The Dopamine Hypothesis of Schizophrenia – Version III

On November 27, 2014, the Division of Clinical Psychology of the British Psychological Society published a paper titled Understanding Psychosis and SchizophreniaThe paper was edited by Anne Cooke of Canterbury Christ Church University.  The central theme of the paper is that the condition known as psychosis is better understood as a response to adverse life events rather than as a symptom of neurological pathology.

The paper was wide ranging and insightful, and, predictably, drew support from most of us on this side of the issue and criticism from psychiatry.  Section 12 of the paper is headed “Medication” and under the subheading “Key Points”, you’ll find this quote:

“[Antipsychotic] drugs appear to have a general rather than a specific effect: there is little evidence that they are correcting an underlying biochemical abnormality.”

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

On the same date, The Mental Elf published a critique of the BPS paper.  The Mental Elf is an Internet website that purports to offer “reliable mental health research, policy, and guidance.”

The critique of the BPS paper is presented in three parts.  The first was written by Keith Laws, a psychologist, the second by Alex Langford, a trainee psychiatrist, and the third by Samei Huda, a consultant psychiatrist.

My purpose in writing this post is to address a paragraph in Dr. Langford’s essay.

“The ‘key point’ that there is ‘little evidence that [medications correct] an underlying abnormality’ is bizarrely unfounded. An excellent summary by Kapur & Howes (referenced earlier in the report itself) and further imaging studies by Howes and others provide solid evidence for elevated presynaptic dopamine levels being a key abnormality in psychosis, and there is copious evidence that inhibiting the action of this excess dopamine using antipsychotics leads to clinical improvement in psychosis.” [Emphasis added]

Note the term “bizarrely unfounded.”  Not “questionable”; not “misleading”; not “false”; not “overstated”; not “open to discussion”; not “unlikely” – but “bizarrely unfounded”!

In support of this assertion, Dr. Langford cites Oliver Howes and Shitij Kapur’s The Dopamine Hypothesis of Schizophrenia: Version III—The Final Common Pathway, Schizophrenia Bulletin, March 2009, which he claims provides “solid evidence” that elevated presynaptic dopamine levels are a “key abnormality in psychosis.”

To help put Dr. Langford’s assertion in perspective, here are some quotes from the Howes and Kapur article, interspersed with my comments.

“The dopamine hypothesis of schizophrenia has been one of the most enduring ideas in psychiatry.”

The authors describe how the dopamine hypothesis, which, incidentally, has been around since the late 60’s, has gone through two major revisions.  They refer to these as version I and version II.  Then:

“Since version II, there have been over 6700 articles about dopamine and schizophrenia. We selectively review these data to provide an overview of the 5 critical streams of new evidence: neurochemical imaging studies, genetic evidence, findings on environmental risk factors, research into the extended phenotype, and animal studies.”

“It [The Dopamine Hypothesis of Schizophrenia – Version III] explains how a complex array of pathological, positron emission tomography, magnetic resonance imaging, and other findings, such as frontotemporal structural and functional abnormalities and cognitive impairments, may converge neurochemically to cause psychosis through aberrant salience and lead to a diagnosis of schizophrenia.” [Emphasis added]

Note the word “may”, which suggests that the authors themselves did not regard the evidence as being quite as “solid” as Dr. Langford asserted.

“Although it is not possible to measure dopamine levels directly in humans, techniques have been developed that provide indirect indices of dopamine synthesis and release and putative synaptic dopamine levels.”

The fact that the primary variables cannot be directly measured, but rather are estimated from “indirect indices” suggests further that the evidence for version III may not be quite as solid as Dr. Langford asserts.

“Seven out of 9 studies in patients with schizophrenia using this technique have reported elevated presynaptic striatal dopamine synthesis capacity in schizophrenia, with effect sizes in these studies ranging from 0.63 to 1.89.”

“This, then, is the single most widely replicated brain dopaminergic abnormality in schizophrenia, and the evidence indicates the effect size is moderate to large.”

So essentially what’s being asserted here is that there is replicated evidence of abnormally high presynaptic dopamine production in the striatum area of the brain in people who carry a “diagnosis of schizophrenia.”

I don’t have the time to review all seven of the articles cited, but I did take a look at one:  Howes OD, Montgomery AJ, Asselin MC, et al. Elevated striatal dopamine function linked to prodromal signs of schizophrenia, Arch Gen Psychiatry. 2008 (number 20 in the reference list).  I chose this because the full text was readily available and because the principal author, Oliver Howes, MD, is also the principal author of the article cited by Dr. Langford.

Howes, Montgomery, Asselin, et al offer the following context for their study and report:

“A major limitation on the development of biomarkers and novel interventions for schizophrenia is that its pathogenesis is unknown.  Although elevated striatal dopamine activity is thought to be fundamental to schizophrenia, it is unclear when this neurochemical abnormality develops in relation to the onset of illness and how this relates to the symptoms and neurocognitive impairment seen in individuals with prodromal symptoms of schizophrenia..”

To address this question, they recruited three groups of people:

  • 24 “patients having prodromal symptoms of schizophrenia,” recruited from a community mental health center;
  • 7 “patients having schizophrenia” recruited from the same center;
  • 12 “matched healthy control subjects” from the same geographic area.

All of these individuals received an intravenous injection of 150 MBq (megabecquerels) of 18 F-dopa  30 seconds after the start of PET imaging which lasted for 95 minutes.  The neurochemistry of all this is extremely complicated, but the basic picture is this.  Dopa is an amino acid that is produced from tyrosine in the liver.  Through the action of the enzyme decarboxylase, it is converted in the brain to dopamine.  Dopamine is the neurotransmitter, the overactivity of which is hypothesized as the cause of the condition known as schizophrenia.

As mentioned earlier, the accumulation or activity of dopamine in the brain cannot be measured directly.  But one of the indirect measures of dopamine synthesis is the rate at which dopa is absorbed or taken up.  When 18 F-dopa (a radioactive analogue of dopa) is used, the uptake can be observed and measured on a positron emission tomography (PET) brain scan.  In these kinds of studies the rate of F-dopa uptake is normally expressed as a Ki value.


As mentioned earlier, there were three groups of participants.

a) Twenty-four “patients having prodromal symptoms of schizophrenia”. The authors describe these individuals as having an “at-risk mental state (ARMS)”. The concept is similar to the APA “diagnosis” of “attenuated psychosis syndrome” (DSM-5, p 122)

b) Seven “patients having schizophrenia.” All seven reportedly met the DSM-IV criteria for schizophrenia.

c) Twelve “matched healthy control subjects” recruited from the same geographic area as the clinic. No information is provided as to how these individuals were recruited or screened.

The results of the study are presented in Figure 2.

As can be seen, the diagram is divided into three vertical blocks: Control, ARMS, and Schizophrenia, reading from left to right.  The Ki values are shown on the vertical scale on the left.

The black horizontal rectangle (▬) indicates the mean Ki value for each group.  So the 12 controls had a mean of 0.0142; the ARMS group 0.0151; and the schizophrenia group 0.0157.  On the face of it, this looks like an impressive result.  The Ki values are steadily increasing across the three groups, strongly suggesting that dopamine synthesis capacity is increasing commensurately.

