Researchers: Study of Schizophrenia Held Back by “Cult-Like” Belief System

Leading researchers complain that psychiatry refuses “to enter the moral era of medicine” and clings to an outdated view of schizophrenia.

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An article published in Schizophrenia Research directs attention to psychiatry’s reluctance to reconceptualize its understanding of schizophrenia. The authors, an international team of researchers led by Jim van Os, argue that psychiatry’s stalemate in the schizophrenia debate reflects an unwillingness to engage in the discussion about the underlying flaws in the specialties scientific foundation, despite longstanding evidence of concerns and institutional corruption.

“A profession whose core values are based on a non-factual belief system runs the risk of becoming cult-like, as it has to find ways to exercise epistemic control of its members, proselytize aggressively against the tide of non-confirmatory scientific evidence and manipulate its messaging to the outside world,” the leading researchers write. “Indeed, institutional power to define ‘specialist’ categories of disease, such as DSM-criteria for schizophrenia, may be considered an instrument to exercise epistemic control par excellence.”

Rooted down concept with an aging rocket ship being held down by growing tree rootsSchizophrenia has been accepted within mainstream psychiatry as the most biological of all mental illnesses and is primarily seen as a brain disease needing proper medication. This narrative has largely dictated messages to the outside world about the origins of schizophrenia and shaped how we, the public, conceptualize mental illness.

However, a core problem within this paradigm of schizophrenia as a “severe genetic brain disease” is that it lacks good scientific evidence. In fact, 60 years of intensive biological research has yielded neither solid nor clinically relevant biology-based distinctions, as pointed out by major players within psychiatry, such as Tom Insel, former director of the National Institute of Mental Health (NIMH). The authors write:

“The psychiatric gaze, therefore, has the hallmarks of a belief system which is used to make promises to the world outside psychiatry. It is not evidence-based, nevertheless implicitly accepted as valid, nurturing the core values underlying the psychiatric way of perceiving the world of mental variation and addressing the clinical problems of patients.”

The adoption within psychiatry of mental illness as a brain disease was enacted mainly with the creation of the DSM-III. It functioned to solidify psychiatrists as the primary line of treatment for those with mental and emotional suffering (through medication) and solidify psychiatry’s legitimacy within the medical sciences. However, the authors argue that this longstanding perception obfuscates the “epistemological complexities of brain-mind-context relationships.”

The refusal of psychiatry to acknowledge its well-documented uncertainty has created a trap in which the failure to address broader epistemological issues has to do with the “psychiatric gaze” of refusing to acknowledge what largely remains unknown. The authors argue a path forward for psychiatry, stating:

“We propose that psychiatry adopts a more complex and scientific psychiatric gaze that is considerably more agnostic and embraces the epistemological complexities of dealing with mental variation at the brain-mind-context interface.”

In doing so, psychiatry would become not only more scientific but less defensive and more responsive to the values of patients and their families.

The authors highlight how psychiatry did this in Japan with their initiative to rename schizophrenia. Ultimately, Japan modeled how the field can abandon its position as an epistemic gatekeeper and participate in the process of co-creation with stakeholders, including those with lived experience.

This course of action reflects what is referred to as a “novel moral era of medicine,” in which treatments are more focused on adding value to the life of patients beyond symptom reduction. Currently, 80% of randomized clinical trials focus on symptom reduction for specific disorders, reflecting what professionals think is important. In contrast, patients struggle with the personal and challenging trajectory of learning to lead a meaningful life despite ongoing difficulties that do not respond well to treatments.

For example, antipsychotic medications, the primary line of long-term treatment for schizophrenia, have side effects that can negatively impact service users’ quality of life and even lead to early death.

In closing, the authors urge the importance of psychiatry cocreating novel concepts and language, together with patients, families, and other stakeholders, particularly beginning with the construct of schizophrenia. They powerfully state:

“A more agnostic and scientific psychiatric gaze would allow for recognition of the fact that DSM-5 is not based in science, and that psychiatrists have been allowed to unilaterally impose their value system on the ill-understood phenomenon of human mental variation. In the new moral era of medicine, it is unthinkable that a domain like mental health, which scientifically, in essence, remains enigmatic and extremely complex and is of tremendous importance to countless users and their families, would be dominated by a distorted belief system and the values of a single profession.”

