Showing 100 of 287 comments.
You are an articulate advocate for social justice; thank you for your community service.
This is a critically important topic that may be easier to understand in the reverse- through investigating nocebos. While placebos describe the affect of positive outcome expectations, nocebos describe the impact of negative outcome expectations. I believe that most suicides are caused by nocebos (including Matt Stevenson); negative outcome expectations are powerful.
I agree… but the value of science is that it is based on “scientific methodology” that is structured to reduce the confirmation bias; this includes the demand for transparency. I greatly appreciate this article for calling bullshit on what is currently passing for the scientific method in “mental health” care and for proposals to correct the pseudoscience.
Yeah, this is a great discussion about an important article; it deserves a bigger audience.
It seems basic to our humanity that physical health (especially nutrition) directly affects brain health and that “brain health” directly affects “mental health.” However, after basic physical needs are met, it is far more human to advocate that distressful experiences cause emotional suffering rather than maintain a singular focus on physical health (either nutrition or exercise) and ignore the social experiences of the disenfranchised.
Thank you for this article; these are startling statistics that deserve proper attention.
The fact that white American “mental health” is dramatically worse than others is a critical point for Psychiatry to address; why are they silent on this issue? Psychiatry proposes that “mental health” problems are medical (biological); why are white psychiatrists not primarily investigating (or apparently even concerned) about their own biological (or genetic) failings?
These statistics prove “mental health” problems are not biological (or support an extreme anti-white prejudice).
“These questions would heal. They would bring us back together with the truth…” is an extremely articulate description of causation for most “mental health” problems. Psychiatry is currently deemed a medical science and thereby advocates that “mental health” problems are medical problems rather than social problems; this obscures the truth and thereby worsens “mental health” problems.
Excellent list Steve; I believe you only missed improved nutrition (and avoiding toxins).
The UN Resolution on Human Rights (1948) addresses the right to a unique interpretation of one’s environment; this seems to cover “cognitive liberty” as a human rights issue. Psychiatry seeks complexity to obscure human rights violations; I believe that it is more in our interest to focus on UN human rights violations than invent a new concept.
Thank you for this articulate description of the harmful hoax of “mental disorders.”
Science has lost its way: anything can now pass. Parsimony is the most basic principle of science: fewer assumptions make better science. Hence, the most basic principle of the philosophy of science is falsifiablility: a science theory must identify its assumptions by explaining how to disprove itself. This “science” makes so many assumptions that it is pure philosophy; prestigious science journals now let any philosophy pass for science.
There is nothing biological about the current bio model; it is pure pseudoscience. The most fundamental principle of biology is biological reductionism (an organism is understandable through its physical mechanisms); biology cannot investigate a philosophy of “mind” by definition.
I believe that the biopsychosocial model is standard psychology (economic and political issues are included); my problem is with what passes for biology and neuroscience. Psychiatry’s neuroscience contradicts the most fundamental principle of every science that informs it (biology, physiology, natural science and general science); it also contradicts the most basic principle of the philosophy of science.
I consider emotional pain to be a natural response to painfully distressful experiences; I support drug therapy for emotional pain managed by general practitioners consistent with medical science guidelines for addressing physical pain.
Yes, I understand physicalism and materialism to be synonymous.
Thank you for your response and again for your community service. Perhaps it is me that is misunderstanding “labels;” somehow I understood you to consider yourself a “Critical Psychiatrist.” I understand Critical Psychiatry to criticize the practice of psychiatry but support its legitimacy in addressing “madness.” I am an “Antipsychiatrist” because I am more critical of the harm caused by the illegitimacy of psychiatry in addressing natural problems with living than the resulting harmful practices.
Thank you for all of your community service in support of the disenfranchised; however, not so much in this post. I contend that psychiatry is a (harmful) philosophy that masquerades as a medical science and that it is illogical to defend psychiatry (or any medical science) based on philosophy. Wittgenstein implicitly rejects psychiatry and other “real” medical sciences when challenging “physicalism” because physicalism is the foundation of medical science. You explain how the DSM categorizes social welfare problems, but thereafter you continue to assume that they are somehow medical problems anyway (the subject of psychiatry). It is difficult for cultural leaders to imagine the natural emotional suffering (pain) of the disenfranchised; they have different experiences. However, tagging social welfare problems as medical problems is staggeringly oppressive for the disenfranchised; it promotes suicide. “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive (C.S. Lewis).”
Well said… again.
This is a great tribute; Matt was an articulate defender of the disenfranchised and will be sorely missed.
“The question becomes why, if both mental ‘illnesses’ and physical illnesses are equivalent, only the ‘mental’ ones justify force.” Your answer (and Szasz’ answer) has a great deal of truth to it (psychiatry plays a major role of social control) but it is not the most understandable answer. “Mental illnesses” are believed to cause a lack of “normal, healthy” judgment; thus, society (led by psychiatry) protects patients (and society) from themselves. This is consistent with the “insanity” defense against criminal prosecution and how we portend to treat children. “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive (C.S. Lewis).”