However, the individual scores in the three groups tell a somewhat different story.  Each diamond indicates the score for a healthy control subject; the triangles give the scores for each ARMS participant; and the round dots give the scores for the participants “diagnosed with schizophrenia.”  If we think of the healthy controls as having “normal” dopamine synthesis, then it is clear that Ki values between approximately 0.012 and 0.016 represent the normal range.  And it is also clear that the only study participants with values outside the normal range were three from the ARMS group and one from the schizophrenia group.  In other words, 87.5% (21 out of 24) of the ARMS participants, and 85.7% (6 out of 7) of the schizophrenia participants had Ki scores in the normal range.

The general point here is that mean values, although very useful and informative with some forms of data, can be quite misleading in other contexts.  On the basis of the findings presented in this study, I don’t think one could reasonably infer that there is “solid evidence for elevated presynaptic dopamine levels being a key abnormality in psychosis”, as Dr. Langford asserts.


Besides the marked overlapping of scores, there were other problems with the study. The first, and perhaps most obvious, is the problem of matched pairs.

In the paper’s abstract, the authors write:

“Twenty-four patients having prodromal symptoms of schizophrenia were compared with 7 patients having schizophrenia and with 12 matched healthy control subjects from the same community.”

This statement – particularly the word “matched” – conveys the impression that the “healthy control subjects” were similar to the members of the two focus groups in every respect except for those factors directly associated with a “diagnosis of schizophrenia” or “prodromal symptoms of schizophrenia”.  This is the essential assumption underlying all matched pairs research, and is a reasonably robust assumption for studies in physical science, engineering, materials testing, and even, to some extent, in general medicine.  In behavioral/psychological studies, however, the technique has serious limitations, because one would have to match on a dauntingly large number of variables to have even a remote chance that the two groups were sufficiently similar to enable one to draw even modest conclusions.

Here’s how it works in practice.  A researcher recruits individuals for his study.  The study might involve the administration of a treatment or, as in this case, observing something going on within the brain.  Let’s say that 20 people have been recruited.  The researcher then recruits 20 controls.  The controls are people who don’t have the feature under consideration (in this case, “schizophrenia symptoms”) but who do match the recruited participants (individual for individual) on a number of variables that are considered relevant.  So if the recruiter determines that age, gender, and education are the relevant factors, he would, for each participant, find a match:  a person of the same age, same gender, and same education.  So, if the experimental group responds to the treatment or yields different observations from those of the control group, one can have a measure of confidence in the validity of the results.

Most matched pairs studies provide a fairly detailed description of the matching process and the matching variables used.  This is not provided in Howes, Montgomery, Asselin, et al.  All we are told is that:

  • the controls were recruited from the same geographic area
  • the controls were “required to have no personal history of psychiatric illness”
  • and that the “…groups were well matched for variables that might putatively alter dopaminergic systems such as substance use and age…”

The point of all this is that, even if we allow that dopamine synthesis was higher in the striatal area of the brain for the ARMS and schizophrenic groups than for the controls, it is unsafe to conclude that excessive dopamine synthesis is a neurological abnormality inherent to individuals who attract the labels ARMS and schizophrenia.  It may be, for instance, that the dopamine difference is a reflection of some other factor entirely – something on which the controls and participants were not matched – e.g.  a history of abuse or victimization or the experience of failure. And we certainly have no grounds for believing that the dopamine excess causes the loose collections of vaguely defined thoughts, feelings, and behaviors that psychiatrists label “schizophrenia” and “attenuated psychosis syndrome”.

This last point is important because it touches on the unreliability of psychiatric “diagnoses”.  In studies of this sort, there is a tendency to accept the labels assigned to the different groups as 100% reliable.  So all members of the ARMS group are considered to “have” attenuated psychosis syndrome; all members of the schizophrenia group “have” schizophrenia; and all members of the control group are considered to be “healthy” – i.e. having  no psychiatric “illness”.  In reality, psychiatric evaluations are unreliable.  The kappa score for schizophrenia in the DSM-5 trials, for instance, was only 0.46.  So if we were to take the 43 people involved in the present study and present them to say ten other psychiatrists in a variety of settings, we will almost certainly get different groupings.  Some of the people in the focus groups will be considered “healthy” while conceivably some of those in the “healthy” group will be considered psychiatrically “ill”.

A further problem with the Howes, Montgomery, Asselin, et al study is the fact that one of the “patients” was taking quetiapine (100 mg/day) at the time of the study, and that others had apparently been taking neuroleptics in the past.  All that the authors tell us is that:

“All patients were not taking antipsychotic treatment for at least 8 weeks, except for 1 patient with ARMS who was taking quetiapine fumarate (100 mg/d[omitted for 24 hours before imaging])”

It is known that neuroleptic drugs affect the dopamine system, and it is a reasonable assumption that none of the control subjects had ever taken these products.  So we have another variable on which the groups were not matched.  It seems unlikely that the neuroleptic-induced dopamine changes in the brain would have dissipated within eight weeks.

Lest it be thought that I cherry-picked the Howes et al study, here’s the comparable Ki graph from another study cited by Drs. Howes and Kapur.  The study was conducted by Stephen McGowan et al (2004), Presynaptic Dopaminergic Dysfunction in Schizophrenia.

Here again, note that although the means differ in each analysis, there is a great deal of overlap when we look at individual scores.  For the entire striatum (A), 11 out of 15 (73.3%) “patients” have Ki values in the same range as the controls.  The corresponding Ki values for the ventral striatum (B) are 7 out of 11 (63.6%).  So here we have another group of people “with schizophrenia”, 60-70% of whom have normal Ki values.  In this study, incidentally, all the “patients” were taking neuroleptic drugs.

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

To return to Dr. Langford’s original assertion:

“An excellent summary by Kapur & Howes (referenced earlier in the report itself) and further imaging studies by Howes and others provide solid evidence for elevated presynaptic dopamine levels being a key abnormality in psychosis, and there is copious evidence that inhibiting the action of this excess dopamine using antipsychotics leads to clinical improvement in psychosis.”

It is noteworthy that Drs. Kapur and Howes themselves were a good deal less certain:

“Two different kinds of evidence could lead to a complete rejection of the hypothesis. PET studies directly implicating presynaptic dopamine dysfunction are a major foundation of this new version of the hypothesis. PET data require to be modeled to provide estimates of L-dopa uptake or synaptic dopamine levels—and the results are inferred rather than direct measurements. Thus, if it turns out that the body of evidence based on PET imaging is a confound or an artifact of modeling and technical approaches, this would be a serious blow for version III, though the data behind versions I and II would still stand strong. While possible, we think this to be highly unlikely. What is perhaps more likely is that a new drug is found that treats psychosis without a direct effect on the dopamine system. In other words, the dopamine abnormalities continue unimpeded, and psychosis improves despite them. A good example of such a new drug might be LY2140023, an mGlu 2/3 agonist. If this were to be an  effective antipsychotic and it could be shown that the new pathways do not show any interaction with the dopamine system, then the fundamental claim of version III, that it is the final common pathway, would be demolished. A similar situation would arise if a pathophysiological mechanism that does not impact on the dopamine system is found to be universal to schizophrenia. Much more likely is the possibility that the hypothesis will be revised but with a stronger version IV.” [Emphasis added]

