Thanks for coming back.

I have visited the Treatment Advocacy Center’s website, but I found nothing there on “current scientific findings on schizophrenia, manic depression, and related psychoses.” Perhaps I’m not getting into the right section. Please give me directions. I am always receptive to valid information.

The fundamental difference between our positions is this: you say that the people who meet the DSM criteria for schizophrenia are suffering from a biological disease of the brain. You also imply that people who don’t go along with your perspective constitute a danger to the individuals concerned.

I say: OK, this may be true – but prove it. Take delusions, for instance. Let’s say that a person says that the CIA has bugged his house with invisible transmitters. My position is that this piece of verbal behavior should be seen for what it is: a piece of verbal behavior. Now it could be that the individual is saying things like this because his brain is broken. But it’s more plausible that he is saying things like this because in some convoluted way this kind of statement is providing him with a payoff. It is an established fact that behavior that receives a payoff tends to be repeated; and that behavior that receives regular payoff becomes habitual. When I hear someone making crazy statements like the one above, I ask myself one question: what’s maintaining this behavior? In most cases the answer lies in the fact that the individual lacks the skills necessary for independent survival in the adult world, and craziness provides him with an acceptable way out.

With regards to “…out-dated Freudian-based hypotheses…,” all I can say is that you’ve got the wrong website. I disagree with the fundamentals of Freudian theory, and in fact I believe I would be hard-pressed to find a single Freudian tenet that I do agree with.

My stance is behaviorism (hence the title Behaviorism and Mental Health). Behaviorism is the scientific study of behavior – pure and simple. We observe what people do. We take detailed measurements; we count; we time; etc., and we draw (or try to draw) conclusions based on concepts like stimulus, response, reinforcement, response generalization, etc..

Finally, you say: “…current planning and care for the SMI is akin to being cared for by Medicine Men.” Well I wholeheartedly agree – but for different reasons. Most of the so-called treatment that I am aware of is based on the broken brain theory – eat your pills and go to the clubhouse or sheltered workshop every day. And so it goes until the onset of tardive dyskinesia, neuroleptic malignant syndrome; impaired liver function; acute renal failure; impotence; cataracts; retinopathy, etc.. Literally the fruits of the medicine men (your words).

So what I say is: 1) prove to me that the criteria listed in the DSM are caused by a brain malfunction. 2) show me a clear-cut test that tells who has that brain malfunction and who doesn’t. Until then, it’s just pharmaceutical straitjacketing. We’re not really helping these people – we’re destroying them for the sake of drug profits.

If I’m wrong – cite me the references!

It is actually dangerous for citizens suffering from these biological diseases of the brain to live in a world of misinformation about their illnesses. Society does not even question the validity of the unproved, out-dated Freudian based hypotheses (not theories) about serious mental illnesses (SMI). What other disease is treated without the benefit of scientific research, but by using only social/psychological theories? 

This is why current planning and care for the SMI is akin to being cared for by Medicine Men.   

Thanks for coming back.

You say that if I were to read current scientific brain research findings, I might agree with you. Well, June, send me the references. I have browsed through a great deal of scientific brain research, and I’m still profoundly skeptical with regards to the “broken brain” theory of schizophrenia. In my view, a behavioral formulation is more explanatory, more informative, and more helpful with regards to remediation. But I keep an open mind. Send me the references that in your view provide the best support for the “broken brain” theory. I will review them as objectively and fairly as possible and will post my response here.

But I would also like to hear your perspective. Your comments tend to be very brief. So it’s difficult for me to know exactly what points you are making. It is only through dialogue and discussion that we move forward.

The essential point of this blog is that modern psychiatry is unhelpful, and sometimes even harmful, to its clients. And I say this after a lengthy career in prisons, addiction units, and mental health centers. I’ve seen the damage and the waste of human lives at close quarters. I’ve also seen people find real help when they are afforded proper respect and dignity – when they are treated like people and not like “chemical errors” that need to be corrected.

I’m not the bad guy here, June. I may be in error – if so, show me. Quote me the references. Tell me where you disagree with me. Tell me what you think and why you think it.