Matt was an articulate voice defending the disenfranchised; he will be sorely missed by many.
Thank you for this blog; it is an excellent tribute.
Thank you for your in-depth scientific analysis; I always appreciate truth.
The power of placebos and especially nocebos is greatly underestimated/misunderstood.
Moreover, all studies shorter than 5-10 years are predicated on the assumption that depression is a disease. Otherwise, it would be assumed that any study shorter than 5 years would be unable to assess whether outcomes were due to the effects of the drugs or a reduction of depression. Light doses of morphine can outperform “antidepressants” during most trial periods but will worsen depression significantly over time.
This is an excellent article; “schizophrenia” cannot be genetic if you kill all “schizophrenics” in a population and the number doubles thereafter.
Well said; I always appreciate your comments.
I believe that the only way to undermine the DSM (psychiatry) without “running afoul of the worship of ‘medical science'” is to challenge its legitimacy as a medical science. A medical science is (by definition) a biological science and a biological science that addresses a philosophy of “mind” is pseudoscience by definition. I believe that our greatest allies are medical students who “bash” psychiatry as “not a real medical science;” they have credibility. Medical students will defend the integrity of medical science (before they become more vested in its defense); students are more reverent of the truth. I am planning to take my protest against psychiatry to the local medical school and protest near the student union.
Best wishes, Steve
And told by a “medical science” that his brain was malfunctioning.
It is shameful that the US abandoned the Geneva Conventions by supporting the “Nuremberg defense” with impunity for war crimes (Raul v. Rumsfeld).
Nothing has changed. “The emerging view is that the more overt psychotic symptoms of schizophrenia…often reflect underlying issues and conflicts in the lives of the sufferers. Most mental health experts today reject classical Freudian explanations for mental illness, such as repressed sexuality or a domineering mother or father.” I rarely defend Freud but a childhood environment of trauma (physical and sexual) remain the largest cause of “mental health” problems (if Freud’s “domineering” parents are today’s “abusive” parents).
It seems wrong to abstractly judge who has more of a right to suffer emotionally. Economic privilege certainly is of great value in a materialistic society but emotionally supportive parents seems like a greater privilege.
It seems unconscionable to put a positive spin on child abuse based on an unknown theory of adaptation.
I am cheering: congratulations on bringing some tiny bit of justice to those abused at Oak Ridge and others similarly treated; their “‘treatments” have now been “officially” explained as “torture!”
I am also cheering because all legal briefs used to support a legal challenge to solitary confinement as torture in prisons should be stronger legal support for a challenge to its use as coerced “therapy!”
Does the public have access to archive photos of the torture?
When I think about problems with psychiatric drugs, I think about someone in a fog from a heavy dose; when I think about anecdotal advocates for psychiatric drugs, I think about someone taking a light dose. It seems like a discussion about drug therapies should include information about dosages.
Thank you for forty years of community service and the formation of the Coalition against Psychiatric Assault.
This is a great article in introducing significant problems caused by different definitions of “antipsychiatry.” I understand “antipsychiatry” to have two meanings; the first is related to being “against” the field of psychiatry (as lacking legitimacy as a medical science) and the second is being “against” the practice of psychiatry (for coercion and pushing drugs). Unfortunately, linguistics is about usage (and the power to define usage) and the power currently seems in the hands of reformists; Dictionary.com defines “antipsychiatry” as “an approach to mental disorders that makes use of concepts derived from existentialism, psychoanalysis, and sociological theory.” I advocate against the legitimacy of psychiatry as a medical science and will continue to use “antipsychiatry” to connote abolition rather than reform.
I have followed your work and wanted to join the Coalition against Psychiatric Assault because the organization’s name is the most articulate (and I agree with the website). However, while you contend that CAPA is open to everyone who advocates abolishing psychiatry, the guidelines (being voted into the group after attending two meetings) restrict most abolitionists.
The research categories are vague (and rely on subjective interpretation) and it is impossible to isolate the variables; it is troubling to see such pseudoscience pass for research.
I agree with your original comment; I do not accept the term “mad” to describe my mental distress. The first definition of “mad” at Dictionary.com is “mentally disturbed; deranged; insane; demented;” none of this describes my natural reaction to traumatic injustice.
However, I did review the MindFreedom manifesto and believe that it needs revising. It does not clearly state that the medical model is a false narrative and it is too long (and redundant).
You are an articulate advocate for the disenfranchised; you deserve admiration for your community service. It is extremely valuable to “bear witness” to the cruelty of our current “mental health care” system and comforting the disenfranchised. Your story is an inspiration.
