Dr. Pies and The Chemical Imbalance Deception

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INTRODUCTION

For the past several years, the eminent and scholarly Ronald Pies, MD, psychiatrist, of SUNY Upstate Medical and Tufts Universities, has labored the point that psychiatry has never endorsed the simplistic chemical imbalance theory of “mental illness”.  As various anti-psychiatry bloggers, including myself, began to accumulate a great many instances of prominent psychiatrists doing just that, Dr. Pies began digging himself in on this particular topic.  In Nuances, Narratives, and the “Chemical Imbalance” Debate (April 2014, Medscape), he wrote:

“In short, the ‘chemical imbalance theory’ was never a real theory, nor was it widely propounded by responsible practitioners in the field of psychiatry.”

And here can be found:

“I have no doubt that some patients heard the phrase ‘chemical imbalance’ from some hospital-based psychiatrists, and I agree that more could have been done by those of us with academic and research experience to ‘debunk’ this notion. But too many critics constantly claim that ‘psychiatry’ endorsed the ‘chemical imbalance theory’ when this was simply never the case – if, by ‘psychiatry’, we mean the profession as a whole.” (April 13, 2014 comment in the post The “Chemical Imbalance” Myth, by Chris Kresser, MS)

Of course, we don’t mean “the profession as a whole”, a standard that would have to embrace every single psychiatrist in the world.  We mean the great majority, including the profession’s luminaries such as Dr. Pies himself!

PIES’ VERY OWN CHEMICAL IMBALANCE THEORY OF SELF-INJURIOUS BEHAVIOR

Last year I came across a letter to the editor in the March 1992 issue of American Journal of Psychiatry.  The letter was signed by the eminent Dr. Pies.  The letter outlined Dr. Pies’ very own chemical imbalance theory of self-injurious behavior.  I have written about this here.

. . . . . . . . . . . . . . . .

In June of 2020, Awais Aftab, MD, psychiatrist, published an interview he had conducted with Dr. Pies.  In the interview, Dr. Aftab talked to Dr. Pies about the chemical imbalance theory.  Here’s the quote:

“…I am not sure I am ready to exonerate our profession. At best, it seems like we were silent spectators, watching as this misleading idea spread like wildfire in the society (including among our patients and patient advocacy groups), doing little to nothing to correct these public misperceptions. At worst, it seems like at least some of us were participants. Ken Kendler writes in a 2019 JAMA Psychiatry commentary, ‘I would commonly see patients who would say some version of “my psychiatrist said I have a chemical imbalance in my brain.”‘  I have had a very similar experience myself. Either way, surely as a profession, we could have done a better job of educating our patients and the public?”

Dr. Pies replied:

“Yes, I agree that we – all of us – could have done a better job of counteracting the so-called ‘chemical imbalance’ trope, which, as your comments imply, was more a creature of ‘Mad Men’ than of men and women who study madness! I wish I had tackled the issue earlier than my 2011 article.”

But then he shows his true colors:

“And, yes – we often hear anecdotes concerning patients who tell their current clinician some version of, ‘My psychiatrist said I have a chemical imbalance . . .’ But where is the evidence that this is what patients were actually told? Who has contacted the patient’s psychiatrist, or reviewed his/her case notes, to see if that was really what the patient was told? To my knowledge, there has never been a study examining the ‘other side of the story’—and, to be clear: patients are not infallible recorders of what their doctors tell them.”

It is my general experience that when people over-react in this kind of way, it is because the topic to hand has “touched a nerve”.  So I developed a curiosity as to what other literary gems might be lurking in the learned doctor’s various cupboards.

MORE DELVING: MORE DISCOVERING

In 1999, Dr. Pies published a delightful little essay in the magazine Creative Non Fiction.  The title of the piece is The Music of the Brain, the Chemistry of the Lute (Issue # 13, pp 75-83).  I am grateful to Peter Kinderman, PhD, Professor of Clinical Psychology at the University of Liverpool and former President of the BPS, for drawing this piece to my attention.

The basic idea is that the workings of the brain can be likened to the music of the lute.  Here are some fascinating quotes:

“All right, let’s be honest.  The brain is not a lute, and the six brain chemicals we will discuss are not precisely like the six strings of the lute.  But the idea I want to explore – that the chemicals of the brain may be likened to specific musical tones – is not without precedent.” (p 75)

“In brief, the brain chemicals underlying mood and behavior relate to one another in roughly the way the strings of a lute interact to produce chords – or, if the instrument is out of tune, discord.  Just as one string, when plucked, exerts a harmonic influence on its neighbors, one neurotransmitter in the brain may modify, augment, or counteract another.  Just as the lute’s strings may be out of tune, the brain’s chemistry may be out of balance.” (p 75) [Emphasis added]

“Just as the strings of a lute may be plucked too loudly or too softly, a particular neurotransmitter pathway may be overactive or underactive – spilling out too much or too little of its chemical messenger.  This can have disastrous consequences for mental health and stability, as we will see.” [Emphasis added] (p 76)

