Mental Illness: The History of a Mistake

The human brain is a pattern-seeking machine.  Because of his brain, man strives to understand the world around him and uses this understanding to improve his lot.  The brain looks for patterns and explanations.  Our ancestors, for instance, discovered that certain rocks, through processing in certain ways, could be shaped to make sharp tools which they used to great advantage.  Later it was discovered that other rocks when heated in certain ways produced iron. And so on.

The brain’s pattern-seeking activity is not confined to great discoveries.  People use their brains every day to navigate through their environment and to find the procedures and practices that work to their best advantage.  Commuters learn which routes have the fewest delays.  Shoppers learn where they can find the best bargains.  Politicians learn what to say to increase their chances of getting elected.  Gardeners learn when is the best time to plant.  And so on.  In all aspects of daily life – great and small – the brain is storing and analyzing data, identifying patterns and explanations, seeking endlessly to optimize results.

It is likely that our ancestors of a few thousand years ago were pretty much as bright as we are in terms of raw intellectual ability.  But their store of valid knowledge was a great deal less.  The ancients lacked our knowledge of electricity, atoms, sub-atomic particles, germs, cells, neurons, periodic table, gravity, galaxies, etc., etc.. They had no understanding of why people got sick, why crops failed, why the moon and sun stayed up in the sky, or why some substances burned and others did not.  They didn’t even understand the true nature of fire – knowledge that is well within the scope of any high school student of today.  But this lack of knowledge didn’t prevent their brains from working on these various questions. The drive to make sense of their environment was as strong in them as it is in us today.  So they invented explanations – explanations that today seem primitive and naïve, but that made sense to them and helped them organize and systematize their experiences.  So they said that the moon and sun manage to stay up in the sky because they are gods (or goddesses), and gods can stay up in the sky.  Readers of this blog will readily recognize the fallacy in this reasoning.

  • Why does the sun stay up in the sky?
  • Because it is a god.
  • How do you know it’s a god”?
  • Because it stays up in the sky.

And, of course, this kind of simplistic logic can be found in psychiatric circles to this day.

But to get back to the main point:  people in virtually every ancient culture invented explanations for phenomena that they didn’t understand.  They then ignored data that contradicted their explanations and highlighted data that supported them.

One of their more significant errors of this kind was, of course, the anthropomorphic god.

  • Thunderstorms:  god is angry.
  • Fine weather:  god is happy.
  • Famine:  god is punishing
  • Etc..

But where the ancient civilizations really erred is in the nature and workings of life.  Today we know that all living organisms consist of cells, and these cells remain alive and multiply through complex microscopic processes involving nutrition, mitosis, etc.. We also know that death occurs when the cells’ DNA – through aging – is no longer able to split reliably and hence no longer able to replenish depleted material.

But the ancients knew nothing of this.  So to explain the phenomenon of life, they invented the soul or mind.  This explained a great deal.  A dead body was one that the soul had left.  In dreams the soul left the body temporarily and travelled to distant places, faint memories of which remained after the soul had returned and the body reawakened.  If you dream about your dead father, it’s because the travelling soul has visited the spirit world and seen him.

This is noteworthy in that we today in the computer age are very familiar with the notion of stored data and even stored images.  But the idea that all of our memories were somehow stored in our brains was foreign and incredible to the ancients.  The storing of data of this sort, which we call memory, was completely baffling to them.  And they “explained” it by the simple expedient of declaring it to be a spiritual activity and therefore, of course, the province of the soul or mind.

Historians of philosophy call this “faculty psychology.”  It goes like this.  Different parts (faculties) of the organism have specialized functions.  The function emanates from the faculty.  So people can think because they have a faculty called mind.  People can feel because they have hearts, etc.. Today it sounds simplistic and naïve, but back then people found it helpful.   Activities such as thinking, remembering, planning, hoping, believing, etc., were most baffling to our ancestors, and they explained these activities by asserting that the faculty from which they emanated (the mind) was a kind of nebulous, ephemeral or “spiritual” entity, which in the hands of many religious leaders became equated with the “soul.”  So all was explained.  The mind (or soul or anima) was inside the otherwise inanimate, insensitive body.  Experience was channeled to the mind through various body parts (touch, sight, etc..), and the mind organized all this data and did the thinking, deciding, etc.. Today, of course, we recognize this as spurious, but for centuries it was central to all Western thinking.

