[D66] Psychiatry’s Nightmarish 2022

[René Oudeweg]

madinamerica.com
<https://www.madinamerica.com/2022/10/psychiatrys-hysterical-defense/>


  Psychiatry’s Nightmarish 2022 & Its Hysterical Defense Against
  Criticism - Mad In America

Bruce Levine, PhD
14-17 minutes
------------------------------------------------------------------------

This year has been an especially nightmarish one for psychiatry defenders.

Receiving widespread attention in the mainstream media was the July 2022
article “The Serotonin Theory of Depression: A Systematic Umbrella
Review of the Evidence
<https://www.nature.com/articles/s41380-022-01661-0>,” published in the
journal /Molecular Psychiatry/. In it, Joanna Moncrieff, co-chairperson
of the Critical Psychiatry Network, and her co-researchers examined
hundreds of different types of studies that attempted to detect a
relationship between depression and serotonin, and concluded that there
is no evidence of a link between low levels of serotonin and depression,
stating: “We suggest it is time to acknowledge that the serotonin theory
of depression is not empirically substantiated.”

Psychiatry apologists tried to convince
<https://www.rollingstone.com/culture/culture-news/ssri-right-wing-attack-joanna-moncrieff-1388067/>
the general public that Moncrieff’s findings were not newsworthy, as
psychiatrist David Hellerstein, professor of clinical psychiatry at
Columbia University Medical Center and director of Columbia’s Depression
Evaluation Service, attempted to belittle Moncrieff in this manner:
“Wow, next she’ll tackle the discrediting of the black bile theory of
depression.” However, given the reality that the vast majority of
society had heard nothing from psychiatry about the discarding of this
serotonin theory of depression, what followed has been public mockery of
psychiatry and its Big Pharma partners
<https://www.youtube.com/watch?v=aVSogil0Vao> for their duplicity.

Then, in August of 2022, receiving less attention was an even more
devastating blow to psychiatry, so damaging and so indefensible that
psychiatry’s only response was to ignore it. Published in the journal
/Neuron/, Raymond Dolan—considered _one of the most influential
neuroscientists in the world
<https://www.science.org/content/article/computer-program-just-ranked-most-influential-brain-scientists-modern-era>_—co-authored
“Functional Neuroimaging in Psychiatry and the Case for Failing Better
<https://www.cell.com/neuron/pdf/S0896-6273(22)00647-X.pdf>,”
concluding, “Despite three decades of intense neuroimaging research, we
still lack a neurobiological account for any psychiatric condition.”

Reflecting on the more than 16,000 neuroimaging articles published
during the last 30 years, Dolan and his co-authors concluded: “It
remains difficult to refute a critique that psychiatry’s most
fundamental characteristic is its ignorance. . . . Casting a cold eye on
the psychiatric neuroimaging literature invites a conclusion that
despite 30 years of intense research and considerable technological
advances, this enterprise has not delivered a neurobiological account
(i.e., a mechanistic explanation) for any psychiatric disorder, nor has
it provided a credible imaging-based biomarker of clinical utility.”

So in 2022, research reviews published in prestigious journals have made
it clear that there is no neurobiological evidence—no chemical
imbalance, no brain structure evidence—for any psychiatric condition.

But that’s not the end of psychiatry’s 2022 nightmare.

>From one of the most prominent establishment psychiatrists in the world,
we heard in 2022 that the /DSM/ (psychiatry’s diagnostic manual,
published by the American Psychiatric Association) lacks validity.
Thomas Insel, when National Institute of Mental Health (NIMH) director
in 2013, had quietly stated in his NIMH blog that the /DSM//’/s
diagnostic categories lack validity, and he announced that “NIMH will be
re-orienting its research away from /DSM /categories”; then, in 2022, he
informed the general public about /DSM/ invalidity in his book
/Healing/, which has received mainstream media attention. In this book,
Insel states: “The /DSM/ had created a common language, but much of that
language had not been validated by science.” In plain language, Insel is
calling the /DSM/, in a scientific sense, /bullshit/.

In 2022, increasing numbers of Americans also heard about psychiatry’s
abysmal treatment outcome record. Insel, as NIMH director in 2011, had
quietly acknowledged: “Whatever we’ve been doing for five de­cades, it
ain’t working. And when I look at the numbers—the number of sui­cides,
number of disabilities, mortality data—it’s abysmal, and it’s not
getting any better.” In 2021, the /New York Times
<https://www.nytimes.com/2021/04/01/health/mental-health-treatments.html>/concluded
that psychiatry had done “little to improve the lives of the millions of
people living with persistent mental distress. Almost every measure of
our collective mental health—rates of suicide, anxiety, depression,
addiction deaths, psychiatric prescription use—went the wrong
direc­tion, even as access to services expanded greatly.” And in 2022,
in /Healing/, Insel repeated to the general public what he had
previously acknowledged about psychiatry’s history of abysmal outcomes,
noting: “While we studied the risk factors for suicide, the death rate
had climbed 33 percent” despite increased treatment, reporting that,
“Since 2001, prescriptions for psychiatric medications have more than
doubled, with one in six American adults on a psychiatric drug.”