“So little compassion, understanding and humanity. When and how is the system going to change?” I contend that the system will change with the advocacy of thousands of people working independently to create a critical mass that de-legitimizes psychiatry and its medical model. I believe that your writing supports a “social welfare model” of mental distress- a natural response to social injustice (I blogged about the “social welfare model” here at MIA on 1/17/17). Consistently, “delusional thinking” is “a protective coping strategy which has been helpful and adaptive for this patient.”
Understanding natural emotions is difficult in our cultures. I had no idea emotions were physical until the warm energy that motivated my happy youth slowly turned to a nondescript aversion after experiencing extreme traumatic injustice. The mental aversion of extremely distressful experiences is naturally painful; emotional suffering is not a disease.
PS- A single caveat: psychiatry only purports “biological reductionism.” Psychiatry lacks any scientific validity; its “biological reductionism” is pure pseudoscience and any reference to psychiatry should be placed in quotes.
Thank you for this article; “forgotten knowledge” is a problem in psychology/psychiatry. I consider dream interpretation (based on simile and metaphor) to be an extremely valuable tool in retrieving memories of extremely traumatic injustices that are typically too painful for recall. I consider it extremely important to “mental health” to recall traumatic injustices in order to neutralize and counter them. I believe that the value of dream interpretation is forgotten knowledge because it is part of Freudian theory that is no longer accepted. It is also forgotten knowledge because the “false memory syndrome” fad of the nineties damaged the credibility of dream interpretation.
Thank you for your community service. I believe that mental distress is a social welfare problem rather than a medical problem; a medical (biological) science that addresses a social “philosophy of mind” is fundamentally pseudoscience. Pathologizing natural emotional suffering worsens outcomes; counselors and social workers should lead “mental health” care with family physicians prescribing drugs (that address the emotional pain and sleep problems caused by emotional suffering). Psychiatry only makes sense if mental distress is a medical problem; psychiatry is THE problem if mental distress is not a medical (biological) problem.
Thank you for your community service and this eloquent, engaging, insightful essay.
However, I believe that you are creating a false dichotomy when juxtaposing “accepting responsibility for overcoming distress” against “identifying as having a biological, chemical brain disease.” I believe that accepting responsibility for personal “mental health care” is critical but that is not the same as taking responsibility for traumatic injustices. The disenfranchised are rarely responsible for the “life circumstances” that cause emotional suffering- mental distress; emotional suffering is not a brain disease (psychiatry has no scientific validity). I agree with Thomas Szasz who advocated that “mental illness” is a tool used to subjugate the disenfranchised (blaming the victims of cultural abuse).
Thank you for promoting civil dialogue among critics of “mental health care” and forty years of service to the community. While I agree that deep polarization is harming our country, I respectfully disagree with a basic assumption of your article. Although you describe most critics on the “other side” of DJ Jaffe’s world, a large number of critics have a more fundamental, theoretical criticism of psychiatry. Many critics contend that psychiatry addresses social welfare problems and thus lacks any validity as a medical science. They contend that it significantly harms community “mental health” to treat the social welfare problems of the disenfranchised (“problems with living”) as if addressing diseases. More to the point, many critics contend that the legitimacy of psychiatry and its concept of “mental illness” is the main problem with “mental health care.”
Well said… except I believe that you omitted that educated women (people) often struggle to understand the perspective of uneducated women (who are far more likely to be victims of sexual assault than college colleagues).
I agree with Steve.
I understand appreciating “critical psychiatry” for providing most of the academic support for abolishing psychiatry; however, our goals are radically different. The “tenets of psychiatry are faulty… (anti-psychiatrists) see reform as having a tendency, irrespective of intent, to reinforce the status quo (Burstow, MIA, 10/26/2014).”
A slash is punctuation used to identify “non-contrasting terms.” Anti-psychiatry and critical psychiatry may be non-contrasting terms under specific circumstances: “anti-psychiatry/critical psychiatry” believe that psychiatrists over-prescribe drugs.” However, anti-psychiatry and critical psychiatry are philosophically contrasting terms that should not be combined.
Congratulations; your scholarship is quite a feat and quite a legacy!
However, I do not understand one concluding remark: “May they help us slowly but surely turn antipsychiatry/critical psychiatry into an accepted form of knowledge.” I do not understand including “critical psychiatry;” I thought you made a strong case for anti-psychiatry (an abolitionist movement) and understand “critical psychiatry” to be a reformist movement. I do not understand how to reform psychiatry (a “medical science”) from pathologizing natural emotional suffering (seeking medical legitimacy).
Best wishes, Steve Spiegel
Thank you for your community service in challenging NAMI corruption; however, I disagree with you, Frank and Oldhead about making NAMI a focus of criticism. Our society holds medical science in highest esteem; it seems ill-advised to focus criticism of mainstream “mental health” care at NAMI for advocating support for medical science (and their “medicines”).
I contend that the harm caused by mainstream “mental health care” can be directly attributed to legitimized pseudoscience: psychiatry accepted as a legitimate medical science. Medical schools are having problems with students who “bash psychiatry as not real medical science;” these students are our greatest allies. Medical schools legitimizing psychiatry is our greatest and weakest enemy since they pride themselves on real science.
