Thursday, June 27, 2019

Comments by Philip Hickey, PhD

Showing 100 of 254 comments. Show all.

  • Rosalee,

    I think that’s a good answer. At present, psychiatry has a stifling effect on these kinds of creative ideas. Psychiatry says: Send them to us – we’ll take care of them. And society shrugs, and says OK. Take psychiatry out of the picture, and we’ll find that there are other non-medical ways to help people.

  • Oldhead,

    “So has society lost its ability to recognize false logic, or are people too intimidated to reveal their inner suspicions when they pick up on any of the disingenuous contradictions permeating such thoroughly mediocre propaganda?”

    That’s a great question. How can they continue to get away with this drivel? My hope (belief?) is that as more and more people join the ranks of anti-psychiatry, we’ll reach a sort of critical mass that will be hard for psychiatrists to ignore.

    Of course, they’re already positioning themselves for this. Remember the great psychiatrist Ronald Pies, MD, asserting that psychiatry never really promoted the chemical imbalance theory! And currently Allen Frances is busy pushing the fairy tale that it was not psychiatry that was doing all the damage, but rather the mean ol’ GPs, and of course, pharma.

  • astrong,

    Sorry to learn of your tardive dyskinesia. Interestingly, virtually every member of the general public with whom I’ve discussed this has expressed the belief that the tardive dyskinesia and the akathisia are “symptoms of the illness”. When I explain that they’re adverse effects of the drugs, the response is invariably one of utter disbelief. But psychiatry has done nothing to dispel this misperception.

  • Neil,

    I don’t think any reasonable person would interpret my contention that psychiatry is a hoax as implying that every single psychiatrist is complicit in that hoax.

    This string began when you questioned/challenged my characterization of psychiatry as a hoax. I responded to this by pointing out the twin deceptions that the vast majority of psychiatrists promote: that depression, and a wide array of other human problems, are caused by neuropathology; and that psychiatric drugs remedy this pathology. The onus, I suggest, was on you at that point to come back with some facts, references, or evidence to the contrary, or at least, a cogent argument.

    But in your response, you completely ignored the deception/hoax issue, and instead launched several groundless ad hominem attacks at me.

    I responded to each of these attacks, and pointed out that you seemed more interested in scoring points than in substantive debate.

    Now you’re back asking me what evidence I have for my accusations of deception. But you’re missing the point. The statements concerned are false. So when psychiatrists promote these statements, they either don’t realize that they’re false (in which case, they’re not too bright), or they are being deceptive. As I don’t consider psychiatrists as a group to be particularly obtuse, the deception conclusion is inevitable. If you wish to read more on my position on this matter, please see my post Psychiatry DID Promote the Chemical Imbalance Theory

    You say that I “foreground drugs”, which I assume means emphasize. This is untrue. I respect the rights of each individual to ingest whatever he or she chooses. What I challenge, and emphatically condemn, is the fact that psychiatry uses blatant deception to induce people to take these drugs. They tell people, who present no indications or evidence of neurological illness, that they have such an illness, and that the drugs are necessary to remedy this disorder.

    You have throughout this string failed to address the matter of the twin deceptions, and have consistently avoided substantive debate. But in your response to Phoenix, you “question” whether I really want to have a substantive debate or merely want to “vent a longstanding grudge”. The implication being that my critiques of psychiatry stem, not from any objective assessment of its activities or perspectives, but rather from some personal vituperation of my own. Is it possible that you imagine that this kind of petty retorting constitutes substantive debate? Is it possible that you consider these gratuitous, deprecative attacks as having some value?

    If you wish to discuss/debate the hoax issue, or indeed any issue on which I have written, then by all means come back. If your comments are pertinent and objective, I will respond. But if you persist in these vacuous and groundless attacks, I will not respond.

  • Oldhead,

    I agree entirely that we should maintain an actively adversarial stance to psychiatry. Psychiatry is not going to “see the light” and abandon their destructive, disempowering, and stigmatizing activities. Nor will they abandon their spurious concepts, because their very existence as “medical practitioners” depends on these concepts.

