This post is a continuation of my post Steven Novella M.D. and Mental Illness Denial.
In Mental Illness Denial Part I, Dr. Novella makes the point that various parts of the brain enable us to do certain things, and that if we are doing these things dysfunctionally, or not well, or perhaps not at all, then clearly there is something wrong with that part of the brain. The example he gives is the activity of paying attention – but I think this is provided as an example, and that Dr. Novella intended his comments to apply to the full range of problems embraced by the DSM.
In the earlier post I pointed out the logical flaw in Dr. Novella’s position, but since then I have thought of a computer analogy that might help clarify my position. (Please note that I am NOT saying that people are computers – it’s an analogy!)
Imagine a computer expert who had a grudge against a company and decided to sabotage their systems so that a particular adverse event would occur as soon as the staff booted up next morning.
Now, I know nothing about computers, but broadly speaking, I think there are two ways that our disgruntled individual could achieve his goal. Firstly he could open up the machine and break something or fiddle with something or whatever, so that when the machines were activated, the adverse event would occur. Or, secondly, he could leave the machines intact and program them to malfunction in the way desired. So what we have is: two completely different ways of achieving the same effect.
Of course the analogy to people is that brain damage, or illness, or “imbalance” (i.e. hardware damage) can cause aberrant behavior, but aberrant behavior can also occur in the absence of any actual damage (i.e. through programming).
And, the analogy can be pushed further. All four of our children work in the computer field, and one of the things I’ve picked up over the years is that different programmers have different styles. If you ask ten programmers to write a piece of code to perform a certain task, there’s every likelihood that you will get ten different programs – all of which will work fine and will perform the task.
The analogy here is that when it comes to behavior, there is always more than one way to get to the same place.
Some people are “crazy” because their brains really are damaged, but there are other ways that a person could acquire similar behaviors even though there is nothing actually wrong with his brain. Parents, for instance, could actively teach a child craziness by rewarding any instance of crazy behavior that the child emitted. (I’m not suggesting that parents do this – but simply mentioning it as an extreme possibility.) In my experience, most craziness results from a combination of an overly demanding upbringing (usually well-intentioned) plus a significant experience of failure in late adolescence/early adulthood. I think it is also likely that people can be driven crazy by persistent cruelty and mistreatment. And of course it’s pretty well-established that criminals sometimes become crazy when faced with the possibility of severe punishment for their crimes.
Back to Dr. Novella. In the same article he expresses the view that “mental illness deniers” fall into three broad groups:
2. People who “rail” against the abuses of psychiatry (which Dr. Novella contends are ancient history, and don’t occur today)
3. Conspiracy theorists who see something sinister or untoward in the relationship between psychiatrists and big pharma.
Note what he’s done. He pretends that he is engaging in honest debate about the ontological status of the conditions known as mental illnesses. But right from the start he marginalizes his opponents (almost to the point of ridicule). Is this a path to honest dialogue?
With regard to group #3 above, the fact is that the psychiatric profession is embroiled with the pharmaceutical companies to a degree that is venal, corrupting, self-serving, and in far too many cases, contrary to clients’ interests. “Eminent” psychiatrists have been paid large sums of money for putting their names to ghost-written peer-reviewed articles that were essentially pharmaceutical company brochures. Psychiatric research has been hi-jacked shamelessly by pharmaceutical dollars, and it is only very recently, and under extreme pressure, that psychiatric researchers have been declaring their financial ties to these companies.
I have addressed these issues numerous times throughout the website, as have other writers both on the ‘net and in conventional print, and in peer reviewed journals. If there is anyone who doubts the validity of these concerns, search the Internet for: conflict of interest, psychiatry, and big pharma. You will be inundated.
But according to Dr. Novella, because I draw attention to this proven, well-documented, and widespread corruption and dishonesty, I’m a conspiracy theorist!
This I have come to recognize as typical of how Dr. Novella operates. As far as he is concerned mental illnesses are brain illnesses – period. There’s nothing more to be said, and anyone who opposes this belief is ridiculed, marginalized, pushed aside. Even the word “denier” is used in his articles in the same sense as “evolution denier,” “climate change denier,” “Holocaust denier,” etc… Dr. Novella’s stance is particularly disappointing in that he is, according to Wikipedia, the president and co-founder of the New England Skeptical Society. One might reasonably have expected from him a little more skepticism in the psychiatric field.
Now, I’m very comfortable with dialogue and debate. There has been a great deal of disagreement on this website, and hopefully there’ll be more. But Dr. Novella’s tactics are tawdry and unworthy.