In reality, the concept of mind was an error – an error prompted by an ignorance of the anatomy and physiology of the brain.  This ignorance was prolonged by an establishment, steeped in dogmatism and certainty, and resistant to any form of genuine scientific enquiry.

Today we realize that “mind” is essentially a metaphor for “self.”  When we say: “I changed my mind,” what we mean is:  “I, myself, reversed my earlier decision.”  And so on.  But in former times people thought of “the mind” as a real “faculty” residing somewhere (?) within the body.  And this kind of spurious psychology held sway throughout the Western world for centuries and is indeed current in some circles to this day.

The notion of madness or craziness has also been around for centuries and was conceptualized largely as an irremediable defect of “the mind.”  Crazy people were cared for by their families and communities and sometimes by religious houses.  Then came the industrial revolution.  People were no longer needed to work the land, so they flocked to the cities, where they found unmitigated poverty and squalor.  Individuals who weren’t productive were often abandoned. This included the “crazy” people, who begged in the streets and ended up in jails.

From this context a number of reformers, driven by humanitarian motives, started a movement to have these individuals housed in specialized institutions.  The buildings would be clean and properly run, and to lend respectability to these places, they would be placed under the jurisdiction of a physician.  From there it was a short leap to the notion that these places were hospitals (which they weren’t) and that the residents were sick (which they weren’t).  And so was born the notion of mental illness. An illness of a non-existent faculty!

The sickness idea was deemed progressive.  Prior to that, the current notion was that these individuals’ “minds” were defective in some way and this defect was regarded more as a morality issue than anything else.  Great shame was attached to the person’s family. Many (perhaps most) of the individuals considered crazy were what today we would call retarded or intellectually handicapped  – but this distinction was not clearly grasped even 200 years ago.  So locking these people away in enormous buildings managed by medical superintendents was considered charitable.  (It also got them off the streets, which was considered desirable).

The more recent history is well-known.  From being a relatively small number of asylum superintendents, American psychiatry has burgeoned to the 45,500 strong that it is today. Mental illness (the spurious disease of the spurious faculty) has been creatively expanded by an increasingly rapacious APA to the point where it can embrace virtually anyone.

So we have institutionalized this error and turned it into a vast drug-pushing enterprise in which human welfare and human dignity are routinely sacrificed to the all-consuming maw of pharmaceutical psychiatry.  There are no minds.  And there are no mental illnesses.  There are people and we people live in a complex world.  And we have problems – sometimes little, sometimes large. And sometimes we lose our way and our thinking becomes distorted.  But conceptualizing these problems of human existence as illnesses to be “treated” by self-styled experts has been a colossal historical error – an error fuelled and maintained by career-building and corporate greed.  The most pressing need in this area today is the de-medicalization of these problems and the provision of concrete help, guidance, and support to the individuals concerned.

  • Martin

    This was a really informative post! It is amazing that most of society accepts the sham of “mental illness.” Dr. Thomas Szasz calls “mental illness” a metaphor and I could not agree more. The concept of a “mind,” “soul,” or “conscience” is used all too often and without the understanding that they are abstract concepts with which cannot be scientifically proven or be used when trying to explain a “sickness.” I recently was in a debate regarding sociopaths (antisocial personality disorder). The two sides were whether a sociopath is a specific type of person with a genetic predisposition to a mental illness or if anyone could display sociopathic tendencies based upon their environment. It was simply a nature vs. nurture debate. I was on the nurture side and argued that the DSM classification of a sociopath (antisocial personality disorder) was a broad explanation of types of behaviors. Two arguments that kept being brought up were that sociopaths are without a “conscience” and could not feel “emotion.” I argued that such a concept was abstract and subjective and could not be proven. Looking through your past posts I could not find anything on sociopaths or antisocial personality disorder specifically. I was wondering how you would explain people with sociopathic tendencies in the framework of behaviorism? All testimonies regarding such a person obviously can only come from that person’s personal account and seeing that a characteristic of sociopaths is that they are good liars and deceivers, how could we take what they say at the end of the day as truth? I do not understand how we can medicalize such individuals or label such people as having a disorder when the characteristics are generally abstract to begin with. It seems more like a philosophical/moral issue rather than medical.