    We need to maintain and support the critiquing of psychiatry as vigorously, and on as many fronts, as possible.

  • Neil,

    The essence of my response to you (above) was that psychiatry has been actively promoting two enormous deceptions for decades. If you are disputing this, then please send me references to support the illness assertions or the curative assertions concerning the drugs. I would be happy to take a look, and, as I’ve said many times in my posts, if the evidence disproves my position, I will promptly apologize for my errors. In the absence of such proof, or even a convincing argument, however, what kind of “moderation” are you expecting? A destructive, disempowering hoax is a destructive, disempowering hoax.

    To the best of my knowledge, there is nothing in my writings that could even remotely be described as Utopian. If you have seen something of that sort, I would be grateful if you could draw it to my attention.

    With regards to the assertions that I do, in fact, make, they are eminently testable against reality. For instance, if it were demonstrated that all the individuals whom psychiatry identifies as “having major depression” were found to have a particular neurological pathology in a part of the brain associated with emotions, then my assertion fails, or at the very least is in serious trouble. To date, despite decades of lavishly-funded and highly motivated research, no such findings are to hand.

    You assert that I seem to lack sympathy for people who have been damaged by psychiatry. How you can interpret any of my writings in that light is beyond my comprehension. I have enormous sympathy toward the people who have been damaged (some, very severely) by psychiatry. Indeed, my primary motivation in writing these posts, which I’ve been doing for the past nine years, stems precisely from sentiments of that sort.

    I assume that your reference to my “lofty” position is sarcasm.

    Your leap from my response to the assertion that I believe psychiatrists’ clients deserve their fate because they are too stupid to see through the hoax is groundless. I have never said, or even implied, anything of the sort, and it is difficult to avoid the perception that you are resorting to ad hominem attacks rather than substantive debate.

  • Phoenix,

    Thanks for this interesting perspective.

    Paradoxically, although I’m very clear about aims, methods, perspectives, and philosophy of the psychiatric profession, I cannot say the same about the profession of psychology. This is because, almost from its beginning, psychology glommed onto psychiatry as a ready-made portal to the “mental health’ business. And in many (perhaps most) cases, psychologists adopted psychiatry’s spurious philosophy whole-heartedly. At present, psychologists in America are lobbying hard at state level for prescribing “privileges”, and in some states have already achieved this. Psychology was co-opted by psychiatry decades ago.

    During my own career (I’m long retired), I always opened my discussions with people who came to me for help with a simple question: “How can I help you?” I then shut up and listened.

    And here’s the great heresy: most of what I did that was helpful wasn’t so much a product of specialized training in psychology, as a willingness to listen, an ability to empathize, and some personal experience of life’s vicissitudes and challenges.-

  • Slaying the Dragon,

    Thanks for this. Please see my response to Frank Blankenship above.

    You are, in my view, correct in pointing out that psychiatry will try to co-opt the PTM perspective. Watch for statements like: careful and experienced psychiatrists have always been cognizant of these matters, etc.

    My own position has always been that psychiatry’s systematic medicalization of all human problems is a destructive, disempowering hoax which has done and continues to do untold damage to people world-wide.

    It is also my position that psychiatry is irremediable, for the simple reason that they cannot let go of their spurious illnesses and their destructive “treatments”. Psychiatry must go, and it is to this end that I direct all my writing.

    In my view, the PTM document sets out clearly and in great detail the shortcomings of the psychiatric model, particularly the fact that psychiatric “diagnoses” are routinely used to conceal many of the great flaws and injustices in our society.

  • Neil,

    For decades, psychiatrists (including psychiatric leaders) have avidly promoted the falsehood that depression which crosses arbitrary and vaguely defined thresholds of severity, duration, and frequency is caused by brain pathology; specifically neurotransmitter imbalance. This is a monstrous deception, but is compounded by the even more appalling suggestion that this supposed pathology is corrected by psychiatric drugs (especially SSRIs). This is a hoax: something intended to deceive or defraud. Similar comments can be made concerning other psychiatric “diagnoses”.