Thank you for your community service; your work has insured you a prestigious place in history!
However, I respectfully disagree with one premise. In 1980, psychiatry abandoned Freudian Theory and lumped neuroses (problems with living) together with their established “diseases” (psychoses); thus, psychiatry “doubled-down” on the “disease model” rather than “adopted” it. Addressing neuroses (social welfare problems) hurt psychiatry’s legitimacy as a medical science so they redefined them as psychoses- medical problems (and abandoned Freudian Theory). Psychiatry has always been based on the “disease model” since it considers itself a medical science.
Your recommendation is a good one; challenge medical students on the legitimacy of their science (or their field). I advocate that mental distress is a social welfare problem and that “First, do no harm” is impossible when believing that natural human suffering from traumatic injustices (or physical problems) is a disease.
Thank you for allowing me to comment on your article and your work in challenging the harm of long-term drug “therapy.”
Well said Steve; the current mental health system’s focus on mythical diseases rather than traumatic injustices is the largest obstacle to suicide prevention.
Psychology’s neuroscience is pure pseudoscience; it contradicts the most basic principle of every science that informs it. Psychology’s neuroscience contradicts the most fundamental tenet of biology, physiology, natural science and general science theory; it also contradicts the most fundamental principle of the philosophy of science.
Psychology’s neuroscience uses neuroscience research to support the status quo, but the foundation of the research is all pseudoscience. Thereafter, they are comfortable describing how addictive drugs can “capture the individual’s motivation system” but cannot explain what the hell it means to “capture” a motivation system?
Autism: The Anatomy of an Epidemic!!! The autism rate has increased from 3 per 10,000 in 1970 to 150-220 per 10,000 today (depending on the government study). The statistics are staggering and deserve a book of their own!!!
I do not understand why the most obvious answer is never considered: atrophy of nervous tissue causes brain shrinkage in “diagnosed people” from depression and especially from sedation reducing brain activity.
“One fundamental mistake I believe is repeatedly made today when it comes to working with those who feel disenfranchised, marginalized, discounted, or discriminated against is believing that the opposite response must be the best response.”
This sentence clearly states the problem. Those “who feel disenfranchised” are at the bottom of a social pecking order of emotional abuse; their “unusual beliefs and behaviors” generally reflect the emotional pain. The “opposite response” is by far “the best response:” emotional support is the best response to traumatic injustice (and behaviors that reflect emotional suffering). It is difficult to empathize with emotional suffering without experiencing true misfortune; emotional suffering is not a disease. Believing emotional suffering to be unnatural leads counselors to discount the distress caused by traumatic injustice and to exaggerate their ability to solve a client’s distressful life circumstances. If a child writes a parent a note “I hate miself,” the parent should not be thinking that their child has a spelling problem.
The video seems to (correctly) imply that the DSM is a Cultural Moral Code rather than exclusively an Atheist Moral Code.
This article clarifies what confuses me about popular criticism of psychology at this website. I am an anti-psychiatrist because psychiatry is pseudoscience; it has no legitimate (scientific) connection to neuroscience and biology (biological reductionism). In contrast, the author (and most psychology critics) wrongly assumes that psychiatry represents a biological reductionism perspective. Critics understand that psychiatry is without scientific support but they seem fearful that real neuroscience might eventually support psychiatry instead of assuming that real neuroscience will prove psychiatry wrong!
I said repeatedly that physical health directly affects “mental health,” and that prior to understanding the basics of nutrition, nutritional deficiencies were the main source of “mental health” problems. What is trite is arguing that nutritional deficiencies that were understood centuries ago could still be the main source of “mental health” problems. You are suggesting that psychiatry should morph into gastroenterology without support from gastroenterologists.
I clearly state that nutrition greatly influences “mental health” in the first sentence and assume that it was the predominate influence circa Hippocrates. However, today in the US, socially distressful experiences are the predominate cause of mental distress. What I said was illogical is replacing the old medical model (of mystery diseases) with a new one based on dietary problems. Consistently, a new medical model paradigm of dietary problems continues to advocate that injustice and socially distressful experiences do not affect “mental health.”
I advocate a free, unified alternative therapies program that includes Nutritional Therapy because better nutrition (better physical health) promotes better “mental health” (UnifiedAlternatives.org). However, claiming that mental distress is caused by nutritional deficiencies and solved by improved nutrition is advocating a new “medical model” that seems illogical for numerous reasons.
It seems illogical to consider whether a medical profession can change itself into a non-medical profession; psychiatrists are heavily vested in the medical model. Psychiatrists like Joanna Moncrleff and Sandra Steingard may understand much of the harm caused by drugging mental distress but cannot imagine mental distress as natural emotional suffering.
