘needed,’ and that if it is going to continue, must be seen for what it is and treated accordingly.” It is a form of social control, but all the “mental health” industries are, more specifically, a group of systemic child abuse covering up industries, according to the medical evidence.

      And since psychiatry and psychology are both historically, and today, systemic child abuse covering up systems – a societal function which is illegal – they should both be abolished as so called “medical specialties.”

      And, unfortunately, in as much as I do believe the “talking therapies” do have a function within our society. I do believe both psychology’s and psychiatry’s massive, and systemic, by DSM design and historic, betrayal of child abuse survivors, should render them no longer trustworthy enough to “care” for abuse and trauma survivors.

      Especially given the fact that “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012).” And these are likely all misdiagnosed child abuse survivors, merely because no “mental health” worker may ever bill any insurance company for ever helping any child abuse survivor ever, unless they first misdiagnose them with one of the billable DSM disorders.

      And also given the fact that none of the DSM disorders the psychologists or psychiatrists misdiagnose all these children (and adults) with are valid diseases.

      https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

      This comes from a mother who has both medical and legal proof that both our psychologists and psychiatrists covered up child abuse for their religions. I’m one of the likely many “widows” mentioned in the Preface of this book, if you doubt my childhood religion is a systemic child abuse covering up religion.

      https://books.google.com/books?id=xI01AlxH1uAC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

      That book is evidence that I’m not the only one appalled by my childhood religion’s systemic covering up of child abuse, by their so called “mental health professionals.”

      But this means, I’m quite certain, many of the psychologists and psychiatrists belong in jail, for their systemic, by DSM design, child abuse and rape covering up crimes. And the psychiatrists’ poisonings of millions of innocent people.

      Let’s take the power away from all the systemic child abuse cover uppers of the psychiatric DSM deluded minion, by exposing their systemic crimes against children – not just take the power away from the psychiatrists. The crimes and fraud of the entire DSM based “mental health system” need to end.

      For goodness sakes, they’re killing “8 million” innocent people EVERY year.

      https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2015/mortality-and-mental-disorders.shtml

      A disclaimer, of course this does not apply to the wonderful, ethical, truth speaking psychologists, like Philip. We need more psychologists like that in the US. Thank you for all you do, Philip. But we need less of the psychologists, who try to steal from mothers of child abuse survivors, in order to cover up prior psychological and psychiatric malpractice and child abuse, for their religions.

      The “dirty little secret of the two original educated professions” does die hard, but so do I. We need a return to the rule of law, yet both psychiatry and psychology are about preventing justice from existing and the truth from being known.

  2. Philip, thanks for hammering away at it.
    Another fine article and thanks for the links.
    Psychiatry made a big booboo, using arrogance, ignorance and bias
    to arrive at hypothesis, turned practice. Then having to use lies
    to try and protect the original ignorance.
    After a while, there is no way out, except coming clean, a full disclosure.
    I believe there are many psychiatrists who are clever and aware enough
    to see how problematic the paradigm is.

  3. I’ve read that endogenous depression may be caused by impaired communication between neurons. And that would work for me, because MAO inhibitors have an effect on me, and they increase the level of all neurotransmitters, and neurons need all not only serotonin to communicate.

    • How does anyone distinguish what is “endogenous depression” from “exogenous depression?” If you feel the drugs were useful to you, I have no reason to doubt you. But you are extrapolating from your own experience to assumptions of physiological cause that are not supported by scientific observation.

      • It reminds me of Jay Joseph who was saying that secluding external factors from intrinsic factors is invalid, hence the binary estimate of heritability was fallacious. Just labels for the sake of a make believe nosology.

        Also, because a drug has an effect does not make it a a legitimate corrective.

        AND, I am really sick of the ‘improved neuronal transmission’.
        Psychotropics don’t ‘increase’ neurotransmission in the sense of enhancement.
        The brain is too complicated to be enhanced by humans means, at least for now.

        Psychotropics mess with it and hinder important mechanisms, which prompt the brain to activate defensive and compensatory reactions in an effort to curb dysfunction.
        Some of the distorsion can have effects on the mind, to the extent that a drug can have psychological alterations. But there is a price to pay for that, like for any drug.

        SSRI litteraly means, ‘lets fuck up your serotonin recapture’.

        Enough of this neuromodulation BS.
        A drug aint a brain enhancer. Period.

      • Well, Steve, depression is a proud resident of the diagnostic wastebasket, while a multitude of physical and psychic causes haunt the landscape of low moods. Some of them, like copper intoxication, or lead poisoning, wouldn’t even rate a psychiatric diagnosis (a good thing, as general medicine has treatments for such ailments). (Duplicate)

    • 1) Almost everyone with a depression label gets drugged. Meaning even if they did find impaired neuron communications the more likely reason for that is the deadly brain changing drugs. Psychiatry likes to be dishonest and claim people who were addicted to the drugs for months and going through withdrawal from them are “drug naive” or “undrugged”.