“When the dopamine string is played too softly, we feel lethargic, depressed and ‘flat’.  The chemical system that underlies our sense of pleasure and reward is activated by dopamine.  Thus, when dopamine is missing, the Beethoven symphony that once excited us now seems like so much elevator music.  The sexual partner who once aroused such passion might as well be the old filing clerk at the IRS.  Even our movements are slowed without dopamine.” (p 76-77)

This seems a little harsh on elderly IRS clerks, and in fact could be seen as a classic instance of ageism from someone who ought to know better.  Aren’t elderly filing clerks at the IRS as much entitled to romance and intimacy as anyone else?  And why has he singled out filing clerks, rather than, say, directors or even cabinet secretaries?  Is this not blatant bigotry against people of lower income?  Is this not essentially the same kind of arrogant bigotry that he displayed when he cast doubt on the credibility of psychiatric “patients” unless their statements could be verified by their psychiatrists?  Is a “patient” intrinsically less truthful than a psychiatrist?  Is it OK to dismiss an “old filing clerk at the IRS” as a paradigm of sexual irrelevancy?

But I suppose a person of Dr. Pies’ elevated rank and station can’t afford to squander his precious time pandering to the sensitivities of hard-working, under-paid elders.  If they feel slighted, or if their feelings are hurt, they can always find an honest, hard-working, and valued psychiatrist who for a meager reimbursement will fix the chemical imbalances in their brains using “safe and effective treatments” like drugs, shocks, and TMS.

“In contrast to all this, the individual with an excessively loud dopamine system may be mad or manic.  In schizophrenia, for example, we think that excessive dopamine drives hallucinations and delusions.  (On the other hand, some of the so-called negative symptoms of schizophrenia – such as apathy and social withdrawal – may be due to too little dopamine in other regions of the brain.)” [Emphasis added] (p 77)

“There is some evidence that the manic phase of manic-depressive (bipolar) illness also involves too much noise from the dopamine system;…” [Emphasis added] (p 77)

“Like dopamine, serotonin modulates mood.  When its volume is too low, people often get depressed.  By increasing the amount of serotonin between brain cells, Prozac-type medications can alleviate many cases of depression.” [ Emphasis added] (p 78)

“More surprising, though, is the connection between low serotonin and aggression.  People who tend to be impulsive, violent, or self-destructive seem to have too little serotonin in their central nervous systems – or their serotonin receptors are somehow ‘tone-deaf’ to the neurochemical signal sent out by the serotonin neurons.” [Emphasis added] (p 78)

“Some individuals who wind up with too much serotonin are prone to develop various kinds of anxiety disorders, such as obsessive-compulsive or panic disorder.” [Emphasis added] (p 78)

“All this is just to say that the chemistry of mood is complex and tightly regulated.  When the serotonin string is either too soft or too loud, too flat or too sharp, mood and behavior may suffer.” (p 78)

“Serotonin does not act independently of other neurotransmitters, of course.  When its string sounds, it actually dampens the reverberations of dopamine.  This may be part of a subtle homeostatic system in the brain, designed to keep mood and motor activity in careful balance.” (p 79) [Emphasis added]

“…excessive norepinephrine in a part of the brain called the locus ceruleus may underlie the phenomenon of ‘panic attacks’ – an instance of the fight-or-flight response gone haywire.  Some symptoms of mania and post-traumatic stress disorder may also be related to too much noise from the norepinephrine system.  On the other hand, when the norepinephrine string is muted or flat, depression may ensue.” [Emphasis added] (p 80)

“…glutamate is actually the precursor of GABA.  It seems that when neuronal activity gets too intense, the enzyme that converts glutamate to GABA is activated – suggesting that the fine counterpoint between these two contrasting strings provides the brain with a self-regulating calming mechanism.  (It is tempting to speculate that in some extraordinarily anxious persons, this enzyme system is somehow defective.)” [Emphasis added] (p 81)

“Acetylcholine also affects mood.  Too loud a tone from this string, and the individual may feel depressed; too soft, and the person may veer toward euphoria or mania.” [Emphasis added] (p 82)

“First, it is clear that certain mental illnesses are critically related to abnormalities in one or more of these six neurotransmitters.  For example, in schizophrenia, the dopamine string may be too loud in some regions of the brain, while the GABA string may be too soft.  This has very direct implications for our treatment of schizophrenia, which normally utilizes drugs that block the dopamine receptor.” (p 82)

“It is also clear that simple ‘deficit’ theories of mental illness do not do justice to the abnormal brain’s cacophony.  For example, depression is unlikely to involve simply too little serotonin or norepinephrine.  Rather, the amounts of a neurotransmitter, the sensitivity of its receptors, its effects on the gene, and its interactions with many other neurotransmitters may all determine its effects on mood.” [Emphasis added] (p 82)