I did look at Treatment Advocacy Center’s website, but I didn’t find anything there to support the “broken brain” theory. Did I miss something?

Looking forward to hearing from you.

You might change your mind on this.

Thanks for your comment.

I actually have a number of very serious diseases, and I can tell you categorically that I prefer my treatment to be based on science than on anything else.

Schizophrenia, however, is not an illness; it is a behavioral problem, but here again, a “solution” based on sound scientific principles will yield better results than a “solution” based on the spurious DSM system.

Which of these would you prefer to be the basis of your diagnosis and treatment for any serious disease?

Thanks for your comment. You make a very good point: one of the best things we can do with our troubles is to share them with someone we trust. And I would certainly agree that one of the critical steps in coping with despondency is this kind of communication.

In my experience, however, the great majority of suicidal talk/behavior is not of this nature. It usually takes the form: “If you people aren’t nice to me, I will punish you by killing myself.” It’s not expressed in these words, of course, but that’s the substance.

As with everything else, however, there is an abundance of individual variation.

I like the idea you expressed of getting something “outside your head.” A great many human problems are amenable to improvement in this way.

Once again, thanks for coming in. It’s always nice to hear from you.

Best wishes.

Thanks for your interesting comment/question.

First, a note on terminology. Webster defines the term “explain away” as follows:

“to get rid of by or as if by explanation; to minimize the significance of by or as if by explanation.”

The phrase “explain away” contains, in my view, an inherent connotation of chicanery or even outright dishonesty. So, for the record, I feel the need to state emphatically that I do not explain things away. My objective in this blog is to provide genuine and valid explanations of unusual or disturbing behavior. In deed, one of the points that I make repeatedly is that the DSM explanations are spurious and invalid. In a very real sense I believe that the APA could be charged with explaining away. When psychiatrists say that hallucinations are caused by schizophrenia, they are using words in a way that looks like and purports to be an explanation, but in fact is nothing of the kind.

Now if you believe that I have engaged in this kind of practice, please cite the passage or passages concerned, and we can have some dialogue.

With regards to hallucinatory behavior, I wrote what I think is a fairly clear explanation of this in the post Schizophrenia is Not an Illness, Part 3, which you can see here. I have now re-read this piece, and it contains all of the main points I would wish to make on this topic. I would be very happy to elaborate further if there is some specific facet with which you disagree or on which you would like more information.

The phenomenon that you describe as “command auditory hallucinations” can be adequately conceptualized in essentially the same way as “ordinary” hallucinatory behavior, with the additional reinforcement that inevitably attends suicidal talk. When a person tells a mental health worker that there is a voice in his head telling him to kill himself, he inevitably becomes the focus of concerted and solicitous attention. Sadly, in our present medicalized, drug-pushing mental health business, this attention is seldom directed towards helping the individual acquire the skills necessary for functional living.

My general position on suicidal talk and behavior (whether successful or not) is that it is much more often a matter of dysfunctional, manipulative communication, than an expression of genuine despondency.

Once again, thanks for your interest. Please feel free to come back on any point if you would like clarification or if you think I’m missing something.

Thanks for your comment.

I agree with you that science eventually trumps nonsense. It’s the “eventually” part that troubles me. Spurious ideas are often backed by enormous resources, and are often promoted with great vigor. The result is that genuine understanding is postponed for years – even centuries. And in many cases this involves the prolongation of human suffering.

Science does not exist in the abstract, but only in and through people – people who put aside their preconceived notions, observe reality, generate testable hypotheses, etc.. When we create an atmosphere in which these individuals are encouraged, then science (and humanity) flourishes. But the opposite is also true, and the present mental health atmosphere, with its pseudo-science and spurious explanations, is damaging large numbers of people.

So, yes, I agree, the nonsense will eventually fade away – but psychiatry has been damaging people systematically for more than a hundred years. I have discussed this topic in my latest post, Legacy of Abuse.

Once again, thanks for the comment and for raising such an important point. Best wishes.