  • Martin: Thanks for your excellent comment. These are deep waters and I feel a little out of my depth, but I’ll have a go.

    Most people do indeed accept the “sham of mental illness.” Recently I was in contact with a mathematics professor at a major university –an extremely intelligent person – and he told me that he had accepted the “depression is a disease” stuff pretty much without question. The problem is that this spurious message is being promoted by very sophisticated marketers in concert with an ostensibly respectable (“board certified’) profession (i.e. the psychiatrists). It simply doesn’t occur to people that the message could be spurious and that the “respectable professionals” are little better than drug pushers. But there it is – and once you see it, you never stop seeing it.

    I also agree with Thomas Szasz that “mental illness” is a metaphor. But I’m not keen on the term because I find it hard to get my head around it. I prefer to say: “There are no mental illnesses. Problems of living are not illnesses.” Or something along those lines.

    Now you mention the word “conscience” and this, of course, is a huge topic. Conscience, the so-called voice in your head that tells you to do right and avoid wrong, is not some kind of “natural,” innate property. When our parents berated us for misbehavior and praised us for doing the right thing, they were in fact instilling a conscience. The child is born selfish, demanding, given to outbursts of temper when frustrated, etc.. And the parent trains the child to obey the rules – through rewards, punishments, coaching, etc.. The voice of conscience is quite literally the voice of one’s early caregivers and other significant figures.

    But if we continue our deliberations, we must recognize that not all families subscribe to the same behavioral standards. In a small number of households, for instance, stealing is ok. The parents steal – indeed it is their main source of income. The issue is to not get caught. So these parents don’t teach their children not to steal, but rather how to cover their tracks so they don’t get caught. But we shouldn’t assume that these families have no rules – for instance they sometimes place a high premium on loyalty and not “snitching,” and on being tough and able to take care of yourself.

    The behavioral mechanisms that the law-abiding family uses to instill a law-abiding conscience are essentially the same as the mechanisms that the lawless family uses to instill their values.

    I’m using the word conscience here, but of course you are right – it is an abstract concept. I have never thought of a definition, but I guess it would be something like: a person is said to have a conscience if the performance of activities that are considered taboo within his sub-culture arouses within him feelings of guilt such that he tends to avoid these activities. But of course as you pointed out, the only way we can know about these feelings of guilt is self-report – which by definition is unverifiable.

    So from a behaviorist point of view, one simply notes the parental interventions and then observes whether the behavior in question has decreased in frequency. So conscience would be operationally defined something like: a reduced probability of misbehavior even when not under direct supervision

    The concept of personality disorder has been around for some time in mental health circles. In practice it tends to be synonymous with “incurable.” And “antisocial personality disorder” is probably considered the most “incurable” of the personality disorders.

    Here are the DSM IV TR criteria:

    A. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:

    (1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
    (2) deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
    (3) impulsivity or failure to plan ahead
    (4) irritability and aggressiveness, as indicated by repeated physical fights or assaults
    (5) reckless disregard for safety of self or others
    (6) consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
    (7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

    B. The individual is at least age 18 years.

    C. There is evidence of Conduct Disorder with onset before age 15 years.

    D. The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode. (p 706)

    So essentially what we are talking about is: lawlessness; deceitfulness; impulsivity; aggressiveness; recklessness; irresponsibility, and lack of remorse.

    But before we get too involved with this so-called personality disorder, let’s take a look at a passage from Walter Mischel’s 1968 classic Personality and Assessment:

    “…indices of relevant past behavior typically provide the best as well as the cheapest predictions. Moreover, these predictions hold their own against, and usually exceed, those generated either clinically or statistically from complex inferences about underlying traits and states.” (p 145)

    And

    “…it is not surprising that large-scale applied efforts to predict behavior from personality inferences have been strikingly and consistently unsuccessful: (p 146)

    Mischel also quotes Meehl, P.E. The Cognitive Activity of the Clinician Am Psychol 1960 15 (19-27)

    “Personally, I find the cultural lag between what the published research shows and what clinicians persist in claiming to do with their favorite devices even more disheartening than the adverse evidence itself.” (p 26)

