The Psychiatric Times has been hosting a point/counterpoint regarding the validity of DSM diagnoses, which began when two Finnish researchers, Jussi Valtonen and Jani Kajanoja, published an article critiquing the presentation on web sites that confound the diagnosis of depression with a causal explanation for that diagnosis. That triggered a reply by Ronald Pies and Mark Ruffalo, which was published in Psychiatric Times, which sought to defend the “validity” of DSM diagnoses. This debate, which addresses an important issue in psychiatry, now has a new reply from Valtonen and Kajanoja.
-
Each word in the DSM and each thought in the head was chiselled by many billions of human hands through time, none of which ever existed. Each thought was chiselled extensively by the many hands of Edwardian metal men that only ever appeared in the eye of the mind. The mind is all that is. Everything within it, including this society, this whole Universe and the DSM, is an unreachable mystery that never was, although it always is. One day it will all vanish into the darkness, even our memory, and finally we will never have been. And we won’t even be there to know we’ve never been, although nothing will have changed at all, because we never even were. There is only THAT. That nothingness really IS, and it is the only thing that is, although it is not a thing and never was, and nor was any thing.
-
“Essentially, SAMHSA is invoking what we have called level 1 causality, cognizant that we do not know the precise pathophysiological processes that explain bipolar disorder or schizophrenia (level 2 causality).”
Well, us critical psychopharmacology researchers have pointed these out. Psychiatry’s antidepressants and ADHD drugs can create the symptoms of “bipolar.” (read “Anatomy of an Epidemic”)
And we’ve also pointed out that the anticholinergic drugs (which includes the antidepressants and antipsychotics) can create the positive symptoms of “schizophrenia,” via anticholinergic toxidrome. And the antipsychotics can also create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome.
“…it is logically circular to say that depression caused the person’s depressed mood, [but] it is not circular to say that depression caused the person to not attend an event.”
But in my case, I had to leave my ex-religion because a non-clinical psychologist chose to behave as an attempted thief, since he was apparently ignorant of psychiatry’s systemic iatrogenic illness creation crimes. But we did not stop attending church services of that religion because either my mother or I claim to be “depressed,” or “mentally ill” in any way.
“But this is precisely where the circularity charge falls apart. For if the depression itself can cause a person to ‘not attend an event,’ then, ipso facto, depression itself necessarily has causal efficacy; ie, it can itself act on individuals to produce clinical or behavioral effects.”
Not if a family leaves a religion – thus does “not attend an event,” like going to church – due to an attempted thieving (disingenuous conservatorship contract handing over), ignorant, psychiatric deluded non-medically trained, non-clinical psychologist is just trying to steal from us.
We left my ex-religion because of a DSM deluded attempted thief, not because of any claims of any “disability” on our part.
“Consequently, there is no reason in principle why depression could not also cause the person to sleep poorly, eat poorly, feel guilty or suicidal, or experience psychomotor slowing.”
I never had any complaints of sleeping or eating poorly (but I did lose weight, via regular moderate exercise, upon the recommendation of an orthopedic surgeon, due to a “bad fix” on a broken bone). Nor did I ever have of feelings of guilt or suicidality. And the only “experience psychomotor slowing” I ever personally dealt with, was “brain zaps.” Which is a common adverse effect of being abruptly taken off of an ineffective supposed (but not approved for that purpose) “safe smoking cessation med,” an actual dangerous antidepressant.
“And importantly: none of these facts requires us to have a complete or even a partial understanding of the pathophysiology or etiopathology of depression itself.”
I disagree. Etiology actually matters, especially when it comes to societal greed only inspired medical crimes.
“when James Parkinson described a well-defined constellation of signs and symptoms he called ‘the shaking palsy,’ he had in fact identified a disease state that caused the patient’s signs and symptoms—and what would later become known as Parkinson disease.”
Well, this might be true, if the psychiatric industry had been honest about the fact their neuroleptics can create dyskinesia, which looks like Parkinson disease to the doctors … but the psychiatrists haven’t been honest about this, to a large extent, until recently.
“It would be absurd, on that basis, to say that Parkinson disease did not exist—or was not the cause of parkinsonian symptoms—until its etiopathology was discovered in the 1950s and 60s.”
