Illnesses or Loose Collections of Vaguely Described Problems?

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On February 10, 2022, Joe Pierre MD, Psychiatrist, VA West Los Angeles Healthcare Center, and Clinical Professor, UCLA, posted the following short entry on his Twitter stream:

“Cancer is a normal and understandable reaction to environmental trauma.”

This innocent-looking assertion is a glib and fallacious counter to those of us in the anti-psychiatry movement who for years have been saying and writing similar things about psychiatry’s so-called “mental illnesses”.  The tweet is followed by the hashtag #dropthedisorder, followed by a question mark.  Drop the Disorder is a Facebook group based in the UK headed by Lucy Johnstone, Jo Watson, Jacqui Dillon and Nollaig McSweeney.

Essentially what Dr. Pierre is asserting is this:

Anti-psychiatry people insist that psychiatrists’ illnesses are merely normal and understandable reactions to environmental trauma.  Cancer is a normal and understandable reaction to environmental trauma, but nobody would conclude from that fact that cancer is not an illness.  Therefore, the anti-psychiatry contention is specious.

DEFINITIONS

In a certain sense, all of the disagreements around this topic are essentially debates about the meaning of words.  But such debates are futile because 1) the assignment of meaning to a certain sound or to a grouping of written characters is entirely arbitrary; and 2) the meaning attached to a word is subject to change if a sufficient number of people start using it in a different sense.  The rapid pace of mass communication has made this latter trend more pronounced in recent decades.

In particular, we need a definition of the term illness because the crux of the matter is psychiatry’s insistence that the various items in its DSM catalogs are “mental illnesses“.

Since the meanings of words are arbitrary, the only logical way to resolve these kinds of disputes is to focus on how the word(s) in question are used by ordinary people in their day-to-day conversations.  This is the method used by the compilers of dictionaries, and is particularly important in the present matter because the words illness, disease, disorder, sickness, etc. are routinely used by physicians of all specialties in their conversations with lay people about their health status.

SOME EXAMPLES

With this in mind, let’s examine some examples of how physicians use the words illness, disease, disorder, etc. in these kinds of conversations.

It is common in modern medical treatment for physicians to order lab tests to confirm the presence or otherwise of an illness.  Sometimes the lab result confirms the illness; other times it refutes the illness; and on other occasions the lab result is slightly elevated but not sufficiently elevated to confirm the presence of the illness.  In the latter situation, the physician might tell the patient that the lab result does not indicate the illness, but is more like a slight deviation from normal.

The clear implication here is that the word normal indicates an absence of illness or disease.

Sometimes physicians order X-rays, CT scans, and other imaging techniques to confirm or refute the presence of an illness.  A common phrase used in the reporting of these findings is: “no acute abnormality detected”.  In this example, the term “abnormality” is being used as a synonym for disease/illness, clearly implying that the opposite term normality indicates a lack of illness/disease.

In the same vein, dictionaries also draw a clear parallel between disease and abnormalities.  My Random House dictionary (1992) defines disease as “a disordered or abnormal condition of an organ or other part of an organism resulting from the effect of genetic or developmental errors, infection, nutritional deficiencies, toxic, or unfavorable environmental factors; illness; sickness” (p 384).  Note the clear statement that a disease is abnormal.

My Merriam Webster dictionary (2009) defines disease as “a condition of the living animal or plant body or one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms; SICKNESS, MALADY”. (p 358)  In other words, a disease is a condition that impairs normal functioning.

Anyone with even a remote familiarity with the basics of medical jargon is familiar with these usages.

THE REALITY

The clearest and least controversial definition of illness that I’ve ever come across is:  a malfunction or structural defect in an organ or in a system of organs.  The essential point is that illness entails pathology:  real physical or chemical or biological pathology.  All the illnesses that are studied and treated by general medicine meet the criteria embodied in this definition. But none of psychiatry’s “illnesses” (except for those that are clearly and accurately described in the various DSMs as caused by a medical illness) meet the criteria.

In addition, the definition accords perfectly with how the term illness is used in everyday speech and in specialized medical communications.  The only group that routinely challenges this definition of illness are the psychiatrists.  They insist that the term illness merely implies the presence of distress or impairment, and they have dutifully written these two “requirements” into every item in their various DSMs since DSM-III.  Essentially what they are asserting here is that: 1) illness is defined by the presence of distress or impairment; 2) psychiatric illnesses entail the presence of distress or impairment because that’s what’s written in our catalogs (DSMs); 3) therefore, our illnesses are real illnesses.