I also believe that John Read has done valuable work but I criticize his questioning whether we are should “soften our criticism of psychiatry” to reach more psychiatrists. Psychiatry is a medical science causing great harm to the community by leading the treatment of human suffering as a medical problem; psychiatry is a medical perspective of human suffering. Softening criticism of psychiatry affords them some level of credibility in addressing human suffering; this is counter-productive. All of the harm caused by psychiatry is founded on the erroneous assumption that mental distress is a medical problem that often alludes self-awareness.
This statement is completely true: “The terminology of psychiatry’s disease model permeates what are actually severe problems in living.” In contrast, I consider the ISPS use of the term “psychotic mental disorder” to describe mental distress in terminology of psychiatry. ISPS implies that “mental disorders” are medical problems that are better addressed through non-medical therapies (social welfare therapies). Consistently, John Read advocates this position when considering whether to work with psychiatry.
It is harmful to the “mental health” of the community to treat “problems with living” as medical problems; consistently, it is wrong to give psychiatry (a medical profession) any credibility in addressing “psychosis.”
What I believe:
“Depression and anxiety may be familiar to all of us to some degree, but … I think that true psychotic experiences are rare” “True psychotic experiences are rare” because the extreme distressfulness of the experiences that produce “psychotic experiences” are rare.
“Therefore I do not think it makes sense to suggest that psychosis is on a continuum with normal experience.” “True psychotic experiences are rare” on a bell-curve that plots the distressfulness of experiences (of distressful life circumstances); they are the extreme end of “a continuum with normal experience.”
“What attracted me to psychiatry … is the intuition that mental disorder has something profound to teach us about the nature of being human.” Good intuition on your part; mental distress teaches us that emotions are feelings that are understood physically rather than intellectually. Extreme mental distress teaches us that the brain has a natural aversion to distressful experiences. Natural emotional suffering from extremely distressful experiences is experienced by the brain as averse- similarly to extreme physical pain (except it does not subside like physical pain). Mental distress is human nature; human aversion to mental distress naturally motivates behavior to avoid distressful experiences. The problem arises when the brain cannot find a behavior to relieve the distress; “fight or flight” will not solve most modern distressful experiences.
“And it does this not by reflecting brain abnormalities, but by consisting of extreme, bizarre, usually dysfunctional and sometimes unfathomable manifestations of human agency.” I would have totally agreed with this sentence until I experienced a reversal of fortune in early adulthood; thereafter, I found my “bizarre” and often “dysfunctional” behavior to completely understandable. The commanding emotional pain of psychosis is analogous to extreme physical pain that does not subside; if you want to understand psychosis, submit to physical torture for a couple months.
When a person lives “on top of the stack” (as I did during my youth), it is hard to imagine what life feels like “at the bottom of the pecking order” (as I did for a couple decades).
This would be great news if mental distress is a disease that cures itself without intervention and only gets worse when the natural emotions being expressed are heavily drugged for extended periods.
The real Open Dialogue is successful because it tries to assist people in solving real “problems with living” within the context of a clients life (at their home with their family/roommates). The real Open Dialogue tries not to pull people out of their lives and put them in an institution and expect their lives to be better when they return home (as if a disease is cured).
This spinoff and others in the US seem doomed to failure for three reasons: 1) clients can rarely solve their real “problems with living” while believing that they are medical problems, 2) clients can rarely solve their real “problems with living” while isolated in a mental institution, and 3) the treatments are expensive and opposed by most psychiatrists.
This spinoff and others in the US miss the central characteristic of the real Open Dialogue that makes it successful; extreme mental distress is natural emotional suffering rather than a medical problem.
I meant daily physical assaults of a control group; they currently allow daily physical assaults of patients in their “care.”
Thankfully, ethics panels prohibit the academic investigation of whether daily assaults promote anxiety.
It seems like you two should put quotes around your usage of the term “communism” if your definition is so idealistic that no examples exist.
I believe that the practice of psychotherapy is valuable (substantially underrated) but that its context as addressing medical (psychiatric) problems causes more harm than it can solve.
Thank you for your community service in challenging mainstream “mental health care.”
“Such a paradigm needs to explain human struggle and how and why suffering occurs. It requires an appropriate treatment approach that heals pain and shows why and how it works;” I propose a “Social Welfare Model” to replace the “Medical Model.” The “Social Welfare Model” describes mental distress as natural emotional suffering from distressful experiences and from physical ailments, rather than a medical problem of a biological dysfunction. This model describes emotions as understandable physically rather than intellectually. Extreme emotional suffering (from extremely distressful experiences) is perceived by the brain similar to extreme physical pain.
The theory of a “The play of consciousness in the theater of the brain” describes an intellectual understanding of emotions. Instead, we physically feel the joy of a happy surprise and physically feel the pain of extremely distressful experiences.
Emotional suffering is the natural, painful reaction to distressful experiences; it is natural, “normal” psychology- natural neurobiology. Most “psychiatric symptoms” misinterpret natural expressions of emotional suffering as a medical problem; psychiatry is a medical science addressing social welfare problems. This misinterpretation of natural psychology causes great social harm.