          *Psychiatry’s Defense: “Don’t Throw Out the Baby with the
          Psychiatric Bathwater” *

Earlier in 2022, responding to Robert Whitaker in a /Mad in America
<https://www.madinamerica.com/2022/05/mia-harm-good/>/dialogue
<https://www.madinamerica.com/2022/05/mia-harm-good/>, psychiatrist Jim
Phelps, in his article “The Baby in the Psychiatric Bathwater,” stated
the following: “Don’t throw out the baby with the psychiatric bathwater.
Mr. Whitaker, I fear you’re doing harm while trying to do good.”

The idiom “Don’t throw out the baby with the bathwater” is an admonition
against discarding something valuable along with something not wanted.
However, the question for any critical thinker is—especially given what
has been made public about psychiatry in 2022—what exactly is valuable
about psychiatry?

A rational critical analysis of an institution—in contrast to a
theological defense of it— would evaluate whether that institution is in
fact valuable and can be reformed to be better. Such an analysis of a
professed medical institution would evaluate whether (1) its fundamental
paradigm and core tenets have scientific merit, and whether with reform
in its practices, it can be improved, or (2) its fundamental paradigm
and tenets are scientifically invalid, and thus, no matter how many of
its practices are reformed, it will continue to do more harm than good.

Critical freethinkers—in contrast to theologians attached to their
institution—would be open to all possible conclusions of this analysis,
including (1) not discarding an entire institution because it is
fundamentally sound and valuable, and needs only to improve its
practices, or (2) discarding an entire institution because it is
fundamentally invalid and unsound, as its core principles are
unscientific and unjust.

In any given time in U.S. history, there have been institutions that
have had a central role in U.S. society that were eventually—with great
struggle—discarded, and which today most Americans are embarrassed ever
existed. Thus, any critical freethinker who has knowledge of American
history will not be intimidated to consider the possibility that /any
/current institution may need to be completely discarded. That is part
of the essence of being a critical freethinker.

Perhaps the most obvious example in U.S. history of a dominant
institution that was ultimately discarded—and which today most Americans
are embarrassed by its past existence—is the institution of slavery.

I bring up the institution of slavery not to hyperbolically equate
psychiatry with slavery—though there are certainly many /Mad in America/
readers who have been involuntarily forced into ruinous psychiatric
treatment, and who would not view such a reference as hyperbolic.
However, for the majority of psychiatric patients, it is hyperbolic to
equate psychiatry with slavery in terms of cruelty. I bring up slavery
as a reminder of the historic reality of (1) the longtime existence in
the United States of a shameful institution, and (2) that when it was
being attacked by slavery abolitionists, slavery’s supporters used
several defenses of it, including the “don’t throw out the baby with the
bathwater” defense.

The various defenses of slavery
<https://www.ushistory.org/us/27f.asp#:~:text=Defenders%20of%20slavery%20argued%20that,Rice%20would%20cease%20being%20profitable.>
included: how the abolition of slavery would destroy the Southern
economy; how slavery has existed throughout history and thus is quite
normal; that slavery is not viewed as immoral in the Bible; and that
slavery is legal. Another major defense of slavery was that it was
beneficial for slaves, and that it would be bad for slaves to throw out
the baby with bathwater. Specifically, this argument went like this: If
slaves were freed, there would be widespread unemployment and chaos, and
that in comparison to workers in the Northern states, slaves were better
cared for, especially when sick or aged. In 1837, as senator from South
Carolina, John C. Calhoun (formerly a vice president of the United
States) stated
<https://teachingamericanhistory.org/document/speech-on-abolition-petitions/>:
“Never before has the black race of central Africa, from the dawn of
history to the present day, attained a condition so civilized and so
improved, not only physically, but morally and intellectually.”

Again, I review this history not to equate psychiatry with slavery in
terms of cruelty but to remind readers that in U.S. history, (1) there
have been institutions that have had a central role in society that were
eventually—with great struggle—discarded, and which today are a source
of embarrassment for most Americans; and that (2) among the many
defenses of such now discarded shameful institutions, one defense was
not to throw out the baby with bathwater.

Slavery is not the only such shameful institution in U.S. history.
Another more recent example is the House Committee on Un-American
Activities (dubbed the House Un-American Activities Committee or HUAC),
which was an investigative committee of the U.S. House of
Representatives created in 1938 to investigate the disloyalty and
subversive activities of American citizens and institutions. After HUAC
destroyed the careers of many Americans who had broken no laws but were
targeted for their political beliefs, HUAC eventually came to be
denounced even by former President Harry Truman
<https://www.archivesfoundation.org/newsletter/the-loyalty-test/> in the
late 1950s as the “most un-American thing in the country today.” HUAC
changed its name to the House Committee on Internal Security, which
itself was abolished in 1975.