What exactly do you claim to be the known “etiopathology” (etiologic) cause of Parkinson’s disease, since this article, which seems to have been published in 2018, says “The cause of PD is not known ….”
https://www.ncbi.nlm.nih.gov/books/NBK536722/
“This fact flatly contradicts the position that only conditions with known and identified pathophysiology count as bona fide diseases.”
Your claimed “fact,” to my knowledge, is not a “fact.” And I know from personal family history that a grandmother had to be quickly taken off of an inappropriately given neuroleptic, because it caused Parkinson like, dyskinesia.
Thankfully, appropriately taking my grandmother off an inappropriately given neuroleptic worked, and my psychic (not “psychotic”) grandmother, never again dealt with “Parkinson” symptoms, and lived a healthy life, to the ripe old age of 94.
“Finally, to be clear: in asserting that some psychiatric diagnoses can legitimately be said to be causative of symptoms, we are not claiming that psychiatric disorders arise solely from constitutional-biological factors.”
Well, that’s wrong, since that’s exactly what the non-medically trained psychologists, and psychiatrists who deny the common adverse and withdrawal effects of the psych drugs, have been doing for decades.
“Of course, we all wish that psychiatry were at the point of invoking level 2 causality in our diagnoses,” but that, too, is also untrue. Since that’s not in the iatrogenic illness creating psychiatrist’s financial best interest.
-
I doubt most psychiatrists would ever be willing to give up their diagnostic playacting. Why should they when it makes gaslighting the public a cinch?
-
Did I get that backwards??? How about this: I’ll bet there are few psychiatrists who’d ever willingly give up their diagnostic playacting. Why should they when it makes gaslighting the public a cinch?
-
-
Are the DSM panels who vote putative mental disorders into and out of existence totally unbiased observers and judges of what constitutes normal and dysfunctional cognition, emotion, and behavior? It’s my assumption that these panels are composed of affluent, western-educated, predominantly male practitioners or academics who, like all other human beings, are necessarily influenced by the mores and prejudices of the societies in which they live or from which they originate. If my assumption is correct, I think it would be logical to conclude that the DSM can be more properly regarded as a sociological document reflecting the views of a privileged caste (much as the notorious “Hammer of Witches” expressed the of the mindset of the medieval clergy, or Cesare Lombroso’s treatise in the 1890s on the supposed physical degeneracy of criminals set forth the views of Social Darwinist scientists and eugenicists ) rather than as a science-based description of real, universally recognized illnesses.
-
It’s nature verses culture.
“Why does you’re sward so drip with blood Arrow, and why so sad are thee?”
“I killed my hopes so good Mother, and had no more but these.”
“You’re hope’s blood was never so red, my dear son – I tell thee!”
“I killed in red rooms, on factory floors: they were so fair and free.”
“You’re dreams are old, you’re red rooms still – for what was it to be?”
“It was my father that I killed: and loss and woe is me.”
“What penance will you do for that, Arrow? Dear son, now tell me.”
“I’ll set my feet on yonder boat, and fall into the sea.”
“What will you do with your tower and pole? They are so fair to see”
“I’ll let them stand until they fall, for no more shall I be.”
“What will you leave to your babes and wife, Arrow, son tell me!”
“The world is cruel – let them beg for life, for never will I be.”
“What will you leave to your Mother dear: Arrow, please tell me!”
“The curse of hell you shall you bear for such council you give to me.”And in a little black book, with names and numbers, and hysteria coming out of my stereo, or something coming out of the stereo, I got a little black book, with names and numbers, with lips, and I swear, they never spoke. Something stung me with malaria. Got beat, got a beat, come on. You’re my Miss Washington DC. All I need is a little coffee.
-
Here’s my interpretation: the people who write the DSM are basically full of shit.
-
I read Pies and Ruffalo’s response. It is as nonsensical as I expected. They compare “schizophrenia” causing hallucinations to a volcano destroying Pompeii. Well hey, guys, a volcano is obviously THERE and concrete and erupts lava that can level a town. How is that in any way like “schizophrenia,” which cannot be seen, felt, or otherwise observed except by its purported effects? The analogy would be more like Pompeii was destroyed by a “City destroyer.” The proof is that the city was destroyed.