“In the larger arena of temperament or character, we have reason to believe that traits such as shyness or risk-taking may be related to the state of one’s neurochemical strings.  For example, socially phobic individuals may be deficient in serotonin, while ‘risk-takers’ may have a bit too much dopamine on the brain.” (p 82)

“Finally, knowing more about the music of the brain may lead us toward ways of enhancing mood, memory, and behavior.  While human creativity can never be reduced to mere neurotransmitters, we may be able to modulate that creativity by tuning one or more of our strings up or down.  Perhaps we can even envision a whole new instrument in which not six, but a hundred strings will play in symphony.” [Emphasis added] (p 83)

This last quote is particularly troubling in that it is clearly aimed, not at a theory of “mental illness”, but rather towards general improvements in the “mood, memory, and behavior” of the human race by the ingestion of psychiatric drugs.

In this regard, it should be noted that Dr. Pies’ essay did not appear in a psychiatric journal, but rather in a literary magazine intended for a general audience.  This, I suggest, indicates that Dr. Pies was attempting to disseminate to the general public an unevidenced chemical imbalance theory.  He now describes this theory as misleading and simplistic pharma advertising, but, to the best of my information, he has never acknowledged the role that he himself played in its dissemination and promotion.

THE SCOPE OF DR. PIES’ CHEMICAL IMBALANCE THEORY

In general, when people speak or write about the chemical imbalance theory, they are usually referring to a fairly limited hypothesis, e.g. the chemical imbalance theory of depression; or the chemical imbalance theory of ADHD, etc.  But in the reportedly non-fiction piece reviewed above, Dr. Pies has sketched out a comprehensive chemical imbalance theory of a very wide range of human traits and behaviors.  These include: depression; mania; euphoria; hallucinations; delusions; apathy; social withdrawal; aggression; violence; impulsivity; self-destructiveness; anxiety; obsessions; compulsions; panic attacks; PTSD behaviors and feelings; shyness; and risk-taking.  Just twelve years later, however, (July 11, 2011), he published an article in Psychiatric Times which contained the following:

“I am not one who easily loses his temper, but I confess to experiencing markedly increased limbic activity whenever I hear someone proclaim, ‘Psychiatrists think all mental disorders are due to a chemical imbalance!’ In the past 30 years, I don’t believe I have ever heard a knowledgeable, well-trained psychiatrist make such a preposterous claim, except perhaps to mock it. On the other hand, the ‘chemical imbalance’ trope has been tossed around a great deal by opponents of psychiatry, who mendaciously attribute the phrase to psychiatrists themselves.”

H’m.  So it’s all our fault.  We “opponents of psychiatry” spread the chemical imbalance deception, and then deceitfully attributed the phrase to psychiatrists themselves.  Apparently Dr. Pies believes that some opponent of psychiatry wrote the “Music of the Brain” and submitted it to Creative Non Fiction over Dr. Pies’ signature, and that the same, or perhaps different, member of the anti-psychiatry movement perpetrated a similar ploy in the submission of the chemical imbalance theory of self-injurious behavior to the American Journal of Psychiatry.  Isn’t there a psychiatric label for these kinds of beliefs?

MORE DISCOVERIES

In 1994, Dr. Pies wrote a book titled Clinical Manual of Psychiatric Diagnosis and Treatment: a Biopsychosocial Approach, published by American Psychiatric Press, Inc., which at the time was the publishing arm of the American Psychiatric Association.  Here are some quotes from the section on Major Depression; Biological Factors:

“Most of the research in this area has focused on neurotransmitters and neurotransmitter receptors.  It seems clear that the catecholamine theory of depression as initially formulated just doesn’t explain the data; that is, major depression isn’t due simply to ‘not enough’ norepinephrine or serotonin.  Rather, depression seems to result when the overall balance of neurotransmitter quantity and function is disturbed.  It’s not necessarily that the neurochemical ‘orchestra’ is missing musicians, but rather that the musicians are playing out of tune.” (p 108) [Emphasis added]

Not much ambiguity there.  But in addition to the clear statement of chemical imbalance, there is an interesting, if minor, detail.  Dr. Pies frequently takes us ignorant anti-psychiatry yobos to task for describing the catecholamine hypothesis of depression as a theory on the grounds that it never was developed or promulgated as a fully developed theory. It was all a little bit pedantic and silly, but lo and behold, in the above quote, straight from the pen of our illustrious, condescending, and self-appointed mentor, what do we have:  a clear reference to the “catecholamine theory of depression.”  But goodness, I’m being petty:  we can let that go.