 

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van Os, J., & Guloksuz, S. (2022). Schizophrenia as a symptom of psychiatry’s reluctance to enter the moral era of medicine. Schizophrenia Research, 242, 138–140. https://doi.org/10.1016/j.schres.2021.12.017 (Link)

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Madison Natarajan, PhD candidate
Madison Natarajan, PhD candidate
Madison is a doctoral candidate in the Counseling Psychology PhD program at the University of Massachusetts Boston. She is currently completing her pre doctoral internship at the Massachusetts Mental Health Center/Harvard Medical School working in psychosis interventions across the lifespan. Madison primarily considers herself an identity researcher, assessing the ways in which dominant cultural norms shape aspects of racial and gender identity for minoritized individuals, with a specific focus on the intersection of evangelicalism and its relationship to Christian Nationalism. Madison has a family history that has been intertwined with psychiatric care, ranging from family members who were institutionalized to those practicing psychiatry, both in the US and India. Madison greatly values prioritizing the experiences of those with lived experience in her research and clinical work, and through her writing in MIA seeks to challenge the current structure of psychiatric care in the West and disseminate honest and empowering information to the community at large.

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38 COMMENTS

  2. Given the fact that the “mental health” industries are “partnered” with the mainstream religions. And some of them are drugging up people for belief in the spiritual realm and the Holy Spirit. And there are many people who’ve had “spiritual emergencies” or unusual spiritual experiences misdiagnosed as the DSM disorders, myself included.

    I find it odd that you are suggesting the “mental health” workers become MORE “agnostic,” and more material world only believing. Since I don’t think an industry that – literally in my medical records – blasphemies the Holy Spirit, and whose DSM “bible” is completely unscientific … yet the “mental health” industries are always begging for more money, even after confessing to having wasted billions on worthless research so far. I don’t think they could behave in a much more “agnostic” – and material world only believing – manner.

    Now, as one who has run into numerous “mental health professionals” and pastors who had God and/or Jesus complexes. Delusions of grandeur filled “professionals” who felt it was their right to play judge, jury, and executioner to a person they didn’t know. I do know that the god-complexed “mental health” and religious “professionals” should overcome THEIR “delusions of grandeur.” And stop believing they have a right to play God, and attempt to murder any one they please, for any reason … like covering up child abuse for greedy, unrepentant, deadbeat, pastors and bishops.

    https://books.google.com/books?id=xI01AlxH1uAC&printsec=frontcover&source=gbs_ge_summary
    _r&cad=0#v=onepage&q&f=false
    https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
    https://www.madinamerica.com/2016/04/heal-for-life/

    I absolutely agree, however, the “mental health professionals” do need to garner insight into “the fact that DSM-5 is not based in science.” And I do hope and pray for a “new moral era of medicine.” Although I do not see such becoming close to a reality, until the entire medical community ends their belief in the “distorted belief system and the values of” the, forced and coerced drugging, DSM “bible” believing industries.

    As to “schizophrenia” … the “gold standard treatments for schizophrenia” can create the positive symptoms of “schizophrenia,” via anticholinergic toxidrome. And the antipsychotics / neuroleptics can also create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome (NIDS).

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

    So most so called “schizophrenia” is likely an iatrogenic illness, created with the “gold standard schizophrenia treatments.” Just like “bipolar” is an iatrogenic illness, that can be created with the ADHD drugs and antidepressants.

    https://www.amazon.com/Anatomy-Epidemic-Bullets-Psychiatric-Astonishing-ebook/dp/B0036S4EGE

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    • Someone Else

      “..Just like “bipolar” is an iatrogenic illness, that can be created with the ADHD drugs and antidepressants….”

      Bi Polar CAN be created by consuming drugs suitable for bi polar – I was put on Lithium (for no real reason) in 1980 and came off it in the early 1980s with a completely changed ‘over the top’ personality.

      But I was already an established Psychiatric patient at Galway Ireland, so there was nothing that could be done about it. There would be no point. And it eventually went of it’s own accord.