    So the plot thickens. Clinicians who rely on personality theories to understand behavior conceptualize the individual as having a number of traits (e.g. kindness, meanness, aggressiveness, etc.) and that these traits are the major determinants of behavior. A behaviorist on the other hand recognizes that behavior is always learned in a context and conceptualizes the situation almost as eliciting the behavior through the process of stimulus generalization. Note also the element of circularity in the trait position. (He behaves aggressively because he has the aggressive trait. How do you know he has the aggressive trait? Because he acts aggressively.) The circularity could, of course, be broken if one could demonstrate some evidence for the trait other than the behavior it purports to explain, but I don’t think this line of enquiry has enjoyed much success. Most of the attempts to measure personality traits rely on self-report (questionnaires) and the correlation between self-reports and overt behavior is often not very impressive. This is true in the case of individuals who are being deliberately deceptive (as you point out) but also for most of us who tend to err towards the positive side when describing ourselves.

    So, is the concept of trait or personality helpful in understanding behavior? It is certainly deeply embedded in our culture, but that does not necessarily attest to its validity. In your comment there is the suggestion that trait may be one of those archaic spurious explanatory concepts such as mind, soul, etc.. In this I would probably agree, though the (scientifically validated) constructs of response generalization and stimulus generalization do provide some underpinning of validity. The problem with trait explanations is that they are difficult to reconcile with the important role that context plays in the elicitation of behavior.

    As always, every topic spiders off into five or six others, but no discussion of trait/personality would be complete without touching on the Barnum effect. Ullman and Krasner (A Psychological Approach to Abnormal Behavior, 1975) describe this as follows:

    “This occurs when a class is handed back individual personality analyses after taking a personality test. After each student has said how good the interpretation is, one student reads his or her evaluation aloud, and all find that they have been given the same write-up.” (p 218)

    A great many of the trait statements made about mental health clients are in fact Barnum statements (as are statements made by fortune tellers, etc.). The name, incidentally, comes from P.T. Barnum, who in promoting his circus shows reportedly used to say that he had “something for everyone.”

    Now to the specifics of your comment. When we ask: do psychopaths or sociopaths have a conscience? Do they feel remorse? – there is an underlying assumption that we can define this population accurately and that this population has an underlying trait that drives and explains their behavior. Both assumptions in my view are unwarranted. Any measurable characteristic that you could mention as indicative of sociopathy is almost certainly distributed throughout the population, and in addition the correlations between these characteristics will be less than perfect. So in other words, you will find that instead of there being psychopaths and non-psychopaths, you will instead find degrees of “psychopathy” (behaviorally defined as rule breaking) and kinds of “psychopathy” (animal abusers; stealers; vandals; aggressive drivers; etc., etc.). But it gets even more complicated – you will find that even stealers are a mixed bunch. Some stealers only steal from wealthy homes; others only pick pockets; still others start Ponzi schemes, and steal billions, etc., etc., etc..

    So if we can’t define the population, then the question becomes meaningless. So let’s ask a different question. Are there individuals who do not experience feelings of guilt even after they have engaged in heinously cruel activity? And here we are back to the self-report issue which you mentioned. So the complete answer to this question is that we can never know for sure. But most human emotions seem to be well distributed across the population. Some people cry at a sad movie, others don’t. Some people are deeply troubled by a family quarrel, others aren’t, etc.. In my view it is highly likely that there are individuals who experience little in the way of guilt feelings regardless of what they have done. How to identify such individuals – well that’s a different matter!

    The next question that arises is: how do you teach a child to perform those activities that are considered indicative of psychopathy? Well most parents manage to teach their children lawfulness – i.e. by the time the child reaches adulthood the probability that he will emit a socially acceptable response in an acceptably wide range of situations is high. And parents achieve this (and it is quite an achievement) by modeling and rewarding appropriate behavior and by punishing misbehavior, and doing all this more or less consistently for sixteen or seventeen years. Any activity on the part of the parents that militates against this will reduce that outcome probability. So imagine parents who are indifferent to their children – who deliver very little in the way of rewards and who deliver punishment largely dependent on their own moods and whims and randomly as regards the child’s behavior. The child quickly learns that his behavior vs. misbehavior is not the issue – the issue is to avoid the flak. So he does what he pleases, but becomes very adept at reading parental moods, anticipating “squalls,” lying, etc. – all of which are “skills” we associate with the word psychopath (or sociopath – they mean the same thing). Note in particular that psychopathy “skills” are learned in accordance with the same mechanisms as lawful “skills.” I’m putting the word skills in quotes because I’m using it in an unusual way – but in fact these really are skills in the same way that riding a bicycle and skiing are skills