There is no treatment for natural emotional suffering beyond time and positive experiences of emotional well-being. In contrast, there is a great deal we can do to prevent trauma in the community by promoting more social justice.
Same old BS from psychiatry: label people “‘pathological’ worriers” with only support from a strong affirmation bias and without any biological support. Same old BS from psychiatry: assume that unusual worrying is a medical problem instead of natural emotional suffering from (natural) fear of repetitive (unresolved) distressful experiences (a social welfare problem).
Certainly the desire to avoid painfully “gloomy, pessimistic thoughts” can motivate a hyperactive drive for relief. Promoting experiences of emotional well-being is therapeutic; drugging natural emotions hardly seems therapeutic.
The more fundamental question is about whether there is a relationship between “mental distress” and “enlarged ventricles” and the implications thereof. I understand the skull to contain the brain and ventricles (air pockets for cushioning against impact). To say that someone has “enlarged ventricles” seems like a funny way of saying that a person has “decreased brain volume.” Decreased brain volume seems like a logical result of depression. Depressing experiences cause depression- emotionally painful hopelessness; hopelessness causes a radical reduction of thinking and behavior. Physiologists contend that “use it or loose it” is the motto for every body tissue; long-term depression causes nervous tissue atrophy- a natural “decrease of brain volume.”
“Enlarged ventricles” can be explained with elemental physiology; it is unfortunate that psychiatry’s neuroscience ignores basic physiology theory while trying to explain their erroneous medical narrative.
Correction: search for “DSM & Medical Model” at Vimeo website.
Correction: sixty years ago.
The distressful experiences of First Nations are staggering; they cannot watch a world series without witnessing unequaled racist caricatures of themselves. The Cleveland Indians mascot (“Chief Wahoo”) is a vulgarity that has no equal since they removed “Little Black Sambo” from my grade school classroom fifty years ago.
I did not intend the video to imply the the “medical model” began with the DSM-III; it began when it replaced the “religious model” (demonic possession) in describing extreme emotional suffering. In the video, I describe the first two editions of the DSM as based on Freudian theory; Freud describes psychoses as medical problems. The DSM-III moved from Freudian theory that described most of the DSM-II categories as problems with living (neuroses) to a biological interpretation of all categories.
Thank you for your comments; I will edit my video to clarify that the DSM-III doubled-down on the “medical model” by claiming that all DSM categories were thereinafter diseases rather than only psychoses.
I did not understand the term “biological psychiatry” to specifically refer to the difference between the psychiatry of the DSM-III and the psychiatry of the DSM-II. The term is confusing because it is redundant; I consider all psychiatrists to be biological psychiatrists since psychiatry claims to be a biological (medical) science.
Yes, the murky, cloudy, swirling image was intended to reflect the increased complexity of the DSM-IV-TR from adding multiple axes (perspectives) while adding nothing of value.
Efforts to promote more justice for children in distressful circumstances is admirable (albeit difficult); thank you for your community service.
The video is posted on Vimeo- a free video dissemination website competitor of YouTube. I assume that the access for TV viewing is similar to YouTube (simply go to their website and search for “DSM&MedicalModel”). However, I also assume that the video can be accessed for TV viewing from the MIA website. I posted my video at the Vimeo website so I could periodically edit it for clarity without revised versions competing with the latest version (as would be the case on YouTube).
I use the term “medical model” exactly as Szasz does- as a “portrayal of problems in living, of thought, behavior and emotion, as medical diseases.” I intend “social welfare” problems to describe “problems in living.”
“Mental illness” is a metaphor better understood as an oxymoron; a philosophy of mind cannot have a medical (biological) illness. Nevertheless, some “problems in living” cause extreme emotional pain that is frequently considered a disease based on the predominate paradigm. Extreme emotional suffering is distressful to witness; most people believe that life is generally cheerful and cannot imagine the emotional suffering of the disenfranchised. The social welfare narrative advocates that extreme emotional suffering is a natural response to extremely distressful experiences. I agree that “mental health” is another metaphor (oxymoron), but I believe that it is a necessary term for communicating about emotional well-being and emotional suffering.
I use the term “medical model” differently than the definitions identified by Graham. I contend that the APA uses a “medical model” to explain behaviors described in the DSM that were previously explained with a “religious model” and are better explained with a “social welfare model.” The “medical model” began when it replaced the “religious model.” Later, Freudian theory dominated the “medical model” until the DSM-III; it described a few medical problems of “psychoses” and numerous social welfare problems of “neuroses.” Psychiatry was losing public legitimacy as a medical science addressing social welfare problems and the non-existent boundaries dividing the two. Psychiatry was forced to either abandon oversight of neuroses (the majority of diagnoses) or double-down on the “medical model” and claim that neuroses were thereinafter medical problems rather than social welfare problems.