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    • As I shared in another comment
      “We cannot evade the conclusion that it is the psychology of definition as it is deployed in contemporary nosology that is responsible for the misperceived perceived necessity that there exist a dysfunction in the individual patient. Today’s nosologists, like many in psychiatry’s history, are psychologically induced to claim that corresponding to a definition of a mental disorder-one one which has been legislated and enacted by a powerful professional body perceived as a source of authority-is a real disease”

      THE PSYCHOLOGY OF DEFINITION AND CLAIMS TO TRUTH
      “An examination of the psychology of psychiatric definition shows that it is no accident that the majority of definitions of mental disorders, as found today in editions of the DSM and the ICD, are construed to be true statements. Yet, as we have seen, such definitions are first and foremost prescriptions that aim to persuade others that what is stipulated and legislated lated should be accepted as diagnostic rules, and rules, we are reminded, are never true or false; they are only conventions, some of which have a value, and others of which do not. The definitions of psychiatric nosologies gies get into trouble when nosologists include descriptive content in their stipulated definitions. It is a psychologically normal characteristic for diagnosticians and other clinicians to construe this descriptive content, which typically enumerates behavioral and psychological symptomatology, ogy, as referring to the real world in a true or false manner. But, in fact, this is a psychological deception”
      From Dr. Steven James Bartlett’s book “Normality Does Not Equal Mental Health: The Need to Look Elsewhere for Standards of Good Psychological Health

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    • Actually, what we call schizophrenia isn’t an independent illness at all, but a bunch of them, which have different effective treatments, depending on their origins. “Schizophrenia” is actually a syndrome, a collection of signs and symptoms, rather than a disease unto itself (excuse me for being so materialistic).

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    • I believe that theres nothing that creates an impression of “Schizophrenia” better than exposure to “Antipsychotics”. I believe the majority of people that attempt to discontinue “Antipsychotics” – experience Antipsychotic Withdrawal Syndrome – NOT Relapse.

      I had never experienced the phenomenon of Auditory Hallucinations, these were produced by Maudsley/ Kings College staff to support a diagnosis of “schizophrenia” – they were not genuine.

      The phenomenon of Delusion was also erroneous as Maudsley/Kings College Medical Staff were intentionally unaware of the foreign country I had just come from.

      But I still only managed to come off Psychiatric Drugs suitable for “Schizophrenia” by the SKIN OF MY TEETH.

      My accompanying UK Doctor (Dr B Stone) on arrival at Galway Ireland in 1980, had presented drunk in front of University College Galway Hospital Doctors. The notes recorded on Admission at Galway in 1980 were not up to any basic medical standard. The process was bent!

      (Dr B Stone died tragically in October 1999 at the Age of 51, in hospital, as a result of injuries received ‘in a fire at his home’.)

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  6. Yes, psychiatry is indeed a cult. When its wild claims to effectiveness are compared to what it actually does to its unlucky patients, anyone who believes in their claims is no longer paying attention to reality. Unfortunately, a large proportion of our society does this. I don’t know what word would really accurately describe psychiatry as anything but a cult.

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    • Everything is a cult, my friend.

      I love cults.

      I have spend many years trying to be a cult.

      Anyone who is in a “cult-ure” is in a cult.

      My old therapy supervisor said of sadism and masochism that these two are needed in each individual. The problem comes when the idividual does not acknowledge they have a masochistic streak or a sadistic streak. What is hidden and unacknowledged goes out of control and rogue and projects onto others that they are masochistic or sadistic.

      So an exemplary acknowledges their dark side; to tame it.

      Cults are similiar. If you do not acknowledge you are one then you behave like only everyone else is a cult.

      A cult is not a dirty word.

      Cults are ancient and healing.

      Abuse and bullying and cruelty are not cult stuff but they interlope into AnY cult and wear the mantles of cult leaders.

      But cults are mostly harmless groups of belonging or resonance.

      Schizophrenia is its own fine cult and culture. It has its own ethnicity and art and music. Which is why people try to erase it.

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      • Cult in the negative sense is a good way to describe mainstream psychiatry.