    And one final point – there is a widespread perception that in explaining a behavior, one is trying somehow to condone or excuse the behavior. Nothing is further from the truth, but it is difficult to convince people of this. There is this need to believe that people who do truly dreadful things are just somehow bad, and the notion that they learned their “badness” the same way that you and I learned to say “please” and “thank you” is somehow anathema. (I’m sure you will have noted the circularity of the “badness” explanation.) Personally I have no problem with trying to understand the genesis of a behavior, whilst at the same time condemning it as cruel, destructive, etc..

    So there, as always, a bit rambly – but wonderful topics, any one of which warrants a great deal more comment. So feel free to come back if you wish.

    I’m hoping to do a post on the so-called personality disorders sometime soon.

  • abby

    This was fascinating. I’m wondering what your take is on a “psychiatric” illness (I’m splitting hairs here with “mental illness,” I realize) such as severe depression, or bipolar disorder. It seems evident that both have components of learned behaviors, but it also seems that there is a clear physiological/chemical factor as well. Thoughts?

  • Abby,

    Thanks for your comment/inquiry.

    First, let’s clarify the terminology. The terms “mental illness” and “psychiatric illness” mean exactly the same thing. There has always been a measure of confusion here because in reality the concepts are fictitious, which was the theme of my History of a Mistake post. Another confusing term is “clinical” – as in “clinical depression.” The notion has gained ground that there exists this entity called “clinical depression” – that is somehow different from ordinary everyday depression. This is simply false.

    There are no mental illnesses. There are no psychiatric illnesses. Talking about mental illnesses is a bit like talking about dragons. One could discuss whether they have scales or skin, how many teeth they have, the temperature of their fiery breath, etc.. But in the end of the day – there are no dragons!

    The leadership of the APA are, of course, aware of this, which is why they try to avoid the issue by using the term “mental disorder.” This term strictly speaking does not necessarily involve the notion of illness – but rather simply implies that something is going wrong – something is not as it should be. However, they also realize that without the notion of illness, it is impossible to justify the drugs. (In fact, it is impossible to justify any medical involvement.) So in their manual (DSM), they use the term mental disorder, but in day-to-day business the membership promotes the term mental illness, with all its destructive implications.

    And the leadership’s definition of a mental disorder – (i.e. any serious problem of human existence) is carried unabashedly into the daily arena, where psychiatrists push dangerous drugs as a “treatment” for virtually any of life’s challenges.

    With regards to specifics: you express the belief that “…it also seems that there is a clear physiological/chemical factor as well”… in “severe depression” and “bipolar disorder.”

    I have discussed depression and the so-called “bipolar disorder” in earlier posts (Depression is Not an Illness and Bipolar Disorder is Not an Illness). I encourage you to take a look at these.

    But the following bears repeating.

    Depression is not an illness of any kind. It is an adaptive (i.e. useful) mechanism which alerts us to the need to make changes. It is nature’s way of saying “get up and get going.” It is a negative feeling whose message is “this isn’t how things should be.” In the same way that the sensation of pain alerts us to the need to remove our hand from a hot object, depression alerts us to the need to change something about our life.

    • The seven natural anti-depressants are: good nutrition; fresh air; sunshine; physical activity; purposeful activity (with at least some successes); adequate and regular sleep, and at least one good open honest relationship.

    • Severe depression is essentially the same as mild depression – just more severe. It is emphatically not an illness.

    • The widespread notion that depression is caused by a “chemical imbalance” in the brain is simply false – but is nevertheless widely promoted by pharmaceutical companies, psychiatrists, and other mental health workers.

    • The widespread notions that depression is an illness (“just like diabetes”) and that anti-depressants are medications (“just like insulin”) are false and destructive.

    • Anti-depressants are drugs just like cocaine, pot and amphetamines. Their purpose is to produce some kind of mood-altering effect. Contrary to popular belief, they are not very effective at relieving depression – about the same effectiveness as a sugar pill.