  • Frank,

    Like you, I am also wary of replacing the psychiatric system with another system. Given the fundamental dynamics of our present society, there is always the possibility that a replacement system can be co-opted by commercial forces. Indeed, I imagine that commercial interests have already set their sights on the PTM framework and the “opportunities” that might lie therein. I like the notion of a get-off-my-back non-system, and I think Lucy’s comment above is apt.

    I personally favor a mutually supportive non-system along the AA model, but without the dogmatism and religious overtones that put so many people off AA. But we also need a radical transformation of our societal values and institutions.

    In my view, the great value of the PTM framework is not that it provides an alternative system, but rather an alternative perspective. Depression is not an illness, but rather an entirely understandable response to truly dreadful circumstances and oppressive discriminative institutions.

  • littleturtle,

    The central problem of psychiatry is that it’s based on a lie – that the problems listed in the DSM are illnesses. Because of this lie, they promote a medical model, which incidentally (or perhaps not) works to their advantage.

  • Someone Else,

    Thanks. Psychiatry really does kill, and I think the link between the mass murders/suicides and SSRI’s, when it’s finally confirmed unequivocally, will be the final nail in the coffin.

  • Lawrence,

    I did indeed read How Psychiatry Evolved into a Religion. It’s a beautiful piece, and the historical analysis is 100% accurate. I’ve read several posts that you’ve put up on MIA, and I’m extremely gratified that we have someone of your skill, experience, and forthrightness on our side.

  • Wallenfan,

    Thank you for coming back.

    You write:

    “You are saying that if we give them plenty of human junk food, so that their diet becomes completely unnatural, the chimp brain will keep functioning as well as on their natural diet. Pardon me, but your position is ridiculous.”

    What I actually wrote was the opposite:

    “The nutrition issue is more complicated, and I would concede that poor nutrition could deprive the brain or other organs of materials they need, which could cause the ‘feeling-apparatus’ to malfunction and the individual to feel depressed.”

    This is the exact opposite of what you attribute to me. In your earlier comment, you had combined “bad nutrition” and “lack of physical exercise” and had made statements about this combination of factors. In my response, I separated these, because I felt they were different kinds of issues. I accepted your position concerning nutrition, but disagreed with you concerning the lack of physical exercise.

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

    “There is plenty of evidence of subtle brain abnormalities for many DSM labels, including depression and schizophrenia. These deviations are not statistically significant, but they exist, for example, greater levels of blood cortisol and inflammation markers in depression. Note that you can’t say that these subtle differences do not exist. They are small and cannot be used for diagnosis, but they do exist. You COULD say that they don’t exist if the average values did not differ between depression and no depression, but the average values differ consistently, in many studies. We can call it ‘a mental disorder caused by a subclinical general deterioration of health’. My position is that this subclinical general medical condition is caused by a bad lifestyle. Most modern psychiatrists are saying that the primary cause is a ‘chemical imbalance’ which has some small physical manifestations. This is the influence of the pharmaceutical industry and their cronies.”

    Subtle brain abnormalities sounds a lot like chemical imbalances with the difference that they are too small to detect reliably. Psychiatry has been pushing the chemical imbalance notion for decades and telling us that the nature of these imbalances will be discovered soon. Of course, this is now discredited, but what you’re doing is unassailable – asserting that the imbalances are too small to ever be reliably identified.

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

    “But you are denying the subtle physical manifestations of mental disorders (despite plentiful evidence), and you don’t tell these people that they need to review their lifestyle.”

    In the previous paragraph you had presented these subtle brain abnormalities as the causes of mental disorders. Now you’re describing them as manifestations (i.e. effects) of mental disorders. Roget gives symptom as one of the synonyms of manifestation. So are the subtle brain abnormalities the causes of “mental disorders” as you had indicated earlier, or the effects?

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

    “Your claim that he [your friend] does not have a mental disorder is preposterous to say the least. Your position must be especially laughable for psychiatrists who see patients everyday.”