Slavery and HUAC are by no means the only examples of powerful
institutions in U.S. history that we are now ashamed to have allowed to
exist. What slavery and HUAC have in common is that they were based on
invalid paradigms. Slavery was based on the invalid paradigm of racial
inferiority of African Americans, and HUAC was based on the invalid
paradigm of what it meant to be “un-American.” If an institution’s
essential paradigm is scientifically invalid and unjust, then all
attempts at reform will be pointless. To put it idiomatically, “You can
put lipstick on a pig, but it is still a pig.”


          *Is Psychiatry’s Self-Defense /Hysterical/?*

While most of establishment psychiatry simply ignores critical
freethinking about psychiatry, there are a handful of psychiatrists who
respond to psychiatry critics, and I can only speculate as to why.
Perhaps their role is to make psychiatry /appear/ to be open to
criticism while in reality imposing limits as to what is allowable
criticism; or perhaps their role is to co-opt truly critically
freethinking publications such as /Mad in America/. In any case, along
with psychiatrist Jim Phelps, I would include in this group
psychiatrists Ronald Pies, Editor-in-Chief Emeritus of the /Psychiatric
Times,/ and Awais Aftab, who has an interview series in the /Psychiatric
Times/.

In 2020, Pies told Aftab
<https://www.psychiatrictimes.com/view/battle-soul-psychiatry-ronald-w-pies-md>
that he distinguishes between two quite different groups of critics.
There are, he tells us, “sincere and well-intentioned critics of
psychiatry—many of whom are psychiatrists—whose aim is to improve the
profession’s concepts, methods, ethics, and treatments.” However, Pies
then goes on to say that there are also critics whose “hostile and
vituperative rhetoric is clearly aimed at discrediting psychiatry as a
medical discipline.” For Pies, it is simply unallowable to question the
legitimacy of the institution of psychiatry, and to do so is inexcusable.

Aftab, like Pies, makes clear that he believes there are critiques of
psychiatry that are responsible and useful versus critiques that are
irresponsible and dangerous. In August, Aftab tweeted
<https://www.madinamerica.com/2022/08/holy-shit-psychiatrys-cognitive-dissonance-display/>,
“Holy shit. . . Whitaker at Mad in America is calling for a class-action
lawsuit against the American Psychiatric Association & scientific
advisory boards of orgs such as NAMI, alleging that the infamous
serotonin hypothesis paper reveals these entities engaged in ‘medical
fraud.’” Earlier, in his July 2022 tweets,
<https://twitter.com/awaisaftab/status/1550661887330865152> Aftab
admonished, “Anyone not attuned to the emerging intersection of
psychiatric critique & far-right politics is not paying attention. We’ve
already seen previews of this relationship when it comes to gender
critical ideology & anti-vaccine sentiment; it’s going to become more
explicit with time”; and then offered this warning: “Those engaged in a
Faustian bargain will realize too late, if they realize at all, what
ugly forces they have unleashed.”

Phelps, Pies, and Aftab are open to criticism of psychiatry as long as
it stops short of acknowledging the increasingly well-documented reality
that psychiatry lacks any scientific merit, which logically results in
the questioning of the legitimacy of psychiatry.

To be a critical freethinker, one need not conclude that psychiatry
should be abolished. One need only be open to questioning psychiatry’s
legitimacy, as a critical freethinker would be open to questioning the
legitimacy of any institution.

A critical freethinker may even conclude that while there is no
scientific merit to psychiatry, given the nature of modern society and
psychiatry’s role in it, psychiatry’s abolition might result in an even
more problematic institution taking psychiatry’s societal role of
controlling inconvenient people and providing fictional explanations for
unhappiness.

While being a critical freethinker does not necessarily mean coming to
the conclusion that it would be a good idea for psychiatry to be
abolished, it does mean being open to any and all facts, and being open
to any and all logical conclusions from such facts. In their lack of
openness, Phelps, Pies, and Aftab make clear that they are not critical
freethinkers.

Webster’s Dictionary offers
<https://www.merriam-webster.com/dictionary/hysterical> both a formal
and informal definition of /hysterical/. The formal definition of
/hysterical/ is “feeling or showing extreme and unrestrained emotion.”
The informal definition is “very funny.”

Maybe it’s just me, but with respect to both the formal and informal
definition of /hysterical/, I find Hellerstein’s equating Moncrieff’s
recent review to “the discrediting of the black bile theory,” Phelps’s
“don’t throw out the baby with the psychiatric bathwater” defense,
Pies’s good-and-evil categorization of psychiatry critics, and Aftab’s
apocalyptic fear mongering of what will be unleashed by freethinking
critics of psychiatry all to be… hysterical/./
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