        Here’s one definition: “…an organized group whose purpose is to dominate cult members through psychological manipulation and pressure strategies …(and) are characterized by:
        1. Absolute authoritarianism without accountability
        2. Zero tolerance for criticism or questions

        These are just two characteristics, but they explain “…psychiatry’s reluctance to reconceptualize its understanding of…..” ANYTHING!

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        • Like I say cults are wonderfully silly. The more the merrier.

          Bullying filters into any cult and ruins what it should have been.

          There is no need to nuke a cult.

          Cultishness is behaviour most people do enjoy. Churches are still standing.

          We ought to allow cults, even support psychiatry to proudly become one. It was part way there in the primal scream sixties.

          Allow cults

          But

          Never

          Allow

          Incursions of bullying.

          Bullying is an oil slick on a pristine cultic seashore.

          (Birdsong, I will leave it at that. Please do not reply. Nobody. I genuinely am in hospital so I hear nurses footsteps coming to check I am not howling as much as I was earlier).

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          • I live in joy each day waiting for the dulcet tone poem words of Daiphanous Weeping willows drooping branches brushing the slow flowing stream of my now-slaked daily experience of consciousness as a liberated mental patient escaped the evil clutches of the fraudulent pseudoscience drug racket and social control mechanism known as “psychiatry”. She sates my word-thirst.

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  7. Dreaming is how the mind creates perspective, just like reading a novel.
    And then there’s waking dreaming, something most people do when they think that drugs are magic, that fitting into the fashions of the day makes you part of a community, that parking your rear end in church makes you Christian, and part of a community, and some deity sparkles about your “purity,” or that following rules that allow you to acquire money or not be arrested for being human, that that’s making it. And then there are those who can’t adapt to all of that with their dreams, dreams that would lead toward enlightenment were they allowed to express themselves, and there you have “schizophrenia.”

    To understand that language, rather than disable the mind, you get “healing,” or simple tolerance.

    When my “schizophrenic” thoughts, the exact ones that were made out to be the most “dangerous” started making sense, is when a miracle happened in my life. But that’s another way of looking at thought in general. It wasn’t even trying to fight against the people saying I was crazy, delusional, it was just being interested in healing, and this miracle.

    And it worked.

    Just meditating twice a day for 20 minutes, and not blocking off the thoughts saying what’s possible and what isn’t….. that might create a whole other reality.

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  8. Szasz writes extensively on psychiatry as a (rather dangerous) religion. I -would- say “cult,” but cults tend to have tension with the state and also surrounding communities. Psychiatry is a tool of the state and seems to be perfectly at ease within most communities in the 21st century.

    Szasz also writes extensively about “Schizophrenia” as psychiatry’s “sacred symbol.” Without “Schizophrenia,” psychiatry would probably not be able to justify it’s ongoing existence.

    I do find it absolutely horrifying that so many mainstream religions embrace psychiatry. And those that don’t often choose instead to punish the distressed (and, admittedly, often distressing) individual, rather than take a look at the “bigger picture” and try to make life better for the distressed and those around them. The religious approaches seem to be: “take your meds, see you in church next Sunday!” or “you’re a sinful weakling and those pills are sinful, too. shape up or ship out.”

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  9. Yeah, people, let’s all argue about whether or not psychiatry is a “cult” or not, and ignore the FACT that the article is about the superstition of so-called “schizophrenia”, and whether or not “it” actually exists, what “it” is, etc.,….
    Way to be lead astray, off-topic, and OUR POWER neutralized by our puppet-master overlords….
    No wonder we have made so little progress in eradicating the scourge of psychiatry….
    We’re an angry anthill fighting the elephant in the room….
    Good luck with that, kids….

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      • Shattering a beer glass over the scrub suit of a doctor who has been trained in a particular way that he cannot change is cruel.

        One cruelty does not justify another cruelty.

        No cruelty is just.

        Lex Talionis bids us to ONLY respond fairly. A psychiatrist might be a rogue. Any people-loving career will attract creepy controllers. That does not mean the rest of those employees are getting up to no good. Most psychiatrists have to heal thousands. Could you? Should we all stagger over to your house and have you make three meals a day for us thousands? I think quite quickly you may lose your empathy right down to a trickle.