    You’re missing the point. The individual concerned may indeed have some problems, but it is dangerous to assume brain pathology based only on the vague and arbitrary DSM checklist. My position is eminently simple: assertions of brain pathology should be based on evidence of brain pathology in every case. Perhaps your psychiatric colleagues would find this laughable. I don’t know. But I don’t find their readiness to dispense with this safeguard at all funny. I think it’s a tragic and destructive hoax.

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

    “Regarding ADHD, there are tests, e.g. sustained attention test, which show deficiencies in patients with ADHD. There are numerous physical signs of protein malnutrition among patients with ADHD, including smaller brain size.”

    Here again, you’re missing the point. The assertion that people whom psychiatry labels as ADHD do poorly on sustained attention tests is not surprising, because habitually low sustained attention is the primary gateway to that label! Nor is protein malnutrition surprising, since stimulant drugs, which are prescribed extensively for this so-called illness, are known to suppress appetite.

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

    “I am sorry, but your concepts of ‘feeling apparatus’ and ‘adaptive response’ seem like personal opinions unsupported by scientific evidence.”

    I’m not sure what kind of evidence you have in mind. Can you provide evidence that the hunger response is adaptive? Or the sensation of pain on touching a hot stove? Or the unpleasant sensation when exposed to extreme cold? Or the urge to flee when confronted by extreme danger?

    There’s not much wasted space in the human organism, and in my view, it is reasonable to regard a response as adaptive unless there is good evidence to the contrary. Why should the human feeling-apparatus be exempt from the general rule that every organ serves an adaptive purpose?

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

    “As I mentioned above, I was depressed for many years in my teens. It was not an ‘adaptive response’ to a bad social environment. It was a boring, unpleasant, and pointless existence associated with many small personal problems without any big negative life events, in a GOOD social environment. Therefore, your theory of depression is incorrect or requires a major revision.”

    Actually, your personal account provides support for my ideas. Firstly, let me clarify my position. I have never stated that depression stems exclusively from “a bad social environment” or “big negative life events.” The phrase I used in my first response to you was “…an adaptive response to loss or to enduring adverse circumstances.” And you quoted this phrase back to me earlier in your reply. But now you morph this into “bad social environment” or “big negative life events”. Social difficulties and major negative life events would be included in my phrase, but so would “…”a boring, unpleasant, and pointless existence, associated with many small personal problems”, which is how you described the situation that brought on your teenage sadness.

    It is not possible in the limited space here to go into this in detail. But in 2009, I wrote a post title Depression Is Not An Illness: It is An Adaptive Mechanism.

    If you have time to read it, I would be interested in your thoughts/feedback.

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

    Earlier in your response you expressed the belief that people go to a psychiatrist partly because they believe they have a mental disorder. And this is undoubtedly true. But if we ask the more basic question: why go to anyone at all, the answer is clearly because they are motivated by the negative feelings to initiate some changes. Which is precisely the point of my position. The actual changes that people pursue is highly individualized – some start going to a gym; others might change their diet; others might take long walks; and others, as you point out, go to see a psychiatrist. In my view, learning is the primary determinant of the precise form that the changes take. But the basic drive to pursue change is a direct product of the unpleasant feelings, and is adaptive. Pleasant feelings, of course, are the opposite: a signal that all is well, and that we should stay on our present course.

    Or, to address the matter from another direction, can you suggest any other function that our feeling-apparatus might serve?

    Incidentally, I’m sorry to learn that my writing comes across to you as preaching. This is emphatically no part of my agenda, but I appreciate the feedback, and will certainly try to avoid such pitfalls in the future.

    Best wishes.

  • Wallenfan,

    Thanks for coming back.

    In my view, you’re confusing the essence of an illness with the measurement of its severity. The essence of diabetes is damage/malfunction of the pancreas, of which the excess sugar in the blood is a symptom. Similarly, the essence of pneumonia is the successful colonization of lung tissue by germs. The essence of peritonitis is infection of the peritoneum by germs. Etc.