    • The so-called “bipolar disorder” consists essentially of a lack of discipline and self-control, coupled with habitual rudeness, temper tantrums, and lack of consideration for others. There is absolutely no evidence to support the notion that this kind of dysfunctional behavior is “really” an illness. Indeed, the notion is preposterous, and like the so-called depressive “illnesses” is nothing more than a facile excuse to peddle drugs.

    All of these themes are developed more thoroughly in the posts linked above.

    Finally, a quote from Elliot Valenstein, Prof. Emeritus of Psychology and Neuroscience at the University of Michigan, in his 1998 book Blaming the Brain:

    “Contrary to what is often claimed, no biochemical, anatomical, or functional signs have been found that reliably distinguish the brains of mental patients.” (p 125)

    Once again, thanks for your comment. I would be interested in your thoughts, so feel free to come back on any point.

  • Susan

    Hello Philip,

    I hope you are well and wanted to let you know I appreciate your blog very much. The article you sent me offered invaluable insight into why so many people, and almost purposefully it seems, try to misunderstand and skew behaviourism. In most of the textbooks I come across for school the sections on behaviourism go something like this “It happened- it was simplistic- and we moved on to better things.”. They often explain the concepts of behaviourism in a bastardized way and then say the concept is too simplistic without offering and adequate explanation as to why (it just is.).
    Not long ago I came across a book called “The Brain That Changes Itself” by Norman Doidge. The man basically believes that the brain can change and rewire itself though purposeful action. After reading a bit of the book I searched for interviews to understand more about his philosophies, how he feels about his career etc. Now, I know the man is psychiatrist, so when I read that he was defending psychiatric drugs I shouldn’t have been surprised- but I was. Whenever I come across an intelligent person I am always surprised when I hear their simplistic views on drugs. During a question and answer he made the following outlandish statements.

    http://www.tvo.org/TVOsites/WebObjects/TvoMicrosite.woa?mysteriesofthemind_qa

    “So why, you may ask, do we use these drugs? Because sometimes the illness they are treating is so terrible, that we have to weigh the risk to the patient’s life in not treating the illness, against the risk of the side effect. We live in an imperfect world, and often our best decisions are the ones with the least serious risk. Still, with all that, we are lucky to have some of these medications — until something better comes along.”

    As far as I know isolated tribes in New Guinea who live in a “primitive” way are actually doing quite well without these drugs. Are we really “lucky” to have them?
    According to Chris Kresser’s research at thehealthskeptic.org,

    “- There is no evidence that antidepressants reduce the risk of suicide or suicide attempts in comparison with a placebo in clinical trials (Kahn et al. 2000).
    – In fact, rates have actually increased in some age groups and in some countries despite increased antidepressant prescribing (Moncrieff & Kirsch 2006), and when antidepressant trials have been re-analyzed to compensate for erroneous methodologies, the SSRIs have consistently revealed a risk of suicide (completed or attempted) of between two to four times higher than placebo (Jackson 2005).
    – Sharply rising levels of antidepressant prescribing since the 1990s have been accompanied by increased prevalence of depressive episodes (Patten 2004) and by rising levels of sickness absence for depression (Moncrieff & Pomerleau 2000).
    – Longitudinal follow-up studies (which study the effects of antidepresants over the long term – not just the 6-8 week periods the clinical trials look at) show very poor outcomes for people treated for depression both in the hospital and in the community, and the overall prevalence of depression is rising despite increased use of antidepressants (Moncrieff & Kirsch, 2006).
    – Over the long-term, people prescribed antidepressants have a worse outcome than those not prescribed them, even after baseline severity had been taken into account (Brugha TS et al, 1992; Ronalds C et al., 1997). No comparable studies exist that show a better outcome in people prescribed antidepressants.”

    Is lucky really an appropriate word? Norman Doidge goes onto say that,

    “Many things have been suggested over the years, and everyone’s needs are different, but I like the approach in Richard Brown’s, Stop Depression Now, with its emphasis on omegas and vitamins. There are some suggestions that a subgroup of depressives with bipolar disease do well with intensive vitamin regimens, if they are missing some minerals in their diets. Remember, Lithium, which is the main mainstream drug to treat bipolar disease is a mineral.”