I use the term “medical model” to describe the DSM disease narrative of behaviors that I describe as natural with a “social welfare narrative.” The definitions Graham identifies all assume the disease narrative (paradigm) and use the term in a variety of other ways.
The images were obviously intended to add impact rather than confuse; do you remember which image seemed inconsistent with the message?
I have ambivalent feelings about Freud; I admire some of his ideas far more than most others while detesting other ideas of his. My point about Freud was that the DSM was founded on his theories and then abandoned by committee vote for a foundation with more popular support; this is not science.
Concerning my tone, I consider myself a scientist and have always tried to write with a (cold) scientific tone while targeting academics and professionals; this is my first effort to write for a public audience. I wanted an exasperated tone at the punch lines to express the calamity of the situation. I wanted to give voice to the pain caused by considering natural emotional suffering and other natural behaviors to be diseases. However, I wanted to sound exasperated rather than angry; I will reconsider my tone.
Thank you, Steve
I do not agree with your characterization of our conversation. I understood you to say that the social ills of psychiatry can only be solved by focusing on challenging capitalism and I advocated that psychiatry will collapse under the weight of its pseudoscience and human rights abuses. I believe that it will be death by a thousand blows with medical students contributing to the critical mass. I thought that Bonnie Burstow’s New Year’s Eve Resolutions blog (December 28) offered a lot of options for people to consider a comfortable way to contribute. I believe that this website and the bloggers and commenters at this website contribute with a valuable, expanding dialogue.
One must be careful when joking about psychiatry because their “truth can be stranger than fiction!” Mainstream psychiatry has already claimed that “new neuro-imaging breakthroughs have been made that allow the diagnosis of ADHD to be precisely made via having children wear brain-wave measuring helmets.” Evidently, you have not heard of the renown psychiatrist, Dr. Daniel Amen.
Dr. Amen was the darling of public television a decade ago for famously claiming exactly what you joke about! Wikipedia introduces Dr. Amen as follows: Daniel Gregory Amen (born 1954) is an American psychiatrist, a brain disorder specialist, director of the Amen Clinics, and a ten-times New York Times bestselling author. Amen’s clinics offer medical services to people who have attention deficit hyperactivity disorder (ADHD) and other disorders. They use single photon emission computed tomography (SPECT) as a purported diagnostic tool to identify supposed sub-categories of these disorders, as devised by Amen.”
This was all the rage a decade ago, but has waned from criticism; however, Dr. Amen is still getting rich pushing this BS because it is such logical support for psychiatry… IF IT WAS TRUE!
PS- Comments to a previous post: the APA introduced “clinically significant criteria” for their diagnoses (starting with the DSM-IV). With this simple phrase, the APA states that only clinicians can understand their diagnostic criteria, and properly use their manual. Hence, the APA cleverly discounts criticism of the DSM based on the lack proper insight by non-clinicians. Also, I am unable to offer IT advice about videotaping because I am completely dependent on assistance.
I describe social problems that cause a community harm; political problems do not cause all of the social ills in a community. Any community benefits from eliminating the disease narrative of emotional suffering regardless of their political system. Every political system is plagued by class privilege that is supported by the disease narrative of natural emotional suffering. Obviously, some political systems promote far more social justice than others but I do not want to highjack my social commentary with a political discussion.
I believe that the most fundamental contradiction of psychiatry is that it is a medical science addressing a social welfare problem.
My “social welfare” paradigm is not a “social welfare system” paradigm. Social welfare (emotional well-being) is promoted by comforting, affirming experiences of social justice (and physical health); conversely, social welfare (emotional well-being) is reduced by distressful experiences of social injustice (and poor physical health). A community promotes social welfare primarily through social justice and harms social welfare primarily through social injustices.
I intended to include behaviors that distress others when describing behaviors that the APA considers “anti-social.” Certainly, psychiatry can induce distress where there was none.
Public assistance is difficult; it is easier to reduce the need for public assistance through more social justice. It is harmful to community “mental health” for eight people to be as wealthy as half the world’s population. This obscenity developed through politics as usual but things can always change. Thank you for your comments.
The medical model (disease model) started when secularists gained control of the narrative about “anti-social” behaviors away from theologians. However, I used the term “medical model” to refer to the DSM-III changing the definition of “neuroses” (most “mental disorders”) from social welfare problems to medical problems. I would consider other terms for the model but I have a problem with the term “biomedical” because it reminds me of the term “biological psychiatry.” The term “biological psychiatry” creates confusion with its redundancy; medical sciences consider themselves to be based on biology. “Biological psychiatry” is used to criticize some psychiatrists as misusing biology while wrongly implying that other psychiatrists are properly using biology- the foundation of their legitimacy as a medical science.
I agree with your analysis of the term “mental illness” but believe that focusing on the absurdity of the term obscures a more important issue. The term describes a widely accepted philosophy advanced by the APA that considers natural emotional suffering to be a disease.