So although Drs. Kapur and Howes express a general optimism for the hypothesis, they acknowledge that the theory could be demolished by future research.  And:

“The next decade will provide more information on the role of dopamine, particularly how genetic and environmental factors combine to influence the common pathway, and better drugs will be developed that directly influence presynaptic dopaminergic function—both logical successors to the idea of a final common pathway.”  [Emphasis added]

In the one Howes and Kapur reference that I reviewed (Howes, Montgomery, Asselin, et al 2009), the authors also express some cautionary notes:

“Results of recent clinical trials suggest that treatment with antipsychotic medication may reduce the severity of attenuated psychotic symptoms and the risk of schizophrenia in patients with ARMS.  Our finding of dopaminergic overactivity in the ARMS group indicates why drugs that act on the dopamine system may have these effects. We conclude that presynaptic striatal dopamine function may be a promising target for future drug development in the treatment of psychotic disorders.” [Emphasis added]


The acknowledgement statement at the back of the Howes and Kapur article states:

“Howes has received investigator-led charitable research funds or speaking engagements from AstraZeneca, Eli Lilly, and Janssen. Kapur has received grant support or has been a consultant/scientific advisor or had speaking engagements with AstraZeneca, Bristol Meyers Squibb, Eli Lilly, EMD—Darmstadt, Glaxo Smith Kline, Janssen (Johnson and Johnson), Neuromolecular Inc, Pfizer, Otsuka, Organon, Sanofi-Synthelabo, Servier, and Solvay Wyeth.”

The financial disclosure statement at the back of the Howes, Montgomery, Asselin, et al article states:

“Drs Howes, Montgomery, Murray, McGuire, and Grasby received investigator-led charitable research funds and honoraria from pharmaceutical companies manufacturing antipsychotic medication.”


The elevated dopamine synthesis hypothesis has been discussed by the British psychiatrist Joanna Moncrieff (The Myth of the Chemical Cure, 2009).  Here are three quotes:

“Another group of studies have measured the uptake of a radiolabelled dopamine precursor molecule, presumed to reflect the synthesis of dopamine in people with psychosis compared with healthy controls (Dao-Castellana et al. 1997; Elkashef et al.  2000; Hietala et al. 1995; Lindstrom et al.  1999; Reith et al.  1994).  Results of these are inconsistent.  Even the results of the ‘positive’ studies are incongruous with some finding increased uptake in the putamen but not the caudate nucleus (parts of the basal ganglia) (Hietala et al.  1995) and another finding increased uptake in the caudate but not the putamen (Reith et al.  1994).  One study found no effect (Dao-Castellana et al.  1997) and the largest study so far found the opposite finding of reduced uptake in the ventral striatal area of the brain (Elkashef et al.  2000).” (p 93) [Emphasis added]


“All recent studies were small, and although efforts were made to identify and include patients who had not previously taken neuroleptic drugs, known as ‘drug naïve’ patients, all but one of the studies also included patients who had taken these drugs in the past, often for long periods.  Therefore prior treatment with drugs known to affect the dopamine system may be, at least partially, responsible for the findings.” (p 93)


“However the biggest problem with all this research is the complete disregard for other possible explanations for increased dopamine activity.  Dopamine release is known to be associated with numerous activities and situations that may differ between patients and healthy controls and may account for the difference in dopamine activity independent of the presence of psychosis.  Motor activity and attention have been shown to increase dopamine activity and dopamine is involved in arousal (Berridge 2006).  People with acute psychosis are likely to be more aroused and agitated than healthy controls and this may account for increased dopamine activity.  None of the recent dopamine-psychosis studies have examined these possible confounders.” (p 93-94)


There is, in my experience, an unfortunate tendency among psychiatric practitioners to overstate their various chemical imbalance hypotheses, and to commensurately criticize, and even marginalize, those of us who offer alternative perspectives.  Dr. Langford’s assertion is a good example of this, and his rejection of the BPS’s statement as “bizarrely unfounded” borders on incivility.  There is nothing even remotely bizarre about the BPS statement, and, in fact, given the limitations of the studies cited, it is extremely well founded.

If psychiatry, at some time in the future, identifies a specific neurological abnormality, and demonstrates that this abnormality is present in all the people that they “diagnose with schizophrenia”, and in none of the people that are not so “diagnosed”, then they will indeed have established a key neurological abnormality associated with this condition.  If, by further research, they establish that the causal sequence is from neurological abnormality to the problematic thoughts, feelings, and behaviors of the individuals involved (as opposed, say, to the causality going the other way), then they will have uncovered something worth talking about.  And if, by still further research, they show that the abnormality is pathological rather than, say, a variation of normal functioning, then they will indeed have established that the condition known as schizophrenia can properly be regarded as a neuropathological condition.

But such evidence is not currently to hand.

  • Anonymous

    They really are brainwashed quacks these psychiatrists. Through reading these flawed and failed “studies” they brainwash themselves to see nothing but a “presumably malfunctioning” brain when they go out into the world and pluck people from their lives by force and force their way into the bodies of the unconsenting. To paraphrase Voltaire, those who believe absurdities will commit atrocities. Psychiatry commits atrocities, simply because it believes its absurd tenets trump the very humanity and the right to say no, of the human beings psychiatrists force themselves on. They have more in common with Josef Mengele than they will ever admit to themselves. It is truly sickening to be living in a world where our fellow man and government has handed these quacks the power to simply sign a piece of paper and gain forced access to the brain of any man, woman or child they should choose to target.

    “More aroused”? Try finding the strength to go on when you’ve been shown you will be kept a hair’s breadth away from totalitarian forced drugging control for the rest of your life. Without articles like this and people doing yeoman’s work in the manner of that which you do here at this blog, the floodgates of total unmitigated alienation from all of society and humanity would open and engulf me, such is the cascading, controlled demolition of my very faith in humanity unleashed by psychiatry’s inhumanity.

    It’s just good to know there are people out there that believe in our humanity, willing to think in a more open-minded way than the pseudomedical, pseudoscientific human rights criminals that produce endless reams of this latter-day phrenology that would be more at home in a Civil War era craniometry journal filed on the bookshelf of some antebellum plantation house’s study. When I want to know if I have a brain disease I’ll go to a real neurologist, not some Jannsen golf bag toting DSM quack that hasn’t seen inside the human body since med school 20 years ago in anatomy class, not some pretender to the throne of “brain expert” who has spent the past 20 years doling out tranquilizer drugs and amphetamines to humans he hasn’t performed a single biological test on.

    They are truly pathetic. It is absolutely no wonder psychiatrists have such a high suicide rate, and that fewer and fewer medical students see psychiatry as a credible career.

    A great many of them deserve to be talking to their family through a Plexiglas window while grasping a prison intercom phone, while the Jannsen golf bag gathers dust in the garage and the family faces foreclosure, the BMW repayments unmet. The booty paid for with blood money earned raping the brains of the unwilling, protesting, powerless, terrified mental patients thrown in a hole and forgotten about by society.