    All illnesses admit of degrees of severity. In former times, simple severity scales were used, e.g. prodromal, mild, moderate, severe, terminal. Today, more formal measures are usually found. These measures, and their administratively delineated cut-offs, are provided by the specialties concerned to clarify the point at which an illness becomes treat-worthy, and perhaps more to the point, reimbursable. They involve a measure of arbitrariness to be sure, but not entirely. Progressive kidney failure, for instance, is often measured in terms of percentage of kidney function remaining. Around fifteen percent is generally accepted as the point where active treatment interventions begin. This is because, above 15%, an individual can get by, but below that level, the adverse effects become more pronounced, and active treatment becomes warranted and, again, reimbursable.

    The difference between this and psychiatry is profound, in that, apart from those DSM entries labeled as due to a general medical condition or due to a substance, there is no DSM label that has an identified essence or biological pathology.

    In general medicine, there is a straightforward causal relationship between the essence of the illness and its symptoms. This is actually the meaning of the word symptom – the visible, testable, tangible manifestation of the essence of the illness – of the biological pathology.

    In psychiatry, all we get are the symptoms – there’s nothing behind the symptom to even warrant calling them such. The delineations and cutoffs used in general medicine draw their meaning and their validity by reference to the biological pathologies that constitute the true definitions of the illnesses. In contrast, the delineations and cutoffs in psychiatry have no validity. There is nothing to which psychiatry can point to justify one month rather than two; three “symptoms” rather than four; etc.

    But it’s actually much worse than even that. Because in psychiatry, it’s not just the “symptoms” that contain arbitrariness, it’s the very “diagnoses” themselves. Psychiatrists, through the votes of their committees, made childhood inattention an illness without the slightest evidence of an underlying biological pathology. Similarly, shyness became social anxiety disorder; criminality became conduct disorder; childhood disobedience became oppositional defiant disorder; road rage has become intermittent explosive disorder; habitual childhood bad-temperedness has become disruptive mood dysregulation disorder. The list goes on and on: arbitrary, and incidentally self-serving, transformation of non-medical human problems into illnesses, with no statement of the essential underlying biological pathology. You assert, in response to Steve McCrea, that “diabetes was invented by doctors…” This, I suggest, is not true. Diabetes was discovered by doctors, but has existed as a disease entity that sickened and killed people, probably since prehistoric times.

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

    “Your basic assumption is that psychiatrists have no right to define illnesses and are not to be trusted, but MDs of non-psychiatric kind have a right to define illnesses and should be trusted.”

    I have never written anything remotely like this. I don’t think psychiatrists can be trusted because they routinely lie to their customers, the public, other doctors, the media, politicians, etc. As a recent example, see Columbia University Psychiatry Department’s press release of May 12, 2017.

    It contains the statement:

    “An international group of experts has concluded that, for patients with schizophrenia and related psychotic disorders, antipsychotic medications do not have negative long-term effects on patients’ outcomes or the brain.”

    Neuroleptics do not have negative long-term effects on the brain!

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

    I have never said or written that mental suffering and mental disability do not exist.

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

    I have never said or written anything like the circular argument that you attribute to me.

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

    I find your introduction of the concept of psychiatrists’ right to define mental illnesses puzzling. I have the right to stand on a street corner and proclaim that the Earth is being taken over by Martians, but that doesn’t make it true. Similarly, psychiatrists have I suppose the right to sit in their committees and assert that childhood bad-temperedness is an illness; but that does not make it so.

    I do indeed say that there are no mental illnesses. My reasoning is that the “symptoms” of the so-called mental illnesses do not arise from biological pathology. And if it were ever established that they did,
    the illness in question would become a neurological or endocrinological illness.

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

    Your theory of “subtle physical problems in the brain” which cause mental suffering or disability is, in my view, problematic because of the averaging and overlapping issues that you yourself concede.