    “But clinicians are not generally using these drugs mindlessly. We try to take patients off them, and often see that they don’t function nearly as well as they did on them. And key to this question: is the diagnosis correct? The problem with the diagnosis of ADD is a deep one. It is a real disorder, but so often, children with all sorts of learning disorders and difficulties are given the diagnosis, and they shouldn’t be.”

    “But clinicians are not generally using these drugs mindlessly.” – I think it’s been clearly establish that they are. Although Norman Doidge is one of the psychiatrists that offers his patients psychotherapy he must be aware of the fact that he is a minority among his colleagues. Only ten percent of psychiatrists offer psychotherapy.

    “Drug companies invest a lot in developing medications, and they only stay on patent for a limited period of time, and by the time they are off patent, and become generic, the companies are on to making new drugs. There is, alas, little incentive to see whether they have long-term negative side effects, or whether they “poop out”. That said, for some people these medications are life-savers.”

    I truly find these simple minded statements appalling. Wouldn’t it be more appropriate to say “That said, some people believe these medications are life-savers.” Instead of saying that they are? Is it really scientific or wise to take what someone has said as fact? I met ex-alcohol who said God saved his life and there people who say ECT saved their life. Why has sensationalism been allowed to overpower facts?

    Anyway, just some thoughts. I’ll be back soon!

  • Susan

    The statements I quoted as being Kresser’s can be found at http://thehealthyskeptic.org/treating-depression-without-drugs-part-iii in the comment section after the article.

  • Susan,

    Thanks for your very interesting comment. Once you start to see this stuff, you see it everywhere. The saccharine ads, the NAMI press releases and, of course, the endless stream of material from the psychiatrists themselves.

    DSM is like an enormous building with lots of windows and balconies. And from the balconies people are giving speeches saying how wonderful the building is and how within the safety of its walls there is endless bliss and joy. But the building is made from sand and has no foundation. It is a sham.

    I’m not familiar with Normal Doidge or his writing, but from the passages you quoted, he sounds like a faithful follower of the bio-pharma-psychiatric bloc.

    You mention the statistic that 10% of psychiatrists offer psychotherapy as well as drugs. I have seen this figure in several different sites and have always been very skeptical. It sounds as if 10% of psychiatric activity is geared towards psychotherapy. Based on my many years of involvement with the mental health system, I would be surprised if even 1% of psychiatric activity was in psychotherapy. I think the source of the discrepancy lies in the word “offer.” If a psychiatrist offers psychotherapy but it is declined (as would almost always be the case) then he will go into the statistics as one of the 10%. It might also be the case the he offers psychotherapy to one client in a hundred. But in a survey he would go down as someone who offers psychotherapy.

    I agree with your comments about the misrepresentation of and hostility towards behaviorism. This is not just an accident of history. There are huge business and commercial interests at stake, in that behaviorism, with its emphasis on verifiability and clear definitions, represents an enormous threat to the bio-pharma-psychiatric bloc, which relies on credulity, muddled thinking, and plain old-fashioned nonsense.

    In my view many of the essential features of behaviorism can be elucidated by the old question: why did the hen cross the road? The traditional answer is, of course: To get to the other side. The behaviorists’ answer is: Because of the stimulus properties of the road and the hen’s reinforcement history. The difference between these two answers is critical. The traditional answer assumes that within the hen there was a goal or purpose, and that it was this goal which drove the road-crossing behavior. The problem with this from a behaviorist point of view is that the putative goal is inherently unobservable and can be indentified only after the fact. In other words, when the hen has crossed the road, one can say: See! Her goal was to cross the road and now she’s done it.

    Science is about two things: Understanding what happens in the world (including ourselves) and from that understanding, making accurate predictions about the future. Now a psychology in which putative goals are put forward as explanations of behavior can never be truly scientific because these goals are unobservable and can never have predictive value (because we can only know of them after the event). So behaviorists have developed a science which stresses observable behavior. Over the past hundred years or so, numerous discoveries have been made, including the importance of stimuli in eliciting behavior and the importance of reinforcement history in shaping behavior.