Back to Dr. Pies’ Clinical Manual:

“True, there are some data suggesting deficient norepinephrine or serotonin in the blood, urine, or CSF of depressed patients (Zis and Goodwin, 1982).  But other data suggest that overactivity of the cholinergic system may also predispose to depression; indeed, McCarley (1982) has proposed a unitary hypothesis taking into account adrenergic function, cholinergic function, and their relationship to REM sleep.  In essence, McCarley hypothesizes that depression may result from adrenergic underactivity, cholinergic overactivity, or a relative imbalance of both systems.” (p 108) [Emphasis added]

Again, not much ambiguity.  And…

“Much of the recent work in depression has focused on the role of the postsynaptic beta receptors.  It has long been known that centrally active beta-blockers (such as propranolol) can cause or exacerbate depression in susceptible individuals (Petrie et al. 1982).  It is tempting to infer that a deficiency of beta receptors – or beta-receptor hypofunction – leads to depression.” [Emphasis added] (p 109)

Now, in fairness to Dr. Pies, he also acknowledges that psychological factors may play a role in the production of depression.  But, he concludes:

“Naturally, neither this view nor the psychoanalytic ones rule out the influence of biological factors in the etiology of depression.” (p 111)

Which, naturally, strikes me as a clear endorsement of biological reductionism.

. . . . . . . . . . . . . . . .

So, Dr. Pies did promote the chemical imbalance theory, not only in his learned papers, but even in an essay aimed at the general public, and when he tells us now that “the ‘chemical imbalance theory’ was never a real theory, nor was it widely propounded by responsible practitioners in the field of psychiatry,” we must – and I say this with the most profound misgivings – draw our own conclusions.

 

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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.

82 COMMENTS

  1. Max Planck said: “A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.”

    Let Pies rest and focus on educating the next generation. You’re arguing with delusions.

    • I read a Yahoo Health article yesterday that referred to Serotonin as one of the chemicals that controls mood and how it’s important to have enough of this neurotransmitter. This is part of popular knowledge that continues to repeat itself like a self-replicating virus. Viral falsehoods are extremely damaging. It is through articles such as this one that the next generation CAN be educated on this matter since the mainstream media has done little to correct the record. Why does it matter that the angle of this article is to hold accountable a psychiatric authority who is trying to rewrite his own history of propagating this myth?

      Max Planck’s quote is interesting but new knowledge isn’t absorbed by the next generation by itself. It is transmitted by people like Phil who write the history of prior falsehoods. Another quote comes to my mind: Those who don’t know history are doomed to repeat it.

    • beokay,
      Opponents die, so do shrinks. And each will be replaced.
      I hope you educate on the ground as many young people as possible. They won’t quite understand it, it comes
      with age, experiences, and actually being personally affected in some way.

      The best info young people can have is this. If you want to have your life ruined, see a shrink because you will get a lifelong label that WILL haunt you in more ways than one. And young people should be told that the “mental health” trope is there to make them fall into the trap of somehow not measuring up, or being “normal”. Guaranteed, all signs will point to “abnormal”, “failing” a certain “mental health”.
      Kids have to be told where to go. Where they will get proper information.
      Kids have to be explained to that junk science is now their science presented as facts. Or “probabilities”, but that where science says “it may”, really just means “this is an area we are studying”. But the shrinks treat this as fact and roll out new chemicals based on very simple rudimentary research and chatter.

      Obviously a teenager will never understand HOW the “study” and “research” are really the only thing holding up a very shaky paradigm. It’s always just hanging on by a thread.

    • Goodness, gracious, the tech companies are really angry with those of us who speak the truth about psychiatry. No doubt, because psychiatric crimes against humanity have historically always been apart of how the communists have taken over countries.

      But since I’m not a communist, and am a believer in the US constitution, and our democratic republic. I do so hope others will listen to a lady, who just today basically read the communist manifesto, out of great concern.

      A video that a friend sent me today, which describes the scientific fraud based psychiatric industry’s involvement with communism.

      Oops, facebook doesn’t allow me to copy and paste the video, but all psychiatric survivors should read the communist manifesto. Hopefully it’s still on the internet.

  2. “Is a ‘patient’ intrinsically less truthful than a psychiatrist?” Obviously we’re not less truthful than Dr. Pies. And as a matter of fact, my artwork is controversial, because it’s “too truthful.”

    By the way, Dr. Pies, the ADHD drugs and antidepressants can create a “chemical imbalance” in a person’s brain, that results in symptoms that look like the “bipolar” symptoms, to the psychiatrists and psychologists. And millions of people have been misdiagnosed.

    https://www.alternet.org/2010/04/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america/

    The antidepressants and antipsychotics can create “psychosis” and “hallucinations,” positive symptoms of “schizophrenia,” via anticholinergic toxidrome.

    https://en.wikipedia.org/wiki/Toxidrome

    The antipsychotics / neuroleptics can create symptoms that look like the “negative symptoms” of “schizophrenia,” as well, via neuroleptic induced deficit syndrome.

    https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome

    The ethical head of family medicine, at a very well respected hospital, was quite impressed with my “one in a million” medical research skills. But I have no doubt, my medical research findings are “too truthful” for most psychiatrists and psychologists. Since an unethical psychologist recently attempted to steal all my artwork and money, with a BS “art manager” contract.