Excellent point; thank you for reiterating it! It is a glaring omission to fail to reference leading critics of mainstream mental health care for further reading at the conclusion of the video. I will seek your advice for a reference page before re-editing.
My comment below was intended to affirm the neuroplasticity of the brain responding to personal experiences that include “mindfulness.” However, trying to think differently about personal injustices has little therapeutic value compared to confronting or countering the injustices.
The video does not address mental health care within a social welfare narrative, but it is a critically important subject that you understand something about.
Thank you for your valuable comments; I will consider them while re-editing the video.
I believe that much your criticisms express a desire for a more academic overview of mainstream mental health care rather than one targeting the general public. I did not believe that I could communicate an overview of criticism of mainstream mental health care in a half hour video (a public information format) with constant interruptions for references. I believe that my video rings true with much of the public, especially those who have experienced mental distress.
Academics and professions also need an overview of the criticisms of their profession; this is an important point that cannot be done in a half hour video (and should probably include more collaboration).
Thank you for your comments. It is hard to imagine mental abuse worse than “gaslighting”- the unfortunate outcome of the medical model of mental distress.
Also, it never occurred to me that “real” medical sciences could benefit from (be vested in) psychiatry creating ambiguity around iatrogenesis.
I do not know about the intent of the DSM but I totally agree that it is unfortunately the primary source for defaming, torturing and silencing the victims of child abuse.
Thank you for your feedback; few things hurt credibility more than misspelled words.
Also, thank you for the warning about my use of the term “everyone” in the video; perhaps I need to clarify my usage. I roughly said that “’everyone’ is afraid of coercive drugging, coercive ECT’s, and coercive confinement in a mental institution” and I meant it. You misquoted me as saying that “everyone” dislikes “seeing a person forced” into some coercive therapies and that is a much different statement that is obviously not true.
You make a good point; describing mental distress as “emotional suffering (or ‘anti-social’ reactions to the suffering)” is not as clear as “’anti-social’ expressions of natural emotional suffering or ‘anti-social’ reactions to it).”
Your second point is problematic; you describe emotional suffering caused by societal problems as a missing point while I thought that it was a main point. I describe mental distress as natural emotional suffering from distressful experiences; societal problems top the list of causation for distressful experiences in a community.
The power of psychiatry lies with its false claim of biological reductionism. It is problematic to imply that psychiatry is biologically reductive since hard science will always be respected by the community more than soft science.
Dr. Well advocates the standard position of psychiatry (albeit erroneous and harmful); it seems unfair to Dr. Wood to challenge Dr. Well directly after a personal reference.
The author describes his own addiction as a “compulsion;” I consider “compulsion” to be a habit and the most accurate term for “addiction.”
Your original narrative sought drugs that could erase natural emotional suffering from unusually distressful experiences as if it were a disease. Your emerging narrative of “recovery” continues to advocate that mental distress is a medical problem (biological dysfunction) while improving care through efforts to increase the social welfare of clients. I consider mental distress to express natural emotional suffering from distressful experiences (or “anti-social” reactions to the suffering) – a social welfare problem rather than a medical problem. Social welfare problems can be caused by physical issues like poor nourishment, fatigue and toxins but most emotional suffering is caused by unusually distressful experiences. Treating “disruptive” expressions of natural emotional pain from extremely distressful experiences as a disease promotes coercion that increases emotional suffering- worsens mental distress.
Psychiatry’s power lies with their claim of biological support for their medical model narrative; thank you for clearly deconstructing their pseudoscience.
This is an important statistic; can you site it?
Also, there are no holes in “Anatomy of an Epidemic;” it is pure science. Dr. Pies and Allen Frances attacked the book (in their own defense); their criticisms were weak and obscure.
I consider the original post to be sound science describing the general problem of early death caused by therapy for mental distress based on drugs and ECT. But moving from a general population to a specific example is typically problematic; as critics have argued, speculating about the cause of Carrie Fisher’s death is merely speculation.
The critical issue about psychiatric drug therapy is whether the drugs are medicines treating biological dysfunctions or drugs masking symptoms of natural emotional suffering (or problematic behaviors). Since I consider mental distress to be a direct function of distressful experiences, I consider drug therapy generally problematic. Physical fatigue, reduced mental acuity, and problematic side-effects from drug therapy are obstacles to solving the real life problems that cause mental distress.
There is no hard science to support the popular contention that mental distress expresses a biological dysfunction. The DSM categorizes behaviors it considers “anti-social” and thereafter tags them as medical problems rather than social problems without any biological (medical) support. The elitists of the APA have never experienced the distressfulness of the experiences of the disenfranchised; they cannot imagine their natural emotional pain. Moreover, they are heavily vested in a medical perspective of emotional suffering.
I meant a medical field needing reform consistent with the Wikipedia definition of “anti-psychiatry” and consistent with most of the bloggers at this website. Only a minority of “anti-psychiatrists” believe that “mental illness” is a myth.