    When most people read these studies, that’s an intellectual exercise in coming to understand the logical errors in psychiatry’s deductions etc. But for me and so many like me, because these sickening brain rapists took it upon themselves to rape my dopaminergic function, reading such material has another ghastly and inescapable element. Because I have to live with the fact that my attackers left no part of my body I could wash out after these pack rapists of neurobiology had their way with me, it reads like some sick observational study of the molecular mechanics of how a rapist’s sperm behaves in a raped vagina. I read the studies, and my face contorts and sneers, in pure crystalline disgust at this abhorrent enterprise, these ham-fisted sickos “researching” what they think is going on, in brains they can enter and alter and rape, at will. I’m sure the screams of nonconsent didn’t even bother Mengele when he would write up the results of his unnecessary amputation of limbs, or a chloroform injection to the heart. Just as I’m sure the psychiatrists that write these studies up don’t have any conception of what it was like for their victims when the psychiatrist forced his or her way into their living conscious brains against their express wishes and screams of terror.

    All of this “research” is founded and built upon miserable, obscene, violent human experimentation.

    There were a great many people that died before World War 2 was finished and didn’t live to see the resolution. One of the things I have slowly come to terms with is that I will die before the world gets to see psychiatry stop destroying millions of lives. All we can do is try and salvage some modicum of enjoyment in life while the carnage goes on in the background each and every day, and see about contributing to the struggle to expose these ghoulishly misguided quacks as best we can.

  • Phil_Hickey


    Thanks for coming in. I frequently write that there is no essential difference between psychiatric drug-pushing and the street corner variety. But your comment reminded me that this isn’t quite true. The guy on the corner never forces people to accept his product!

    Best wishes.

  • heartofatum

    What are people with genuine severe mental illness suffering from then? & how do you suppose ‘we’ treat them? – let them live on the streets & then throw them all in jail? As you currently do in the Enlightened & Great USA.

  • Anonymous

    I of course don’t accept the premise of a question that claims anybody has an “illness” of the “mind”. You make many presumptions, that I’m American for one, and you make the sad, old, tired “streets or prison” argument. Patently and demonstrably false, given the millions of Americans who have been name-called with so-called “serious” DSM labels/libels who are neither on the streets nor in prison, I am myself a person who has had to bear “serious mental illness” slander from those who believe in such dehumanizing crap, I’m not on the streets or in prison. It’s not up to you to “let” me live anywhere. I propose as you can see from my above lengthy comment of three months prior to treat human beings humanely and to not initiate violence against peaceful people no matter how bizarre and alien you might find their current beliefs, thoughts, speech feelings and behavior provided such behavior is non-criminal.

  • heartofatum

    “I of course don’t accept the premise of a question that claims anybody has an “illness” of the “mind”.”

    & what is your reasoning that mental illness doesn’t exist – other than some very tired & refuted anti-psyhciatry arguments from the 60’s?

  • Anonymous

    Only an organism can be diseased. There’s no evidence my body is/was diseased so therefore quite reasonably I don’t view my experiences and these parts of my life, states of mind, whatever you want to call them as medical problems let alone “illness”. Simply branding something “tired and refuted”, do people often take that lazy crap seriously? I suppose you think by claiming something is “refuted” that is a refutation in and of itself huh. Shocking. Believe whatever you want though, I don’t mind.

  • heartofatum

    i have refuted the anti-psychiatry argument of Szasz at the bottom of this post if you want to debate it intelligently then be my guest –

    The brain can be ill just as any organ can. If we’re talking dualism (a question anti-psychiatry doesn’t answer), then it’s very well argued the mind can have a psychopathology.

    The danger with anti-psychiatry is in denying the reality of what people are experiencing.

  • Anonymous

    Oh thank you for telling me that part of an organism can get a disease, I can see, (laughing at you) how my previous comments could have given you the impression I wasn’t aware of that fact. You haven’t refuted Szasz at all, I think the comment you linked to is absolute garbage. If you have any proof my brain is “ill” or diseased, please table it, or for that matter any other part of my body, I’d be interested to know. Do you run around assuming you have a diseased body part when no physician in the world can prove it is diseased? I certainly don’t. Is it impossible that I have a brain disease? Of course not. Just as it is not impossible that you currently have HIV. But you can get a test to determine your HIV status and until that time you’d be a moron to just assume you have HIV. There are no biological tests for any of psychiatry’s spurious constructs, and therefore it would be absurd and moronic of me to live my life and organize my life as if I have something wrong with my body, and to assume that this mythical and unproven bodily problem millions of fuckwits seem to assume I have, is the ultimate cause of any problematic thoughts, feelings and behaviors I’ve encountered in life. Only real doctors, who examine, identify and treat disease in the physical human body based on western biomedicine have earned the right to use the word pathology, psychiatrists don’t practice real medicine and I don’t take seriously people using the word ‘pathology’ to refer to thoughts and feelings they are not a fan of.

    I have immense undying respect for real pathologists, they are real practitioners of a medical art. Don’t sully their name by assuming some clown declaring states of mind ‘pathological’ by fiat or by voting along with his fellow quacks, has earned the right to genuinely pathologize anything. You became an unserious person to me the moment I saw you mention ‘panpsychism’.

    “denying the reality of what people are experiencing” is a meaningless sentence to me and numerous posts and comments on this blog will show you that most of the people who come here regularly, and certainly the blog owner, don’t deny people suffer. Disagreeing with the ridiculous and deformed belief that problem thoughts, feelings and behaviors are ‘pathological’ does not constitute a denial that problem thoughts, feelings and behaviors exist, for fuck’s sake.

  • heartofatum

    You’re certainly energised in your opinion. i don’t personally agree entirely with biomedical psychiatry, nor do i agree with anti-psychiatry, i’m very critical of the system, & in favor of far more comprehensive psychological/social support approaches & far more in depth integral approaches & understandings to madness – But i’m Not going to deny that people are mad/mentally ill to various degrees & in various ways – they simply are, & there is evidence of pathology, across physiological & other levels. Medication can also be very helpful to some people in some cases, as can a diagnosis.

    i can’t fathom what you imagine people are actually experiencing? Nor how you rationalise it all, & i’m Not aware of your individual case – maybe nothing was wrong to begin with?

  • heartofatum

    “You haven’t refuted Szasz at all, I think the comment you linked to is absolute garbage”

    & i think Szasz & anti-psychiatry is absolute garbage. i did ask if you wanted to intelligently debate the argument – i don’t think you understand what was said?

  • Anonymous

    I don’t describe myself as anti psychiatry, if you want psychiatry if anybody wants psychiatry good for them. I don’t know or care what you mean when you invoke ‘anti-psychiatry’. There isn’t evidence of pathology, no pathologist in the world can ‘diagnose’ the things you believe in, in the living or dead human body. The name-calling you seem to think deserves to, or has earned the right to be called ‘diagnosis’ is invalid, despite the subjective ‘feels’ and gladness to have a name for their pain some people might be fans of. You seriously can’t fathom that there are people out there, me included who believe in problem thoughts, feelings and behaviors, but don’t consider these to be “illnesses”, if you can’t fathom this then I can’t help you.

  • Anonymous

    Good for you. You’re free to disagree with Szasz’s contention that only the body can be diseased. He and every pathologist, every coroner, every pathology textbook in the world, will continue disagreeing with your fantastical belief that problem thoughts, feelings and behaviors constitute the sole evidence required to establish the existence of a diseased brain. I admit I barely looked at the ridiculous post you made where you confessed to being a panpsychist (someone who believes rocks and dead flies are conscious)

  • heartofatum

    There is a growing evidence base for physiological aspects to mental health conditions. The main diagnostic categories do fit certain ranges of observed/reported symptomatology – & always have done (albeit referred to & understood in different ways throughout the ages).