The following analogy is illustrative of what’s involved in this scam.

Imagine a company makes metal ornaments, which they advertise in magazines and other publications, and sell by mail order only.  Their ads specifically highlight the claim that all their products are made from “precious metals”.  But in their warehouse, which customers never visit, there is a sign on the wall that states that the following precious metals are used in their products: brass; bronze; and stainless steel.

When customers complain that the ornaments that they’ve purchased are not made from precious metals but from brass and stainless steel, the company points out that there is a sign on the wall of their warehouse that states clearly that all the kinds of metals used in the production are in fact precious metals.  So what is there to complain about?  The metals in question are precious metals.  Otherwise, the sign wouldn’t claim that they are. Besides, we pay a lot of money for them, so they’re precious to us.

So when psychiatrists claim that their illnesses are real illnesses, they are relying on a non-standard definition of illness, but they never reveal this to the clients.

And, although the scam has been working well for decades, they betray a total lack of confidence in their bogus criteria by the effort and money that they have expended for the last fifty years searching for the biological pathologies that they are convinced, without evidence, must underlie or cause their various “mental illnesses”.

So, to put the matter succinctly, they invent a spurious and misleading definition of the word illness.  On the basis of this spurious definition, they invent an entire nosology of “mental illnesses” (real illnesses, just like diabetes).  Then, having established the illusion of legitimacy with this fabricated material, they proceed to discuss and develop their nosology as if the items therein were real illnesses based on genuine pathology.  For years they promoted to the public, the government, and the insurance companies that their “illnesses” were “real illnesses, just like diabetes”, while at the same time pouring billions of dollars world-wide into the search for proof.  This was an enormous fraud, constructed on an enormous hoax, and it continues to this day in every mental health facility and in almost all psychiatrists’ offices.  It should also be noted that the psychiatric method of discovering illnesses (make them up, sell them to the public, and look for proof later) is in marked contrast to the method used in real medicine (find proof, give them names, and then inform the public).

CANCER

Cancer, in sharp contrast to psychiatric “illnesses”, is a real illness, with real biological causes, many of which are indeed activated by environmental forces, e.g. sunburn, tobacco use, industrial pollutants, etc.  To attempt to draw parallels between cancer and “psychiatric illnesses” is to dishonor the work of oncologists and the victims of this dreadful disease.  It’s a bit like saying that there are parallels between dying of cancer and losing one’s job.  The latter would be a serious setback for most people, but not even in the same league as dying of cancer.

WHAT’S NEEDED

What’s needed at this time are not glib, inane rejoinders, but an honest scrutiny by psychiatrists of their fundamental assumptions and methods; apologies and amends to the people they’ve wronged; and a switch to honest work.  There is also a pressing need for real physicians to challenge the legitimacy of psychiatric “illnesses” and “treatments”.

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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.

22 COMMENTS

  1. Bravo, Phil, as usual…. Not to change the subject TOO much, but did you see that “Dr.” Jeffrey Lieberman, yes, THAT Dr. Jeffrey Lieberman, just got CANCELED, canned, & fired, for dissing a supermodel on Twitter? He compared her rhetorically to a “freak of nature”, based on a shared tweet that itself was spreading false information. In other words, he got scammed, conned, & fooled. I think his “crime” was far more minor and excusable than the SJW’s, and hordes of “woke” activists will admit. He did NOT “call her” a “freak of nature”. There’s no arbitrary or objective way to measure “skin tone”, to determine who has the “darkest skin in the World”, but that’s what the false meme alleged. Guinness Book of World Records honestly denies any such category. But I think this ties into semantics, society, & psychiatry. Lieberman is so accustomed to spouting off whatever he thinks, and having his words treated as secular gospel. Sounds like those arrogant shrinks, doesn’t it?….
    BTW, my favorite cliche metaphor: “So-called “mental illnesses” are EXACTLY as “real” as presents from Santa Claus, but are NOT more “real”, and for the same reasons.” Think about that, Phil, & see if you agree with me? Keep up the good work, Doc!