    Thanks, as always, Philip, for speaking and reporting the truth. “In a Time of Universal Deceit — Telling the Truth Is a Revolutionary Act.”

  3. Dr. Pies does seem to revel in creative non-fiction. In all my years with the shrinks, they always told me I had some sort of chemical imbalance and that’s why the drugs. They also told me that how I responded to the drugs could determine what diagnosis fit me. Since, there really is no way to determine if there is a chemical imbalance, they based their assumptions only going backwards. But, this is an illegitimate backwards. If the only real test for your diagnosis other than the flimsy DSM is the person’s response to the drugs, then it really reflects that psychiatry actually begins and ends in criminal malpractice. I say this because it is putting the patient at risk just to bring about a conclusion or a diagnosis which is faulty at best. This is why creative nonfiction is more evil than even an oxymoron. Thank you.

  4. One big problem with a psychiatrist claiming mental illness is a “chemical” imbalance is that we humans aren’t made of “chemicals.” We’re made of BIOchemicals. These all-natural chemicals are made from the nutrients we take in including minerals, vitamins, proteins and fats. So when we have an illness it is often due to an imbalance of these BIOchemicals. I wanted real help for my loved ones so I’ve treated them myself with nutritional medicine, NAET, and homeopathy. I saw niacinamide (one form of vitamin B-3) work miracles for so-called “ADHD.” I saw L-methionine + vitamin C+ calcium + B Complex cure another relative’s “incurable” diagnosis of “bipolar with psychosis.” Psychiatrists had him on three daily antipsychotics. So I learned how to use the orthomolecular approach, tapered him off the antipsychotics and he hasn’t needed psych drugs in years. He’s had other natural treatments too in order to bring his health to an even higher level. My whole family has done this. Psychiatry fits the definition of a racket: “Widespread fraud for the purpose of making higher profits.” Psychiatrists are nothing but drug pushers for the pharmaceutical companies. American psychiatry cures no one. It isn’t even designed to cure anyone, just suppress symptoms until the patient dies because that’s what brings in the highest profits. –Linda from Facebook, “A Dose of Sanity.”

  5. “Finally, knowing more about the music of the brain may lead us toward ways of enhancing mood, memory, and behavior.”

    This Is Serious Mum
    He’ll never be (an old man River) or I’m on the drugs that killed River Phoenix.

    https://www.youtube.com/watch?v=1-mLIdLZZeI

    I saw his body thrashing round.
    I saw his pulse rate going down.
    I saw him in convulsive throes.
    I said “I’ll have one of those”.

    Now I’m bored and there’s no stopping;
    I need another celeb to fill a coffin;
    Where’ll I get my next drug action?
    Odds on it’ll be Michael Jackson.

    Symphony of the Brain my arse lol (is that Dr Pies crowd surfing at the show? From a Beethoven symphony to Punk Rock with a pill? If only it was a choice as to what we played on our own CD players but …… it’s them picking the tunes. And when you’ve got a copyright on certain tracks, guess what your gunna play?)

  6. Dr. Pies should do a Google search. Not only has psychiatry promoted the chemical imbalance theory in the past, but the theory is still being promoted on many prominent websites.

    The Mayo Clinic says problems with certain naturally occurring brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. As for depression, the Mayo Clinic cites one cause as abnormal or impaired neurotransmitters.

    WebMD says studies show that certain brain chemicals that control thinking, behavior, and emotions are either too active or not active enough in people with schizophrenia.

    The American Psychiatric Association says brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry.

    The Merck Manual says there are numerous causes of depression. One theory focuses on changes in neurotransmitter levels, including abnormal regulation of cholinergic, catecholaminergic (noradrenergic or dopaminergic), glutamatergic, and serotonergic (5-hydroxytryptamine) neurotransmission.

    • I think a lot of the problem is the deliberate use of the word “chemical imbalance.” Psychiatrists use this term to suggest it’s the cause of a psychiatric illness. The next step is always a prescription for just the thing to “fix” it, i.e. psych drugs. In reality, humans can only have a “BIOchemical” imbalance and we need natural BIOchemicals to fix it. The late Abram Hoffer, MD cured almost all his patients with the use of biochemicals, namely niacinamide (vitamin B-3), B Complex, zinc, Vitamin C, etc. Using nutritional medicine to cure psychiatric illnesses is called “Orthomolecular Medicine.” It’s wonderful.

  7. It seems to me, Phil, you have an unhealthy obsession with this character, Pies. Most (I would say all) psychiatrists I have come into contact with are liars. Furthermore, most people in our society are more than happy to go along with the lies told by them. Everyone who is aware knows why that is. No-one is willing to explore that aspect of humanity. Look at any other profession. You will find the exact same thing.