    In part your arguing straw men – it’s well established for anyone with half a brain cell that a combination of physical, genetic, psychological and environmental
    factors can make people more likely to develop a mental disorder.

  • heartofatum

    “You seriously can’t fathom that there are people out there, me included
    who believe in problem thoughts, feelings and behaviors, but don’t
    consider these to be “illnesses”, if you can’t fathom this then I can’t
    help you”


  • heartofatum

    “I admit I barely looked at the ridiculous post you made where you confessed to being a panpsychist”

    i’m a panpsychist as much as your an anti-psychiatrist 🙂

    i never did admit to such a thing, try reading the post & watching/listening to the video – a lot of us have moved on from the 60’s – it is 2015 after all.

  • Anonymous

    If you believe that the proliferation of “studies” that have led to no replicable gold standard biomarker ever being discovered for any of the spurious constructs that you choose to call “conditions” constitutes a “growing evidence base” then, my friend, you probably think a “growing evidence base” was brewing during the era of scientific racism and measuring the skulls of slaves. A bunch of sciencey sounding noise and clamor does not a discovery make. I sleep at the same level of soundness or unsoundness whether you moronically believe there is something wrong with me physically or genetically, I don’t care what you believe. I know that no geneticist and no pathologist on earth can examine my body and prove there is anything understood to be amiss, diseased, ill, about my body or genes, and be able to conclusively prove a causality between this never-proven-nor-found-in-my-body-or-genes alleged “evidence” and the phenomena, states of mind, problems, that you’re convinced for some reason ought to be known by the moniker “mental illness”. Did people get sad throughout the ages? of course, did people get bizarre throughout the ages? of course, have you or anybody else proven that I have a brain disease, or any given person labeled “mentally ill” has a brain disease? no. If only life were so simple. Wouldn’t it be lovely if the extremes of life were as simply explained as a seizure is? Sadly the problems of life are not an illness unless medicine can prove they are. Psychiatry has never passed that threshold. Always so mildly amusing to hear words like “symptomatology” invoked by people who literally believe they are talking about real medical problems though so thanks for that mild grin you elicited in me.

  • heartofatum

    “He and every pathologist, every coroner, every pathology textbook in the
    world, will continue disagreeing with your fantastical belief that
    problem thoughts, feelings and behaviors constitute the sole evidence
    required to establish the existence of a diseased brain.”

    i don’t disagree at all – the primary aetiology is psychogenic.

  • Anonymous

    Oh no buddy boy, it’s not semantics at all, was it semantics when homosexuality left the realm of being called an illness to transit to the conceptual status it enjoys today? Was it semantics when masturbation left the pseudomedicalized pathologized realm it was in during the 19th century and entered the conceptual framework it exists in today? oh no. I view the phenomenon that you view as an “illness” as fundamentally not being medical in kind.

  • heartofatum

    In the vast majority of cases i also agree these conditions are Not brain disease – but that doesn’t negate a physiology. i’d see the primary aetiology as psychogenic.

  • Anonymous

    To me you just sound ridiculous. You may as well describe the etiology of your parents’ marriage as psychogenic. Why even adopt this ridiculous pose of “medicalness”. Do you think by dressing your speech and thoughts in the garb of doctors you’re understanding the extremes of life better? I find it very unnecessary and I think it completely short circuits understanding. I don’t think you’re in any position to be declaring a “primary aetiology” (evoking a “secondary aetiology), at all.

  • heartofatum

    Not primarily biomedical, no, i agree. Doesn’t mean to say that people aren’t ill. You haven’t refuted the argument that there is a psychopathology – i think it’s a case of agreeing to disagree .

  • Anonymous

    Absence of demonstrable biological pathology means it is nonsense, useless, and diversionary to muse and speculate about unproven biological pathology, as absurd as you assuming you have diseased kidneys when no physician on Earth can back that up. I disagree with and find no wisdom, and much harm, in calling people’s problems a “condition”.

  • heartofatum

    & who are you to declare one doesn’t exist? lol

  • heartofatum

    Comes back to the realities & question of what exactly is it some people are experiencing then?

  • Anonymous

    If you live in a version of reality where it is not laughable, harmful, distracting, and agency-robbing, to brainwash people to believe that the fact they have some problem thoughts and feelings means they “are ill” then go right ahead. I live in the version of reality where that was the most dis-empowering, disgusting, dehumanizing, agency-robbing, thing to ever happen to me, other people who believed the sorts of things you believe, interfering in my life. I just think it is utterly ridiculous to even claim for a second that outside of the biomedical realm it is prudent to throw around concepts like “illness”. As Szasz showed, such talk as metaphorical only. To believe in an “illness” that no pathologist in the world can show in vivo or on the autopsy table, is to engage in nothing I want any part of, but you’re of course free to continue plucking thoughts, speech, beliefs, and feelings out of the human experience and branding them “illnesses”, I just hope you can imagine the squashed sneering face and eye rolling such a habit invokes in me. The same face you probably make when someone calls gays ill, is the face you get from me when you call any combination of thoughts and behaviors ill (in the absence of demonstrable biomedical pathology). I just pity people at this point who still believe in this crap.

  • Anonymous

    It’s called life. They are experiencing life. Life consists of thoughts and feelings etc. Just because some thoughts are more extreme or constitute something you find bizarre doesn’t mean they are fundamentally different and somehow a “special event” like a seizure. They are still thoughts. Ask them sometime what they are experiencing. What on Earth makes you think someone outside the people you are talking about would know better than they do what they are experiencing?

  • heartofatum

    There was a time not that long ago when it was seriously believed that epilepsy wasn’t a brain condition, & that it had nothing to do with the brain/physiology.

    Leaving psychiatry aside – i’ve been in some very extreme altered states – to say there was zero physiology to any of it is insane, Of course explore what those states are. i’m very highly critical of psychiatry – But i’d also acknowledge that the way some people are effected by their experiences is an illness/unwellness of some kind, & i think it’s just as inhumane to deny that reality.

    i disagree with an extreme biomedical psychiatric view, but i just as much disagree with the just as extreme Szaszian lunacy.

  • Anonymous

    You invoked a supposed “primary aetiology”, when I see you doing that I am right to assume you believe in a “secondary aetiology”, or even a “tertiary” one, I was just pointing out how pointless, speculative, unevidenced and bizarre you sound to me. You have no evidence there is anything wrong with anybody’s biology or genes who you’re labeling “mentally ill”. Regardless of whether you weasel out and declare it, unilaterally without evidence, to be the “secondary aetiology”. Your self-declared little kingdom of etiology contributors is nothing but a banal, boring, just-so story. Name one geneticist on Earth who can prove the “secondary aetiology” of the unhappy lady using molecular biology technology tests, today in May 2015. Just one will do. He/she doesn’t exist. All that exists is your mindless quasi-religious belief that ” it’s well established for anyone with half a brain cell that a
    combination of physical, genetic, psychological and environmental
    factors can make people more likely to develop a mental disorder.” So “well established”, mind you, that no physical or genetic test even exists. Lol.