    My own position, which I sketched out in my earlier response, is that depression is not a pathological state, but is rather a signal from the deepest core of our consciousness that something is amiss – either in our lifestyle, context, relationships, safety, etc. just as hunger is a message to eat, depression is a message to make some changes. I think your quest for a pathological underpinning, interesting as it may be, is a wild goose chase. There is no pathological underpinning! Or at least several decades of highly motivated and lavishly funded research have yielded nothing. The chemical imbalance hoax is long discredited, and psychiatry has nothing to put in its place. This is not to say that our “feeling –apparatus” cannot malfunction. Obviously it can. Every organ can malfunction. But this does not establish the general principle that all negative feelings spring from neurological malfunction.

    In addition, recognizing depression as essentially normal and adaptive is more parsimonious than insisting, without evidence, that it is pathological.

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

    “…all significant problems of thinking, feeling, and behaving…” is a paraphrase of the APA’s definition of a mental disorder in DSM-III, IV, and 5. The definition in DSM-5 has some additional verbiage, but the content is essentially the same.

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

    “Bad nutrition or a lack of physical exercise can make a person depressed because the brain is not functioning well and this suboptimal functioning leads to various personal problems, which make the person feel depressed. Antipsychiatrists here would say that the low mood is a response to personal problems and no biological problem exists, whereas modern psychiatrists (DSM) would say that low mood is a functional mental disorder caused by a chemical imbalance in the brain, which appeared out of nowhere. On the other hand, critical psychiatrists who believe in biological psychiatry (such as myself) would say that the low mood is caused by the bad lifestyle, and correction of the lifestyle will improve functioning of the brain, and thus resolve personal problems, and the mood will improve when the problems are gone.”

    There is, I suggest, an interesting fallacy here. The opening statement is true: “Bad nutrition or a lack of physical exercise can make a person depressed…” The fallacy is in the next phrase: “…because the brain is not functioning well…” You don’t have evidence to support the causal assertion. My position is that the human organism thrives on physical activity, especially purposeful activity. And when this doesn’t occur, our “feeling apparatus” sends us negative messages using the only “language” at its disposal. Inactivity-induced depression is not an indication of neurological malfunction, but rather the opposite – the brain and other feeling-related organs working in harmony to encourage us to get moving. It’s an adaptive response, no more pathological than the experience of a fear response if confronted with a lion rampant.

    The nutrition issue is more complicated, and I would concede that poor nutrition could deprive the brain or other organs of materials they need, which could cause the “feeling-apparatus” to malfunction and the individual to feel depressed. But wouldn’t this fall under the category that psychiatrists call depression due to a general medical condition? It is well established that various genuine medical conditions (e.g. hypothyroidism) can have these kinds of effects, but as stated earlier, this does not establish the general position that all, or even most, depression is caused by biological malfunction.

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

    Your references to functional mental disorder are interesting and nostalgic. I haven’t heard the term used since psychiatry started going cause-neutral in the late 70’s. The idea here is that a person who is depressed because his wife of fifty years has just died “has the same illness” as a person who is depressed because his feeling apparatus has malfunctioned for whatever reason. And this assertion is considered warranted because – and this is psychiatry’s supreme inanity – the two presentations meet the inherently vague and arbitrary criteria set out in the DSM checklist. This is about on a par with the assertion that all small bright objects in the night sky are stars!

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

    Concerning ADHD, here again, my position is, I suggest, more parsimonious. Children are born distractible. We train them to focus on the things that we consider attention-worthy. This is an integral part of parenting. When we encounter a child – or for that matter an adult – who doesn’t display an age-appropriate level of focusing, it is reasonable to conclude – in the absence of any other obvious causal factor – that the training didn’t occur or was insufficient. And incidentally, parents who are neglecting to train their children to focus and sit still when required may also be neglecting to train them in other areas.

    If the “symptoms” of ADHD are caused by brain malfunction, I think the onus is on psychiatry to state the nature of this malfunction and diagnose it by brain test. Until then, it’s just another unsubstantiated, self-serving assertion.

    Best wishes.