  8. I would say that Phil has a very healthy obsession with the truth, AND a deep determination to eradicate one of the most oppressive institutions on the planet.

    Every one of Philip Hickey’s blogs, exposing the fraudulent nature of psychiatry, simply brings me GREAT JOY whenever I read them.

    Cynicism and negativity serves as a barrier to making significant change in the world. It’s time we all work on seeking out liberating ideology, organization, and decisive political action.

    Richard

  9. “I have no doubt that some patients heard the phrase ‘chemical imbalance’ from some hospital-based psychiatrists”

    Oh those pesky uninformed psychiatrists.

    “And, yes – we often hear anecdotes concerning patients”
    Anecdotal- not necessarily true or reliable, because based on personal accounts rather than facts or research.
    Yes much less reliable to present personal account than actual facts. Hmm, where should we go for the facts? About oneself? About what happened? Wait, I’ll get you a shrink who will inform you and the public of facts about you and about his profession. Because what comes out of a shrink’s mouth is absolutely not anecdotal.

    “Yes, I agree that we – all of us – could have done a better job of counteracting the so-called ‘chemical imbalance’ trope, which, as your comments imply, was more a creature of ‘Mad Men’ than of men and women who study madness!”
    Oh so now it’s not the pesky silly shrinks in hospital that spread information, it’s really all the crazy people out there. WHICH of course includes anyone that is not a shrink, or anyone that tells the truth.

    And then he goes on to speak about chemicals and lutes. Now it’s lutes, not diabetes. Your brain is a lute, and the chemicals “MAY”, “MAY” play a part lol. DUH, Pies will explain it to the media and young shrinks. And no one will be the wiser. So Pies is feeding people “chemicals” in pill form. For what? Is he “correcting” something? And what is that? You really have to know what you are feeding people, based on facts, not anecdotes about flutes, lutes and chemicals.

  10. Many of the analogies presented in these comments may or may not be debatable. Some are just beyond hilarious. However, in my opinion, the theory of chemical imbalance in the brain and the resulting desire to either attack or “keep it in check” with these drugs and other companion therapies, etc. is neither debatable or hilarious. These drugs and companion therapies cause damage to the brain and thus the body which is basically life-changing. They are not only damaging, but dangerous and usually debilitate, disable or tragically even kill. When you stop taking the drugs, even for a small amount of time, you must go through a nasty withdrawal period. And, after the withdrawal, you must learn to adjust your life in accordance with the damage done to you. And, you will probably do this alone. Even, many times, your family and friends don’t understand. Some may refuse to understand or may shun you. Some, because of the oddness of behaviors during the withdrawal and sometimes after the withdrawal think you should return to the horror and terror of the psychiatrists, etc. again. And, of course, the mass media and other such things may be against you, too. You are, in essence, double or even triple stigmatized. These are the downsides, but, if you are willing to basically walk away for this psychiatric tyranny, you will be rewarded. Your mind, although different from before the drugs and therapies, etc. is clearer. Your whole body feels and is cleaner inside and out. The stinking dirtiness of the drugs and therapies, etc. is gone. You will probably have to adapt your life and lifestyle in some unusual ways. There will be things you can’t do or may never be able to do again. And there are things, you may or may have thought you could not do that now give you a sense of peace and accomplishment. You will probably have to adapt your diet, your sleep habits and tons of other stuff. And, you are very understandably allergic to doctors, etc. You may probably find that there are now great limitations to any drugs you can take, even OTC Meds or even commonly prescribed meds. Yes, your life is different now, but, you have survived maybe a greater challenge than Daniel ever did in the Lion’s Den. Thank you.

    • On my very first appointment with a psychiatrist he told me I had major depression and would need drugs for the rest of my life just like a diabetic would need insulin. He had his pseudo mantra down pat and at the time I had no reason to doubt him.

      Once again, Rebel, you have written a heartfelt and realistic description about walking away from psychiatry and psychiatric drugs to be your own person. The pain psychiatry inflicts is beyond description. I’m a different person drug free but my life is so much better, fuller.

    • “ sometimes after the withdrawal think you should return to the horror and terror of the psychiatrists, etc. again”

      Psychiatry is like an abusive partner whose insults get under your skin and wear down your own sense of yourself so that even after you leave for good, and especially during tough times, you might question yourself and think you still need them. You still hear words like “mentally ill”, “crazy”, “noncompliant” etc the same way you might hear “fat”, “stupid”, and “worthless” from your abuser. The whole point of psychiatry is to instill the idea that what is wrong in your life is something wrong with you and that you need them (drugs, therapy) in order to survive. It’s incredibly abusive and destructive, and it targets and grooms its victims just as stealthily as any abuser does.

      • Kindredspirit

        You comment is so true about how the oppressive effect of psychiatry penetrates deep within those who fall victim.

        It makes me think of Matt (who sadly may have taken his own life because of this), and some of the other writers here who have described the allure of going back when times get rough.