      2) Were these impaired neuron communication findings replicated? MRI studies of mental illness show the point I’m trying to make. One MRI study will find those labeled with depression have a larger brain region and it will be declared a biological cause. Another study will find the same region is smaller and again be declared it is a cause. While a third will find no difference and be ignored.

      3) MAOI’s cause an increase in dopamine, serotonin, norephinprine, and other chemicals. Another drug that has some similar chemical effects is Cocaine and meth. Given all Antidepressants and MAOI’s more than double Dementia, and cause cognitive impairment claiming they improve cognitive function is an anti-science claim.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347943/

      https://pubmed.ncbi.nlm.nih.gov/26295747/

      https://pubmed.ncbi.nlm.nih.gov/22377782/

      3) I’m sure a drug that increases dopamine and/or other chemicals can get you high or provide an active placebo effect. I’m sure addicting drugs cause withdrawal and make the addict feel like shit when they try to quit. This does not mean the drug is good and helping you. It means the drug is addicting and/or you had an active placebo effective or got high before tolerance kicked in. There are zero studies actually finding any psych drug has any long term benefit. Psych regularly touts studies finding the drugs are addicting and cause withdrawal and falsely claim this means the drugs are good but that is all they have. All long term studies that don’t utilize withdrawal data or account for it find all psych drugs worsen all outcomes by hundreds of percent.

      MAOI’s increase all cause mortality by 75%. All “antidepressants” cause large increases in death rates. MAOI’s on average will reduce your life expectancy by 7 years.

      https://pubmed.ncbi.nlm.nih.gov/28903117/

  4. Phil I thought you were joking, and that my click would open up another delusional rant by Dr. Pies!!

    What a great (and “shareable”!) piece this gentlemen has granted us. There’s no shortage of them, as he points out, but this one is so succinct. And I agree that the time for reforming the system has come and gone. Thanks for posting!!

  5. Well, Steve, depression is a proud resident of the diagnostic wastebasket, while a multitude of physical and psychic causes haunt the landscape of low moods. Some of them, like copper intoxication, or lead poisoning, wouldn’t even rate a psychiatric diagnosis (a good thing, as general medicine has treatments for such ailments).

  6. Well, the case against psychiatry has been made for ages now, the question is what are we going to DO about it, i.e. how do we eliminate psychiatry, and avoid falling into reformist traps or appeals to “save” psychiatry (which is the EXACT OPPOSITE of what we need to do).

    Abolitionist survivors and other potential activists who wish to take this conversation further should email us at [email protected] for more info.

    Good to see you being so prolific recently Phil. 🙂

  7. Psychiatry is more or less a conspiracy. It survived because it managed to manipulate the main sectors of society, which are made up by people who do not think independently, who take the establishments as they are.

    This is WHERE IT SHOULD BE HIT. From inside, it will take too much time to collapse.

    Focus should be on changing masses’ mind about what psychiatry actually is.

  8. This year I’ve been dealing with a chronic recurring infection that keeps coming back. I kept having to going to see doctors in the ER and whatnot because I was having some of the severe symptoms. I would tell them my symptoms and initially they would be open-minded but then they would pull up my electronic health record. Suddenly they would stop being open-minded to trying to help me with what I thought to be a severe dissemated infection.

    They had seen on my electronic health record I would presume that I had a hospitalization for being psychotic. I wasn’t psychotic I was just pissed off and decided I wouldn’t cooperate with them in my confinement. But yeah long story short I have now been diagnosed with a very bad parasitic infection. Despite my having very real physical symptoms which was dismissed by one ER doctor as a somatoform disorder.

    But coming back to my main point psychiatrists are actually even worse nowadays than they have been historically because they can inflict damage in almost universally in every aspect of one’s life.

    I think we need to remove any power of doctors to be able to forcibly commit someone right off the bat and make it totally a judge’s decision from now. And we need a much higher standard than a scattershot of different review boards and commissions in different places. We should be given the same rights as someone as if they were being charged with a crime because the effects of commitment are the same: having our rights taken away

    • When they saw your sheet, they “knew” you were into some kind of mischief because they saw that “psych” label on your sheet. They’re guys I wouldn’t care to have around- to act that way, particularly if they expressed psychiatric smugness, would make me a candidate for jail, and the interrogator a candidate for a sudden outbreak of Fist-to-Nose disease.

  9. Dorothy Dix’s reforms only came rather late within the context of reforms that actually drove the expansion of imprisonment in the name of “mental health”. I tend to think the real problem began with early privatization, that is, an effort to profit off the scapegraces of the rich and aristocratic coupled with additional opportunities to extend treatment, mistreatment really, of the poor and disenfranchised. Although the aim was more compassionate treatment the reality inevitably became something else entirely.

    I tend to agree with OldHead on this one. You need to be selling “distressed states of mind” if you’re going to get anywhere with selling “compassionate listening”, and the “distressed states of mind” industry, as ever, is booming.

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