    Behaviorism is often criticized by outsiders as reducing human existence to a kind of mechanistic simplicity because it denies the reality of goals. This is simply not valid. Obviously people have goals. My goal at this moment is to complete this reply and post it on the website. But this doesn’t actually explain why I’m doing this writing. I might, for instance, have such a goal, but choose instead to sit in the recliner and do crossword puzzles. So if we want explanations of behavior, we have to look deeper – we have to look to my reinforcement history. In my childhood I was strongly encouraged, for instance, to reply to communications, and it is within that kind of training that you are more likely to find a valid explanation for my present writing behavior. Similarly within my childhood there was encouragement for getting the work done first – entertainment and play later. So I’ll get to the crossword after I’ve finished this reply and a few other things I have to write. And so on. Now because of the complexity of human existence, the precise confluence of past events that bear upon each item of present behavior is impossible to discern. But in controlled experimental work, with human and non-human subjects, the importance of stimulus and antecedent reinforcement are consistently confirmed.

    So it’s not that behaviorism portrays us as mindless, goal-less automatons. But simply that we look for explanations in observable and verifiable events.

    Just this morning I was listening to a piece on NPR about the importance of “self-control” in children. Now there’s nothing wrong with self-control, provided one recognizes that it is a descriptive concept and not an explanatory one. We could devise a set of behavior-specific criteria for “self-control” and without a doubt children who met these criteria would have better outcomes in almost any area than children who did not. But all this says is that children who are successful grow up to be adults who are successful. In other words, the best predictor of behavior is behavior. The concept of self-control has no explanatory value. When a person says: “John behaves so well because he has excellent self-control”, the impression arises (because of the language) that an explanation has been given. But the acid test is the question: “How do you know that John has excellent self-control?” and the only possible answer is: “because he is so well-behaved.” In other words, the only evidence for the putative trait is the very behavior it purports to explain. (You will find this idea throughout these posts applied to the putative mental illness explanations of behavior.)

    So behaviorists have nothing against notions like self-control – we just see them as descriptive rather than explanatory.

    The various references you cite are appreciated. Keep up the good work. As more and more of us recognize these issues and raise our voices, the sand castle starts to wobble and, who knows, may one day fall.

    Best wishes.

  • Martin

    I found this paper written by John Watson. I read that this was his “behaviorist bible” and thought that the framework he lays down to understanding the behaviorist perspective puts a lot of things you touch upon into even greater perspective.

    http://smash.psych.nyu.edu/courses/fall10/learning/papers/Watson1994.pdf

  • Martin,

    I agree. It’s a great paper, from one of the great figures in behaviorism. Did you notice that the paper is an extract from one published in 1913! Almost 100 years ago. These concepts have been around for a long time, and yet the spurious DSM nonsense continues to hold sway.

    Keep up the good work.

    Philip

  • ReaverKing

    Said this in another thread, gonna say it again here:

    Mental Health as a medical field may leave a lot to be desired, but
    I’m sorry, Mental Illnesses DO exist! That is, unless the brain is
    somehow completely immune to the failings that can befall every other
    part of the human body.

    When the pancreas suffers from an inability to produce or regulate
    insulin levels in the body, we call that condition diabetes. Few would
    argue that diabetes is a false condition or the result of some
    conspiracy.

    We’ve done at least enough research over the past fifty years to prove that the brain operates by producing and regulating dozens of chemicals. How our neurons communicate and how we THINK itself are a result of our brain releasing and absorbing chemicals within our brain tissue. Given that our sense of “self” is a direct product of these chemical interactions, a fault in our brain’s ability to properly manage any ONE of them could produce any number of changes in behavior, cognition, memory, perception, or even how other organs in our body function.

    Trying to skate by pretending that these facts are instead lies shows a profound disregard for basic biology.

  • ssenerch

    Sorry, but you’ve proven absolutely nothing in your comment. No one is saying that the brain is immune to illness or pathology. Think Parkinson’s. Think TBI. Those are actually identifiable illnesses. No physical pathology has EVER been proven to exist systematically in any of what are called “mental illnesses.” That is a basic fact that psychiatry has been conveniently and amazingly ignoring. It’s not enough that the idea that “mental illnesses” are caused by random brain chemical malfunctions sounds reasonable and believable to you. To be established as scientific fact it has to actually be proven, which it has not been and likely will not be.

  • Jeff Kelly

    There is so much truth here I have to wonder why this blog hasn’t mysteriously disappeared as so many other such postings have on the Internet. I hope I haven’t jinxed things by saying this!!

  • Phil_Hickey

    Jeff,

    Thanks for coming in. I guess we’ll just take our chances!