  2. Though I find this discussion a bit overworked, the basic proposition is perfectly valid.

    Many words have multiple meanings, and most meanings are rooted in cultural traditions that trace back into forgotten history. To say that the meanings are “arbitrary” overstates it a bit. One either uses a word in line with its traditional meanings or misuses a word in the hopes that it will somehow impress or fool people. Some of the misused meanings enter the cultural tradition, such as “xerox.”

    “Illness” is derived from a word meaning “evil” and reflects earlier beliefs that unhealthy conditions were caused by possession by evil spirits. The word definitely implies poor health or reduced ability to survive bodily. But I don’t like to concentrate in these words. It is obvious that Psychiatry would like us to believe that mental problems are caused by some unhealthy condition in the brain. They equate mind (mental) with brain. To me, this is totally absurd. The two have only a loose connection to each other. That is the huge mistake, and we will not escape it simply by changing terminology. We actually need to figure out what a mind really is.

    Next we need to attain a full list of the actual causes of diseases and/or illnesses, and develop techniques to address all of them. To assume that biological disease only has biological causes is amazingly narrow minded which would not be tolerated in many other fields of knowledge. Most recognize the environment as an obvious factor. This includes of course all the various possible environmental toxins. But the list is not yet complete. Freud and many others had the idea that past “trauma” would be another possible cause. How Psychiatry succeeded in dropping this whole line of investigation is another story, but Psychology never totally did, though their dogmatic blinders have prevented them from discovering the whole story. A few got close.

    And so we have the current scene. Regardless of terminology and rhetoric, most practitioners of Psychiatry and Psychology don’t know what a mind is and don’t know how to solve mental problems. As one might expect, I have my own ideas on this subject. But the beginnings of a better understanding have already been delved into by the old hypnotists, parapsychologists like Ian Stevenson, and a few others considered outliers by those wedded to medical answers but who actually are getting closer and closer to better answers. The way things are going, they may never arrive. I feel confident, however, that this knowledge exists in a workable form and is factually publicly available even though most practitioners will deny it with their characteristic academic arrogance.

  3. Shook my head after I finished reading. I lost a parent to cancer a few years ago… Dr. Pierre’s attempted comparison between mental illness and cancer is ridiculous and harmful for many reasons. Was the previous terrible analogy to diabetes not enough? Is their argument so frail that it can’t even stand up on it’s own, thus it’s promoters have to keep leaning it against completely different medical issues to keep it’s legitimacy?

    When one of my grandfathers was diagnosed with pancreatic cancer, he was told his 5 year survival rate was below 10%… what mental illness is comparable to that? In fact, what’s the 5 year survival rate without treatment for any mental illness? I can’t imagine it’s equal or lower to the rates for the majority of untreated cancers. If mental illnesses can’t be diagnosed the same way as cancers, and the treatments are very different, and the risks of death are not the same… how are these two things comparable at all? How is this anything other than grasping at straws?

    You’re right Philip, it is dishonourable and we don’t need people making these comparisons in the first place. It helps no one. We absolutely need honest scrutiny – we need people to ask honest questions, we need people to seek honest answers. Amends should be made, apologies given, lessons learned or nothing will change. I hope Dr. Pierre at least feels the status quo is not acceptable the way it is and there is MUCH improvement to be made, but I have found myself bewildered by some of the thoughts of mental health practitioners before…

    • Heck, I forgot to mention yet another ridiculous thing about this… would Dr. Pierre and his colleagues accept a diagnosis of cancer without any lab work or imaging? Would he agree to undergo radiation, chemo, immunotherapy or surgery without those tests done, showing them the cancer is truly there? Would anyone consider a person’s demand for real cancer pathology testing before undergoing cancer treatment to be unnecessary or unreasonable? Would they assume the person is ‘being difficult’ or use their demand of further testing as proof that they have cancer that NEEDS urgent treatment? “This person is suffering horribly from cancer, so much that it’s effecting their ability to think clearly. They can’t admit that they need help, so for their own good it’s best we commit them under the Cancer Health Act and make sure they undergo life-saving treatment.” If that sounds like nonsense, it’s equally nonsense to push that line of thinking on anyone labelled mentally ill. It will always be absurd to me that a person with primary cancer has a right to refuse treatment even if they will die as a direct result, but anyone with a mental illness is strictly forbidden from doing the same. They get arrested, detained, forced under surveillance and medicated without any real voice in the matter as a response to their desire to pass on. There is a massive divide in how we view those who are deemed physically ill or those who are deemed to be mentally ill.