        And I agree with OH about the quality of your writing here.

        If we go back to this past summer and fall, your writings on Covid 19 and the importance of legitimate science being followed for very difficult decisions, your courageous stance on these vital questions has proven to be SO TRUE. I hope others who participated in these conversations will review these past dialogues to reassess their own positions on these life and death questions.

        Richard

        • Thank you, Richard. I appreciate your kind words in light of some of the disagreements we’ve had in the past. I’m not sure exactly how to respond; I’m not much of an approval seeker, as I’m sure you know, so I’ll just say this:

          DragonSlayer refers to psychiatry as a Dragon which I think is an extremely apt metaphor as it illustrates how Psychiatry becomes like a living breathing entity in people’s lives with the power to completely destroy. What it took from me were my early aspirations – educationally and career-wise, and severely limited my social status in ways that still follow me despite all I’ve gained. But it did give me time in the form of being declared disabled and left largely to my own devices for many years. And I have used that time to educate myself and learn as much as I can about as many different topics as I could in as great a depth and breadth as possible and I can view that as nothing but a gift. I don’t really suppose any academic or intellectual could ask for more, except maybe fewer labels and stigma. Again, thank you.

        • Also Richard, yes, I often think of Matt with a mix of anger and sadness. I know all too keenly how he felt. I know how deep, as you say, the judgements of psychiatry penetrate. I have allowed it to fuel a deep sense of righteous anger to propel me when I might otherwise sink into similar thoughts. I wish I could have shared some of that with Matt. There is a very real way in which Matt’s suicide can be viewed as murder by the system. What it does is a slow murder for all too many who take that path, seeing no other way out, and having internalized the judgments. May he and all those gone but not forgotten Rest In Peace and their memories sustain those of us still fighting the Dragon.

          • The most important lesson to be learned from Matt’s experience is that it is not enough to have an intellectual grasp of psychiatry’s fraud, the remnants of the psychiatric narrative must be rooted out of one’s soul. At that point you don’t need the “validation” of so-called “experts,” a need Matt never managed to shake.

  11. And on January 13th, 2021 Dr Pies realised how utterly paternalistic and discriminatory he sounded the year before and backtracks on his assertion that “patients are not infallible recorders of what their doctors tell them” and just think we are being told these things. Now we get “Just as patients may sometimes misperceive or misunderstand a point or statement made by the psychiatrist, so, too, psychiatrists may err in what they recall or in what they write in their notes.” https://www.psychiatrictimes.com/view/what-we-tell-patients-about-depression-what-they-say-they-have-been-told

    He still manages to escape properly acknowledging that “patients” may say they have been given this message by their psychiatrists because they actually have been. The closest we get is a kind of ‘not all psychiatrists’ cry that reminds me of the ‘not all men’ line I get thrown in the way of an attempt to talk about rape culture. He says only the bad psychiatrists do this, only a few bad eggs, turn your attention elsewhere etc.

    Nor does he account for the many ways this message gets conveyed indirectly, through the choice to focus on medications as ‘treatments’, and the way they always mention the possibility of chemicals first in their list of potential causal factors and relegate the psychosocial dimensions that carry the most evidence to similar status. Most info resources they dish out will mention the brain chemicals too, and as they gave the info it will be assumed they agree with the info. There are many professionals who will share this message with service users, not just psychiatrists alone, it is a team effort, but given it is allll through their textbooks and journals it is clear they are sharing it round and soaking it up all the time.

    Dr Pies gives a good example and he doesn’t appear to be able to tell he is doing it: “My point in the interview was that any valid claim or report regarding what patients have been told about so-called “chemical imbalances” must take into account not only the patient’s recollection, but also: what psychiatrists themselves recall saying; what they intended to convey; and in what context the term chemical imbalance was used. For example, did the psychiatrist say something like, “Your illness is definitely caused by a chemical imbalance”? Or was it more like, “We don’t know the precise causes of depression, but chemical changes in the brain may play some role, along with psychological, social, and environmental factors”? There is nothing fundamentally wrong or misleading, of course, with the second type of explanation.” I disagree Dr Pies. Also what a bloody cop out to be giving someone you have assessed a generic explanation for their troubles such as this instead of an individual formulation based on the actual person before them or better yet, co-constructing a shared formulation together.

    I am not sure what he hopes to achieve by pretending this doesn’t happen and that he has never taken part. I do like that he seems to be trying to make his profession clean up its act and get out of the grip of big pharma marketing. There is no need for him to redact his history or deny reality to do that. Seems that the other psychiatrists listen to him though, maybe they have a shared distaste for uncomfortable facts.

    • Right you are! What if he said, “Well, we don’t know what really causes depression, but microwave radiation from cell phone towers may play a role?” Everyone would be immediately (and appropriately) up at arms! Science doesn’t speculate, except in the formation of hypotheses. It makes zero sense to share hypotheses that are purely speculative as if they were somehow sharing some budding scientific discovery that is “just around the corner.”