  • heartofatum

    imo there is a physiological component & a psychopathology – that is my experience. Lets get all zen & non dual – everything is just life – cancer, child rape, murder, war, etc – why specifically mark any of it out?

  • Anonymous

    I pity anybody who believes that a seizure, can be compared to the heterogeneous, unique experiences of life’s extremes in question here. You have no evidence your brain caused these ill-defined “states” it is just speculation on your dishonest part. It’s not “inhumane” to disagree with a mindless speculation that brains that nobody in the world can prove are diseased, are diseased. Yes, a living brain, physiology is required to have a thought, just because that thought or those thoughts are strange and bizarre does mean the meat is malfunctioning, any more than it means brains are to blame for bizarre beliefs you might find in history, foreign cultures, or anywhere in the human experience. Your parents needed a brain to get married, you can’t prove a brain disease made them get married any more than you can prove a brain disease made any given person you consider “ill” do something. There remains zero hard evidence that you have any legitimate cause to believe it has been verified that there is anything wrong with your brain, unless you put brain disabling drugs into it, or you have a pathologist-verifiable brain disease. Speculate all you want if it makes you feel better.

  • Anonymous

    Cancer is a disease. The other things you mentioned are human actions. Keyword with you is “IMO”, newsflash buddy, it’s not an “opinion” whether you can name a single pathologist in the world who can prove your brain is diseased, it’s a put up or shut up objective fact. Either you can table evidence your brain is diseased and ought to be considered the source of your life’s problems or you just retire while I roll my eyes at your “opinion” that you “have some physiological illness”. Your belief that you have a physiological problem inside of you, is about as evidence based as you claiming the CIA put a chip inside of you.

  • heartofatum

    Your obsessed with brain diseases. i have never thought that is the primary issue.

  • heartofatum

    Your arguing straw men – have never said anything of the kind. Big difference between saying it’s all brain disease & in saying there is a physiological aspect to these conditions/experiences.

  • Anonymous

    And you’re obsessed with weaseling out of the fact that you’re clearly trying to smuggle into your argument some mythical “secondary” claim of diseased brain that you think lives in the background of your foregrounded “psychogenic” alleged issue. How about this, if someone claimed they think your parents’ marriage was primarily psychogenic and cultural, but that defective genes and a slightly diseased, abnormal malfunctioning brain are its secondary cause what would you say? Oh wait, you’re not just going to let me make unfounded garbage claims about your parents genes and physiology. Oh but why not? I never believe their defective genes and diseased biology was the “primary issue’.

  • heartofatum

    Not a diseased brain no – physiological aspects/components, You can’t rationally separate physiology from environment, & psychology.

  • Anonymous

    Big difference? no, not really. If you are saying ANY of it is a brain disease, I want you to prove it, is that too much to ask? Apparently so. And how dishonest and weasely to claim “physiological aspect”, that is saying precisely nothing, there is a physiological aspect to learning to speak German, so what? Do you invoke the “physiological aspect” of the Muslim call to prayer too? Why even invoke or wheel in the “physiological aspect” at all?

  • heartofatum

    Because there is evidence of certain physiological changes.

  • Anonymous

    Again, why are you even focusing in the slightest on physiological “aspects”? if you have no evidence of anything going physiological awry? Do you fixate on your bowels when you are not on the toilet? Do you think about your immune system when you don’t have any reason to?

  • heartofatum

    Because there is a lot of evidence that there are physiological changes within mental health conditions.

  • Anonymous

    Wiping your rectum on the toilet, reading a map, turning a shower tap, walking toward a shower, proposing a marriage, applying for a job at the CIA, believing the CIA is going to kill you, are all part of human life, at every moment molecular changes are occurring in the body, a “change” does not constitute pathology, causation, or a disease. You can name no scientist on Earth, no doctor on Earth, who can point to “changes” inside me or you and conclusively prove they caused the thoughts, feelings and behaviors you label as an “illness”.

  • Anonymous

    Refer to my answer above about why “changes” mark every aspect of life. Again with the nonsensical branding of these problems as “health conditions”

  • heartofatum

    “You can name no scientist on Earth, no doctor on Earth, who can point to
    “changes” inside me or you and conclusively prove they caused the
    thoughts, feelings and behaviors you label as an “illness””

    i presume you’re referring to ‘functional’ mental health conditions – plenty of brain conditions with more known physiological etiologies, even then in say Alzheimers – very little is really still known. We simply know so very little about the brain & how that interrelates with genetics, CNS & consciousness.

    So plenty of cases where a disease pathology/etiology of the brain do indeed cause often major changes to thoughts, feelings, behaviours & are illnesses.

    Brain changes (structural, functional, & chemical), & other physiological changes (non medication related) have been observed in cases of schizophrenia & other ‘functional’ mental disorders.

  • heartofatum

    A reasonable marker is levels of distress from symptoms/experiences, & effect on functioning.

  • Anonymous

    No, I specifically said the thoughts, feelings and behaviors you label as an illness. Those were my words. Re-read that a few hundred thousand times until it sinks in. That means I was referring to anything you can throw at me, that consists solely of a thought, feeling or behavior.

    Was I referring to the demonstrable organic pathology found in the dead and living brains of Alzheimer’s patients?, no. Was I referring to real, proven brain diseases that have a definite course for all who have them that nobody ever comes back from or recovers from? no.

    Brain “changes” is a garbage weasel word, and evoking them along with the “schizophrenia” name-calling label means/proves nothing any more than evoking a study that shows “changes” in the brains of London cab drivers (such studies exist) proves the “changes” caused them to choose a job as a cab driver. Your phrase “functional mental disorder” means jack shit to me.

    What do you claim is not “functioning”?

  • heartofatum

    “What do you claim is not “functioning”?”

    Go spend some time with the genuinely severely mentally ill.

  • Anonymous

    A heart, lungs, the biology of a brain, we know how these are supposed to be functioning. There are no biological markers for any of psychiatry’s spurious and invalid constructs. A distressing experience is not an “illness” just because you say it is. A divorce can be distressing, is divorce an “illness” then?

  • heartofatum

    Someone can certainly become mentally & emotionally ill after such an event, yes.

  • Anonymous

    Ah the cop-out one liner that assumes people around here meet the following two criteria, I wondered when it would come in this debate,

    1. You assume I share the belief with you that the people you name-call as “severely mentally ill” have something medically wrong with them, something you’ve shown you can’t prove at all.

    2. You assume I’ve never been name-called and treated as such in my life. You also assume being in the mere presence of what? bizarreness? proves the validity of the whole nine yards of your belief in “illness”? Ridiculous.

  • Anonymous

    I don’t believe in “illnesses” of the emotions, I believe divorce can be traumatic and that it is not necessary to pretend that trauma is a “medical” problem in order to understand it and get through it. In fact I positively belief it is downright dehumanizing and harmful to indoctrinate the recent divorcee that his experiences are an “illness”.

  • heartofatum

    i question to what level of severity of experience some people went through?

  • Anonymous

    That sentence doesn’t make sense at all.

  • heartofatum

    & i think people can be rationally mentally/emotionally ill, for many reasons, & that it’s dangerous & inhumane to deny that. So what do we do? It’s a case of agreeing to disagree. i do see what you are saying – i just don’t think it’s entirely rational.