      I wonder if Dr. Pierre was aware of all this when he posted his tweet. Truly, there is no real comparison between the two and it feels a bit callously ignorant to say there is.

  4. Cancer, diabetes, COVID, influenza, kidney stones, dental caries, appendicitis, bronchitis etc. have nothing to do with a person’s character, conduct, feelings, and sanity.

    Human suffering is real and can require urgent help, these psychiatric characterisations in terms of disease and illness are often, in practice, used to justify malicious attacks on a person’s character and incessant gaslighting. There’s absolutely no justice when that happens. None whatsoever.

    I have seen people, be it mental health workers, patients themselves (who are probably totally reliant on mental health workers and have no other choice but to spout their party line even if they don’t realise it) and even members of general society talk about “There is nothing derogatory about psychiatric diagnoses. It’s like saying you have the flu”.

    Once again, the flu has nothing to do with a person’s character, conduct, or sanity.

    And you can’t retaliate back. The very garbage you are labelled with is their weapon against you. Condescension and gaslighting are all that comes in the form of retorts like “poor child, no one likes being labelled and accepting they have a problem” or “how many people with *insert x disorder* will be here in defensiveness and denial?”. Or it’s the usual “Scientology guys back at it again.”

    People really need to know what they’re getting into socially, legally and medically when they’re seeking help from the mental health profession because most psychiatrists and psychologists really want to protect their image at all costs and won’t take anyone who opposes them seriously unless it comes to a stage where they have no choice but to. In that case, either a suffering person is left to fend for themselves, or is psychiatrised even more or their character is assassinated. And then we have to retaliate in a similar fashion and this war rages on.

    • Actually, some physical maladies do have a spiritual causation component. This can be seen in Ian Stevenson’s work on birth marks that match a past life wound. But of course it is commonly accepted that the only reason people get sick is because of a pathogen or a poison. Attempts to apply the same rule to “mental illness” are absurd, and if we addressed the spiritual component of strictly physical diseases, we would keep more people healthy for longer periods of time. Yet another reason why the Medical Establishment wants nothing to do with actually effective remedies.

      • Of course, “the medical establishment wants nothing to do with actually effective remedies.” It would put them out of business. Also, if you accept the truth that alleged mental illnesses, especially as defined by the DSM are a lie, then there are no “actually effective remedies” because there is no “illness” to “remedy.” Additionally, the overall sad component of all this is how we radily accept in society how everything is a “problem” that needs a “diagnosis” and thus some “treatment” or “remedy.” We have “medicalize” our lives to a such an extent that if you take the traditional line from the marriage ceremony, “in sickness or in health” we need to drop the “in health” and just keep the “in sickness” part. This is true for all ages no matter their possible marital status. The important point is that as a society we have come to value “sickness” over “health” and even reward people for their “sickness.” Thank you.

  5. I agree with some of the points made here, but I also have problems. There are people who suffer from serious disabilities and maybe illness is not a bad description for their difficulties even if there are no physical causes. For example, someone who is convinced the television news moderator is not discussing trade issues but is really talking about her, in code. Or the man who can’t leave his home because of overwhelming anxiety. One dictionary definition of illness is an unhealthy condition of body or mind.

    The DSM goes too far in its categorizing almost every problem that causes suffering or difficulties in functioning as illnesses. It’s so corrupt as to be almost useless conceptually. But that doesn’t mean that there are no illnesses of the mind. Or if you don’t want to use the term illness what term do you use?

      • It would be good if that were the only thing going on, but it isn’t. There are plenty of people who need real help. Though many of them were triggered by bad experiences, we can’t ever hope to totally eliminate bad experiences from life. That’s just not realistic. We can strengthen people when they want to be stronger. That’s about all we can realistically do, and that’s more than we are doing now.

        Ultimately, “society” is only a product of all the people participating in it. So, you can’t blame “society” without taking a look in mirror.

        • “We” meaning whom?

          Not a lot to argue with, but you’re getting off the original subject, about an alternate term to “mental illness.” My main point is that changing the label but maintaining the illusion that there is a “thing” a person “has,” regardless of the label, is a way of mystifying the situation.