        When a psychiatrist is hounded by thousands of patients all clamouring for being fixed that thousands is a huge batch of case notes best hurled into a truck. A few psychiatrists are far iller than their patients. But service users are not meant to see that hidden suffering.

        I see it.

        Sometimes it is the healers who need the love, support, and healing.

        In psychotherapy the therapist and client are EQUALS, and so the client learns how to look after themselves in that test pilot dummy relationship. To practice being more effective at getting needs met requires practicing on “a human”, a flawed ordinary human full of positive traits and rubbish traits. But ENTITLED DEMANDERS tend to want the doctor or psychiatrist or nurse or therapist to be a nodding adoring mechanical robotic godsend.

        This is also “only human” to be a client who wants that. But because a medical doctor is passed as adequate when all they do is pummel your rib cage without politely asking, or siphoning of quarts of plasma to experiment on, it is easier to not damn them. Those doctors are allowed to disrespect the fact you are aggrieved that your tee shirt has been scissored to ribbons. Those emergency on call doctors and surgeons are not meant to like you. Be worried if they do, because that means they are not focusing on your liver and lights.

        Psychistrists are not meant to like you. As with the surgeon, the doctor who spends years becoming a doctor before becoming a psychiatrist is not supposed to whisper sweet nothings into your cochlear whorl since that doctor turned psychiatrist is only meant to like your body and brain. As my Altzheimers relative is very much reassured about.

        Psychiatry DOES utilize science. Psychiatry IS scientific. But it is also, as many things in life are, a faith. Most faiths play with scientific certainty, a certainty in science logic that is absurd the closer you peer at it. But this means that there is nothing wrong with using a sprinkling of science in a faith to serve as theatrical authority, like when a particular faith uses sciencey tweezers to pick apart the dirty tee shirt of the Turin Shroud.

        All faiths are optional choices laid on a table for you to select from…the herbalism faith choice, the yoga faith choice, the Soteria faith choice, the three hot meals and a soft bed in a hospital faith choice.

        You can get rid of bad bullies in any of these organizations WITHOUT demolishing the herbalism faith choice or the psychiatry faith choice.

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    • I feel you may have heard that quote, or close approximation to it, issuing from my held opinion.

      It is interesting Birdsong.

      (for the rest of this I am using the word “you” in a way that means everyone)

      People do have a right to voice their opinion without being regarded as a bully.

      So what can creep in to that though is where one person takes up a whole magazine or a whole church podium or a whole cult camp or a whole comments section with an opinion to the extent that they are not allowing A DIVERSITY of other opinons to add to the mix.

      Having an opinion and voicing it is a basic human right. Another basic human right is my right to not “HAVE TO” listen to any opinion that I as a unique individual do not want to. When another person is too eager to show that their opinion is THE ONLY RIGHT OPINION it then goes from being an opinion shared to being an opinion foisted repeatedly in a style akin to harassment, dogma, propaganda, conversion therapy.

      I have a basic human right to hold my own opinion AND I have a basic human right to not HAVE TO change my opinion for your opinion.

      I am free to ignore your opinion. I do not ever stop you having your opinion. I like diversity. I have no energy or impetus in my life to change any one thing about your opinion. That would make me a bully. So I do not think I have EVER persuaded ANYONE to drop their opinion. I have respectfully listened and prodded the substance of their opinion to examine its worth to me. Mostly opinions start to sound like repeats repeats repeats of the same gratifying accusation and blame. I myself am spiritual not political. So I have no interest in blaming as a solution. So from the outset I cannot waft the placcard that most people here do. But my pacifist opinons may not be welcomed unless “I” am persuaded or goaded to change them. When that fails then anyone’s opinion can be turned into a deafeningly loud crescendo, all UNITED and all chanting the same consensus opinion.

      A CONSENSUS OPINION say clogging up a comment thead on youtube is just mass trolling using the excuse of collectively loudspeakering an opinion as intimidation or victimizing anyone with an unusual or outsider or different opinion.

      I prefer no reply to this. I am sick.

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