    Yes debate best ways of helping & healing people – But this polemical argument is noddy – it’s arguing 2 sides of the same coin.

  • Anonymous

    You might, I doubt it, understand why it is terrifying to nonbelievers to see you claim that it is “inhumane” of people to not share your quasi religious belief in dubbing the problems of life “illnesses”. I look upon your belief in declaring the problems of life “illnesses” as your imaginary friend. I want you to keep your imaginary friend if he makes you happy but to keep it the hell away from me.

  • heartofatum

    Is everyone severely mentally ill? i think it’s very apparent it’s only a very small percentage of people that are, This is part of the problem – 80% of people or more ‘under’ psychiatry or who come into contact with psychiatry, don’t have a severe mental illness.

  • heartofatum

    As per the other part of the conversation – then literally everything is the problems of life.

  • Anonymous

    After such a long conversation one might assume you learned you’re not speaking with somebody who accepts the premise of your “severely ill” claim. You may as well be asking me “Is everyone a severe sinner”. I don’t believe in the religious doctrine of sin and I don’t believe in your psychiatry religion’s doctrine of “illness”. A small percentage of people have auto accidents each year, the fact that a small percentage of people in a given year experience a severe personal problem proves nothing else about that problem. I don’t accept the unfounded premise of your belief there exists “severely mentally ill” people, there are people name-called as such yes, people who often have very serious challenges and problems to overcome, but your entire conceptual framework about this is as foreign to me as some meeting at the Vatican would be for a noncatholic.

  • Anonymous

    Life has many problems yes. Some problems are more strange and difficult to overcome than others. Evidence to prove that just because a thought is extreme and extremely troubling it constitutes something “medical”, an “illness”, zero. You’ve got nothing but cultural belief around this issue on your side, nothing but mindless uncritically accepted declaratory statements courtesy of psychiatry.

  • heartofatum

    i admire your ‘faith’, but i don’t share it, Szasz imo was a deluded idiot, & you appear to be one of his disciples/minions.

  • Anonymous

    What you see in me is a faithlessness, not a faith. You’re well and truly the one with the imaginary friend here, that friend is a belief in the existence of “illnesses” pathologists can’t prove exist on the autopsy table.

  • heartofatum

    The entire range of what comes under ‘mental health’ i wouldn’t think can be summed up as strange thoughts, & i find it very bizarre to assume that? It’s Not what i primarily experienced.

  • heartofatum

    When the primary etiology is psychogenic in most cases, then i wouldn’t expect they would do?

  • Anonymous

    I never said it did. No, according to you, what “you experienced” was “primarily aetiologically” something, and “secondarily” related to some genetic/physiological “change” that you’ve got no doctor/scientist/neuroscientist in the world you can name who can back you up about the extraordinary claims you’re making about your own body. But whatever your experience was, your psychiatry religion/cult has told you it was an “illness” therefore that is “the reality” and it is “inhumane” of me to not view it in the exact same terms you do, apparently.

  • heartofatum

    Why do you put so many words in inverted commas? Do you emphasis that in ‘normal’ speech as well? Must be very tiresome.

  • Anonymous

    Ah again with that weasel distinction “primary”, normal people assume “primary” lays next to a “secondary”, and none of your pathologists can prove your “secondary” either, so there’s that. Nothing is going to convince a believer in the psychiatry religion that their problems aren’t a “health condition”, go ahead and continue believing that burned toast is a breakfast condition and burned out is a health condition. And accusing those who disagree with your “healthizing” of the problems of life to be “inhumane”… yep.

  • Anonymous

    It is intended to, and I believe effectively does, convey how sneering and sarcastic I am being when I handle the words of your psychiatry religion. In spoken word I usually just say “so-called” before the word/phrase. It’s not tiresome, I’ve had years of practice. The whole idea is to encase the psychiatry religion’s key terms in sneer quotes, sort of like the way the Fukushima nuclear plant has been encased in concrete. At all times, I’ve learned never to write as though I accept any of the psychiatry religion’s premises. When I use the words the psychiatry religion has dreamed up, I am always showing that I’m quoting or exampling from the mind of someone who actually believes in this stuff, which of course I don’t believe in at all.

  • heartofatum

    i don’t agree with Szasz nor biomedical psychiatry.

    i wish more people would think for themselves.

    Was banned off MIA for having an opinion different to the anti-psychiatry cult – i wonder what this place will be like?

  • heartofatum

    i’ll share this here – although given the flavour of this site i expect it’ll be taken the piss out of –

    How many people here can identify aspects of psychosis as a visionary state?

    When i was 17 i had been out one evening, & upon returning home i
    became very euphoric, & was convinced that everyone was going to
    heaven. i felt like i was on the verge of discovering the meaning of
    life. i had been reading a lot of spiritual & obscure books at the
    time & sat down on the bedroom floor & opened one of the books.
    There was an exercise i’d been practising about turning conscious
    awareness within. In an instant i heard a disappearing scream inside of
    me, which i was immediately convinced was me losing my soul, & i
    went into a extremely altered state. Very hallucinatory physical vision,
    & i was in a state or sheer terror.

    It was like waking up to the Universe & having a massive ‘download’
    of information – i saw a vision of a Global conspiracy & the end of
    the World. i was in a highly distressed state. i was living with my mum
    & brother at the time, & was so panicked that all i could think
    of was escape & some idea of finding a ‘Christian Underground’. i
    kept running away & the people around me were very worried about the
    state i was in. After some days of not sleeping & the police being
    regularly called, i was sectioned & spent 4 months on a locked ward,
    & was very heavily medicated.

    That was the beginning of my journey with severe psychosis 25 years ago. Things have never been the same since.

    i can’t find definite answers to it all, & i have kind of concluded
    it’s what psychiatry says it is – a severe case of schizophrenia –
    whatever schizophrenia is meant to be exactly?

    i went on to go through another 8 major episodes/breakdowns, around
    & years in florid psychosis, & 3 more hospitalisations. A lot of
    the experiences i had i would describe as visionary.

    Have maintained the medication for the past 10 years, & it does seem
    to take the edge off things. i have also found the work of John Weir
    Perry interesting (among other things) & it has resonated with me –

    i have tried everything i can to more fully resolve & heal from
    things. The first hospitalisation was a very traumatic experience.

    i tried to live without medication, & came off the current medication 3 times – it lead to worsening episodes of psychosis.

    i think things could have been & could be approached very
    differently – But what could i have done? & what can i really do
    about the way this society & system operates.

  • Anonymous

    “How many people here can identify aspects of psychosis as a visionary state?”

    You are wrong to assume others accept the validity of the concept of “psychosis”. I certainly don’t. It is a word that a pathetic profession called psychiatry uses to describe all manner of strange and unusual thoughts, it refers to nothing concrete, nothing concrete at all. When you use that word, it is like a religious person using the word “sin”. I don’t believe in sin but I do believe in immoral acts. I don’t believe in psychosis, but I do believe in unusual, bizarre, troubling, profoundly catastrophic thoughts and fixations. I wholehearted reject the need to cling to psychiatry’s ridiculous concepts.