          • We, as in all of us, Mankind, or anyone who cares and has proper training.

            But I should be clear that I do think it is NOT an illusion that some mental problems stem from something a person has (or created for themselves).

            I don’t think that today’s “toxic society” is the problem. It gets in the way of implementing solution, but there are many other toxic societies and relationships and decisions that have contributed to the problem.

        • I agree with I_e_Cox and Marie,

          There is such a thing as having problems. And there is such a thing as improvement – I have benefited from the wisdom of others. But I certainly have not benefited from Heavy Duty Psychiatric Drugs.

          I regularly attend 12 step fellowship (though – I don’t like all the members). The 12 Step deals very successfully with Extreme Anxiety and Strange Ideas among lots of other things.

    • @Marie:

      I don’t agree with many of the responses here. I completely understand why the sort of problems you mentioned are conceptualised as illnesses and how (depending on the case), urgent, problematic and long-lasting a person’s suffering can be. But, as I mentioned in another comment, I also see how psychiatric language and psychiatric categorisations set up the illness concept to invalidate people, assassinate their characters and personalities, gaslight them etc. You can’t do this with bronchitis or kidney stones because they don’t pertain to character, conduct, feelings, mood and sanity. Hence, people’s opposition to the illness characterisation.

  6. “Cancer is a normal and understandable reaction to environmental trauma.” This is just plain fraudulent bogus stupidity and then to take it a logical fallacy and try to smear those who even question psychiatry and its alleged diagnoses is so infuriating. My sister passed away from cancer twenty years ago this April. Nothing in her diagnosis indicated as a response to environmental trauma or any other trauma. To this day, we can only speculate as to why she came down with cancer. And to elaborate even further, after seeing my sister suffer through the disease, the chemotherapy, the radiation therapy and the secondary cancer, she got from the chemotherapy and radiation therapy, absolutely none of this seems normal to me to be allegedly caused by “environmental trauma” or anything else. The other point that reflects the utter stupidity of this argument is that the DSM states that some of the alleged mental disorders listed in the DSM may be the result of some sort of environmental trauma. One major example is PTSD (Post Traumatic Stress Disorder). Most of the time, most people actually do not become “anti-psychiatry” until they themselves or a loved one has been exposed to the “psychiatric system.” I just don’t know what to say. As long as this kind of thinking exists, we will not be able to discover either a cure for cancer or even teach people the skills to deal with the problems and issues of life. Oh, but if we did the latter, then we wouldn’t need the “mental illness industry” like the psychiatrists, their diagnoses and dangerous treatments involving mind-altering drugs and brainwashing therapies, etc. Thank you.

  7. This article triggered me to think, who are these people we call Psychiatrists to whom we depend upon for our mental well-being?

    In my experience they are mostly medically trained Doctors with a little bit extra added on. Reil back in coined the term psychiatry, (Greek, meaning medication of the soul)

    If we continue to train “Psychiatrists” with such knowledge we will continue to get the same disastrous results, an increasing number of patients overly medicated with neuroleptics. Instead they could have recovered from their “thought crisis” and been living a relatively healthy life should they have kept away from medication and sought a psycho-social solution to their dilemma.

    Who was it who said the definition of insanity is repeating something that doesn’t work, believing that it could?

    Let’s leave out the biological explanations for one split second, who cares what the hypothalamus is doing or how many or where the neurotransmitters are. Is it a problem, and if it is is it fixable with chemical additives or are we just playing God with peoples lives.

    The best recovery methods involve a combined approach and a concerned one. This is a familial approach and goes to the heart of what it is to relate to one another.

  8. What’s needed at this time are not glib, inane rejoinders, but an honest scrutiny by psychiatrists of their fundamental assumptions and methods; apologies and amends to the people they’ve wronged; and a switch to honest work.

    Yeah, when pigs fly…. 🙂

    Just Say No!

    Great deconstruction of the cancer analogy too.

  9. Thank You Dr Philip,
    In terms of non illness – if a a person remains disabled while co operating with treatment, and makes full recovery as a result of stopping treatment, then I think, it could be assumed that treatment, not Illness, would be the problem. Most people that recover – recover through abandoning treatment.

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