    • “We don’t know the precise causes of depression, but chemical changes in the brain may play some role, along with psychological, social, and environmental factors”?

      So he mentions the “chemical” changes first. And what would he offer for that? Chemicals? So he offers people chemicals based on whimsical theory?
      And what is he doing about the social and environmental?
      He supports the chemical theory. It’s an outright lie.
      Like oldhead says, “just as anger and fear are correlated with adrenalin release — which is not considered the “cause” of the emotion.”

      Anyway Dr Pies as do other shrinks go on to make such outrageous non scientific statements, that really the bloodletting is making equal sense. The “science” is just as reliable. If they would simply state what it is that their job is, instead of cloaking it in embarrassing pretense.
      They should not have an honorary doctor title, since NOTHING what they do is based on science, and thus, not medicine.

  12. Time for me to step back and give some general props to Dr. Hickey, the man.

    Several years back, when Phil was a participant in talks leading up to the (now) survivor-run anti-psychiatry project to which I have alluded elsewhere, he ended an email to me saying (and this is close to a direct quote): ” I have no ego concerns. My only interest is anti-psychiatry.”

    Many people claim there are no egotistical reasons for their pronouncements on this or that, but in Phil’s case it turns out to actually be true. Otherwise he would have stopped writing for MIA after one of his recent articles was taken down.

    Phil is in many ways a “pure” intellectual and a gentleman, to the extent that he opposes making demands for fear of them creating a contentious atmosphere; he sincerely believes that the power of reason will overcome in the end. Can’t say I agree, because the power of power plays a major role in the outcome of many ostensibly “reasoned discussions.” (Consider the constant bs about policies those in power decide to implement being “evidence-based.”) But, while he is certainly open to changing a position based on a cogent argument to the contrary, Phil remains firm in his convictions and will not be “polite” at the expense of pulling his intellectual punches. He is a major ally of anti-psychiatry survivors and a key leader of the AP movement as a whole.

    Carry on Phil!

    • Oldhead, When I hear the phrase, “evidence-based” I cringe. I ask on whose evidence, on what evidence? Where’s the evidence? More than likely, the real evidence is being hidden and all we are allowed to see is some fabricated evidence. Aah! Creative Non-fiction strikes again! Thank you.

      • Additionally, since 90% or more of the funding goes to drugs, naturally, the only “evidence base” that exists is for the drugs. So anything else, except DBT apparently, can’t be considered “evidence based,” because the lack of financial incentive means no one has bothered to study it!

        • There is evidence that people who have been to a shrink receive bad or no medical care. Why is this evidence not important to base a practice on? The labels even something benign sounding such as “anxiety” plus the record of having seen a shrink result in medical people completely dismissing most complaints.
          The discrimination does not come from the general public. It comes from those systems that were put in place to “protect and serve”. If psychiatry was interested in this very life threatening and diminished quality of life, for the people they label, they would absolutely take away the made up labels, since in doing so, would potentially add quality and extra years to people’s lives.
          Now amazingly the medical establishments themselves send people to shrinks. It’s called free trade.

          “anxiety and woman” are the two labels that will not serve one well. One would be MUCH better off in countries without “care”. Even if we die younger. The years one lives mean very little if one has to be scared of seeking help.

      • I mean, shouldn’t it be ASSUMED that the assertions of scientific and medical “experts” are based on evidence? Even having to say your conclusions are based on evidence sounds defensive and suspicious. (How about producing the evidence?)

        I have the same reaction when I see the “new” rainbow flag with the Black & brown stripes to show that POC are “included” among the ranks of gay people — again shouldn’t that be assumed? Having to point this out specifically seems to message that “we are white, but we include POC too.”

        Also, “evidence” is used in BOTH sides in court cases, and proves nothing without considering it in context, along with conflicting evidence.

  13. Thank you so much for keeping after Ronald Pies, Phil. He certainly deserves it. How dare he spout all these hypocritical denials when the whole of psychiatric drugging is based on the “chemical imbalance” lie, which psychiatry and mainstream media have never stopped promulgating – and which an ever-increasing number of “patients” inevitably keep falling for. I wish many more people had access to your views.

  14. There could be a living made in the ability to debrief people. Because honestly, debriefing should follow
    a psych evaluation.
    As with parents or friends calling, or making someone more sensitive feel like a “loser”, which often people will see a shrink for, just to have shrinks and or medicine, become the abusive system people came from, well that really puts the stamp on it, doesn’t it.
    To seek validation and safety by going to god, asking him, “am I really fucked up”, and god says, “yes you are, and I will tell you why and what it is. Basically you are sick. You are disordered, so all your friends, your parents, everyone was right. You are disordered and there is nothing to cure you”

    This takes a lot of debriefing, especially if you took it to heart in that subconscious way, the way you did as a child. Psych IS the final pathogen.

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