That trained academics engage in such childish arguments to defend an indefensible concept is beyond my comprehension!
-
Let the clowns posit all day. They can’t avoid the fact that their arguments are exceptionally self-serving, aka circular, that the only real value the DSM has is that it makes them feel important, and even safe(!), not unlike a child’s security blanket.
Anyway, I wouldn’t mind hearing blowhards like Pies, Ruffalo and Aftab try to explain how 5 different psychiatrists routinely come up with 5 different “valid” psychiatric “diagnoses” as these three truly are DSM bible thumpers to the core, “biopsychosocial” claims notwithstanding…
-
It comes as no surprise to me that Pies and Ruffalo resorted to patently absurd analogies to defend an “indefensible concept.” For the mental health field is essentially a mercenary, elitist cult that confers upon its members a status and level of authority (not to mention abundant financial windfalls resulting from their ties with pharmaceutical companies and ECT device manufacturers, speaking engagements, ghost-written articles in professional journals, etc.) that stroke their overblown egos. That “trained academics” often make use of sophistical arguments, if not outright cover-ups and lies, to legitimize their profession is nothing new in the history of science in general and psychiatry in particular.
I happen to be reading again, after a hiatus of many years, Dr. Jeffrey Masson’s seminal work (written in 1988) “Against Therapy: Psychological Tyranny and the Myth of Emotional Healing,” which is replete with examples of deceit, grandiosity, fraud, and incompetence on the part of many of those engaged in this shameful endeavor masquerading as a branch of medicine. -
…and ultimately there’s no denying the fact that psychiatry is essentially a shell game. I don’t care who you are.
-
-
The psychiatric inventors of the DSM I through V have never bothered to prove the scientific validity of this diagnostic manual. They did not try because they cannot do so.
The question of validity is quite simple: how can we be certain that a person who is diagnosed with “bipolar disorder” in fact has “bipolar disorder”? In order to make this assessment, we have to have some other way of determining bipolar disorder other than the diagnostic process itself.
But we do not. Despite psychiatrist’s repeated claims that “mental disorders” are either biological or hereditary, they have never proved that any mental disorder in fact has such causes. And therefore they have never developed any physical or genetic tests to detect any mental disorders.
So that is why critics say the claims for validity are circular (and worthless) since they refer back to the diagnostic process itself. There is simply nothing to compare the diagnosis with in order to test its validity.
So starting with the DSM-III in 1980 (and since), psychiatrists ignored the concept of validity and concentrated on the concept of “reliability” in particular, inter-rater reliability. They made claims for high reliability for diagnoses using the DSM.
As Kirk and Kutchins pointed out in “The Selling of DSM,” these claims were a myth from the beginning.
But even if there were high reliability, this would in no way prove the validity of the diagnoses.
We could develop criteria that a person is a witch if we can find three of five specific markings on their bodies. And if the criteria are specific enough, we may even have high inter-rater reliability.
But this would in no way prove that we have been making valid diagnoses of witches or that anyone we have so diagnosed is in fact a witch.
Neither scientific validity nor reliability are confusing concepts in medicine. They are only confusing concepts in psychiatry because it lacks a bona fide medical foundation because it is not diagnosing illnesses, but social and cultural differences. Or as Thomas Szasz called them “problems in living.”
-
Love this comment. The ‘witch criteria’ comparison to psychiatry’s rudimentary DSM checklists brings home the importance of actually thinking through psychiatry’s hollow claims of diagnostic validity. One would think reputable scientists would be embarrassed standing by something so blatantly subjective. But we are talking psychiatry here, which explains why some psychiatric “diseases” suddenly vanish into thin air while others pop out of nowhere!
-
-
Psychiatry wrote the book on gaslighting, the DSM specifically. And I would bet the majority of psychiatrists know deep down they aren’t medical doctors in the truest sense. Why else would their leaders go out of their way to defend such a fallacious document? Their collective refusal to accept reality is very telling indeed.
Here’s the lowdown: psychiatry’s repeated attempts to try and refute their use of circular logic in defense of their DSM is, well, circular, which leads critically thinking people to only one conclusion: psychiatry is more propaganda than science.