    Firstly, thank you for sharing your story. I would like to express my profound sorrow at how negatively impacted your life appears to have been by these thoughts, and psychiatry’s interference in your life.

    The approximate scenario of “religious ideas/books/thought IN, profoundly extreme beliefs/thoughts OUT” is something that has been a part of millions of peoples lives.

    Approximately the same caliber of things have happened in my life. I too, have been interfered with psychiatry against my will. I must say at this point that I do not consider psychiatry’s tranquilizer drugs to constitute true “medications”, its buildings to be real “hospitals”, I find it all to be a pale imitation of what real doctors do. Consequently I no longer take the substances psychiatry claims are “medications”. The cessation of such substances and being able to live without them was only achievable for me due to my rejection of the false notion that “psychosis” was a “thing that was happening to me”, instead, the understanding that I had the power and agency to master my thoughts and grasp on them, was what helped me escape psychiatry.

    If you feel that taking these drugs works for you than I would never stand in your way.

    Yes, of course things could be done differently, in the lives of millions of people who encounter such troubles. No, you don’t have much power to change anything, only your own future, not the “system” or anything like that.

    Feel free to contact me at I would be only to happy to talk to you privately.

  • heartofatum

    Thanks – have sent you an e-mail.

  • Anonymous

    Hardly surprising, they are famous for their draconian commenting policy. You’re not missing out on much.

  • Anonymous

    Anonymous says: I have taken the step of retracting my, I felt, overly heated debate here with heartofatum, he and I have talked and got to know each other and I like the guy. The posts I have removed are the standard extreme thoughts and feelings are not a disease stuff, you’re not missing much. So I felt I would self-moderate, amazing what can happen on websites that actually allow freedom isn’t it? I think we all know a place that could take a leaf out of this place’s book when it comes to commenting policy. Here we have a case of two people who have made each other’s acquaintance and shared ideas but it was only possible through a liberal commenting policy. The other place is deluding itself if it thinks its 100 ridiculously rigid commenting rules and “quick to ban” mentality promote idea sharing and people networking and meeting each other. Thank you Phil once again for providing this forum.

  • heartofatum

    Good to have a chat – will delete mine also

  • all too easy

    SO, OLD PHIL, YOU ARE ACCUSING, PUBLICLY, MY DOCTOR OF BEING A STREET DRUG PUSHER. You are accusing me of being a street punk, a drug abusing felon. You must call the police and name names; you must, by law, tell them everything you know. Come on now Phil. Back up your words with actions. Stating as facts who and what these lawbreakers are doing, you have a legal duty to go straight to the police this instant and report these crimes and these criminals. Are you ready bro? If not, would you like to be sued for defamation of character?

  • all too easy

    Even the results of the ‘positive’ studies are incongruous with some finding increased uptake in the putamen but not the caudate nucleus (parts of the basal ganglia) (Hietala et al. 1995) and another finding increased uptake in the caudate but not the putamen (Reith et al. 1994). One study found no effect (Dao-Castellana et al. 1997) and the largest study so far found the opposite finding of reduced uptake in the ventral striatal area of the brain (Elkashef et al. 2000).” (p 93) [Emphasis added]
    The bad news for these boobs is that these studies, like all studies, are sponsored by Big Pharma and ergo have no basis to be analyzed with the expectation of fairness. Sorry fellas. Tough break.

  • all too easy

    Of course Phil don’t cherry pick. That would be a big no-no for a Pharisee. But, he is going to pee himself. From the same material as quoted above under “conclusions” guess what we find:
    Brain structure and function
    Research has also examined the possible role of brain structure and function.22 For example, recent brain imaging studies have examined patterns of blood flow and electrical activity in the brain.23 Some studies have found differences in structure (e.g. volume of ‘grey matter’ in certain areas) and
    function (e.g. more or fewer signals appearing to pass between different areas) when average results from a group of people with a diagnosis of schizophrenia are compared with those from a group of people without the diagnosis. Some of these differences, for example in the size of structures known as the hippocampus and amygdala, appear to pre-date formal diagnosis.
    Uh oh! Better get maaco

  • all too easy

    I hate to spoil the fun they are having, but facts is facts.

    “Scientists have for the first time shown how the disruption of a key gene involved in mental illness impacts on the brain.

    The discovery could be used in the future to help develop psychiatric drugs.

    The DISC1 gene is a risk factor for a number of major mental illnesses, including schizophrenia, depression and bipolar disorder.

    Brain imaging studies have already revealed that these illnesses involve alterations in both the structure and connectivity of the brain.

    Genetic studies of several generations of one Scottish family affected by these psychiatric illnesses have revealed these are connected to the disruption of the DISC1 gene, though it is not clear how.

    For the first time, neuroscientists have shown that the disruption of this key risk gene significantly modifies the organisation of functional brain networks.

    Lead researcher Dr Neil Dawson from Lancaster University said: “Our data strongly suggest that disruption of DISC1 is a key molecular event that can contribute to the emergence of disease-relevant alterations in brain function.”

    “Through these studies we have been able to define deficits in brain function and functional connectivity that result from the disruption of DISC1 and are relevant to a range of psychiatric disorders.”

    He said these included schizophrenia-related alterations in brain function, functional brain network connectivity and the functioning of the glutamate neurotransmitter system.

    These findings parallel alterations seen in the brains of schizophrenia patients and could pave the way towards the development of new drug treatments.

    The research is published in Nature’s Translational Psychiatry.”

  • heartofatum
  • Anonymous

    Although this article is mainly on Langford’s reaction, it seems you are really downplaying the Howes and Kapur paper’s claims that environmental factors and socio-cultural experiences are vital to the eventual manifestation of schizophrenia. In fact, when they explicitly list the novel aspects of dopamine iii, they say “Third, dopamine dysregulation is linked to ‘psychosis’ rather than schizophrenia, and perhaps in the fullness of time it will be about ‘psychosis proneness.’ The exact diagnosis, however, reflects the nature of the hits coupled with sociocultural factors and not the dopamine dysfunction per se.” Maybe this was discussed more in the above article and I just missed it. Either way, I’d say the majority of clinical researchers I know in schizophrenia research (I’m basic science) like dopamine iii precisely because it says that dopamine dysfunction does NOT CAUSE schizophrenia or psychosis, but rather is a molecular-level manifestation that arises from multiple risk factors, to which environmental and social experiences are central.

  • Phil_Hickey


    Thanks for writing.

    As you say, my primary focus was on Dr. Langford’s misrepresentation of Howes and Kapur, which I think is a common problem in psychiatry generally.

    I have re-read my article, and I don’t think I was unfair to Howes and Kapur or to any of the authors they cited. In particular, I think the passage that I quoted

    “It [The Dopamine Hypothesis of Schizophrenia – Version III] explains how a complex array of pathological, positron emission tomography, magnetic resonance imaging, and other findings, such as frontotemporal structural and functional abnormalities and cognitive impairments, may converge neurochemically to cause psychosis through aberrant salience and lead to a diagnosis of schizophrenia.” [Emphasis added]

    is pretty clear in assigning the cause of aberrant salience to neurochemical dysfunction, as opposed, say, to the individual’s reinforcement history.

    But I am receptive to the possibility that I misconstrued or misrepresented some aspect of these issues. If you would like to come back with something more specific, I would be happy to take another look.