Are ‘Psychiatric Disorders’ Brain Diseases?

by Phil Hickey on January 19, 2016

Steven Reidbord MD is a board-certified psychiatrist who practices in San Francisco.  He writes a blog called Reidbord’s Reflections.  On December 12, 2015, he posted an article titled Are psychiatric disorders brain diseases?  It’s an interesting and thought-provoking piece, with many twists and turns.

Here are some quotes, interspersed with my comments and reflections.

“Of the conditions deemed inherently psychiatric, some seem rooted in biological brain dysfunction.  Schizophrenia, autism, bipolar disorder, and severe forms of obsessive compulsive disorder and melancholic depression are often cited.  It’s important to note that their apparently biological nature derives from natural history and clinical presentation, not from diagnostic tests, and not because we know their root causes.  Schizophrenia, for example, runs in families, usually appears at a characteristic age, severely affects a diverse array of mental functions, looks very similar across cultures, and brings with it reliable if non-specific neuroanatomical changes.  Even though schizophrenia cannot be diagnosed under the microscope or on brain imaging, it is plausible that a biological mechanism eventually will be found.  (The same type of reasoning applied to AIDS before the discovery of HIV, and to many other medical diseases.)  A similar argument can be made for other putatively biological psychiatric disorders.”

This is a complex paragraph.  Dr. Reidbord names five psychiatric “diagnoses” and expresses the belief that they seem “rooted in biological brain dysfunction”.  He stresses that their apparently biological nature derives from their appearance (natural history and clinical presentation), and not from diagnostic tests or a knowledge of any pathology involved.

As an example of this, he states that “schizophrenia”

  • runs in families
  • usually appears at a characteristic age
  • severely affects a diverse array of mental functions
  • looks very similar across cultures, and
  • is associated with reliable, though non-specific, neuroanatomical changes

And, it has to be acknowledged, that, at first look, these five factors, if present, might constitute grounds to suspect brain dysfunction. But let’s take a closer look.

RUNS IN FAMILIES

A “diagnosis of schizophrenia” is based on the presence of two or more of the following:

  1. delusions
  2. hallucinations
  3. disorganized speech
  4. disorganized behavior
  5. apathy or avolition

It seems obvious to me that each of these behaviors (or lack of behaviors, in number 5) can be passed on from generation to generation through normal social learning, without any assumption of a genetically-mediated pathology.  If I, for instance, believe that airplane contrails contain toxic substances that are being spread by the government as part of a sinister plan to render the citizens docile and debilitated, and if I had communicated these concerns to my children during their formative years, there is a good chance that one or more of them would have accepted these assertions at face value, and might even pass them along to their children in turn.

Similarly if my growing children had witnessed me responding to stimuli that were clearly internal rather than external, or speaking in a markedly disorganized way, there would be, I think a reasonable expectation that one or more of them might also acquire these habits through social learning.

And so on for the other three “symptoms”.  There is no need to assume genetic transmission in these behaviors.  Indeed, an assumption of genetic transmission of any behavior is always doubtful.  Genes transmit biological structure.  Structure has an impact on behavior, obviously, but there are always multiple intervening factors.

APPEARS AT A CHARACTERISTIC AGE

I have addressed this issue at some length in earlier posts (here, here, and here).  But for the present purposes, it is perhaps sufficient to note that the “characteristic age” for the “onset of schizophrenia” is during the transition from late adolescence to adulthood (i.e. about 17 to 25).  For a majority of the population, this is probably the most difficult period of life, especially because it comes at a time when we are particularly inexperienced in dealing with complex challenges.   It is a period during which many people experience a good deal of failure, disappointment, embarrassment, and discouragement.  All of which can push an individual towards a negative perspective, and in severe cases to a state of belief that would qualify as “delusional”, without any assumption of a “biological brain dysfunction”.

DIVERSE ARRAY OF MENTAL FUNCTIONS

These are not so diverse really.  The APA criteria essentially identify:  false/mistaken beliefs; responding to internal stimuli; lack of organization in speech and behavior; and apathy/joylessness.  But only two of these need to be present in any given individual.

LOOKS SIMILAR ACROSS CULTURES

This issue has become almost impossible to address in any methodical way, because western influences (including the influence of the DSM) have reached virtually every corner of the globe.  The DSM has become the distorting lens through which all problematic behavior is viewed and assessed, and there are enormous formal and informal incentives for psychiatrists everywhere to find “diagnoses”.

But in 1963, these influences were considerably weaker and less widespread.  In that year, Henry Murphy, MD, et al sent questionnaires about “schizophrenia symptoms” to psychiatric centers in various parts of the world, and received responses from 27 countries.  Here’s how they summarized their results:

“The main significance of our findings at this stage is that doubt has been thrown on the picture which Euro-American psychiatry has built up of the schizophrenic process.  For instance, considering the high percentages of the simplex and catatonic sub-types of schizophrenia reported for certain Asian samples (in some instances our respondents kindly sent actual figures) and the low percentages of the paranoid sub-type, it might be questioned whether the delusional systems which are the most familiar feature of chronic schizophrenia in Euro-American hospitals are an essential part of the disease process.  Might they not be culturally conditioned attempts by the personality to ‘make sense’ of that process, attempts which Eastern cultures inspire to a much lesser degree?” (pp. 248-249 Murphy HBM et al, A cross-cultural survey of schizophrenic symptomatology, International Journal of Social Psychiatry, 1963, 9: 237-249)

Dr. Murphy et al are obviously committed to the disease concept, but their finding of such cultural diversity casts doubt on the universality of “schizophrenia”.

And in 1973, E. Fuller Torrey, MD, prior to his conversion to biological reductionism, reviewed the evidence on the universality of schizophrenia, and summarized the matter:

“In fact, however, there is no evidence upon which to base a belief in the universality of schizophrenia.  The studies which have been used to support this belief are found, on careful examination, not necessarily to point in this direction at all.  If anything, they may lead to the opposite conclusions:  Schizophrenia may not be a universal disorder.” (p. 53 Is schizophrenia universal? An open question, Schizophrenia Bulletin, 1973, 7: 53-59)

and

“‘Once an idea becomes part of a textbook, it develops a life of its own and is seldom questioned.  This is what has occurred with the idea that schizophrenia is universal.'” (ibid, p 56)

and

“Finally, within the past few years some preliminary data on schizophrenia in New Guinea have become available. Burton-Bradley, a psychiatrist who has been there for a decade and a half, reported 343 cases of schizophrenia among the first 1,000 cases of mental disease which he examined. Virtually every one of the cases, however, occurred among individuals who had been living in the larger towns (‘the person of limited cultural contact, the so-called bush individual, very rarely presents with the symptoms of schizophrenia [Burton-Bradley 1969]’) or who had just migrated from rural areas to the towns (‘Not uncommon is the acute schizophrenia of sudden onset coming on usually within three months of  the patient’s leaving the village and working for the first time in a large town. Such patients readily recover and are returned to their village, at which level they can function without disturbance [Burton-Bradley 1963]’)” (ibid p 57.  The Burton-Bradley reference is:  Burton-Bradley, B.G. Culture and mental disorder.  Medical Journal of Australia, 15:539-540, 1963)

So, the fact that “schizophrenia” looks similar across cultures is more likely to reflect an artifact of cultural colonialism than any intrinsic property of the so-called illness.  And this is not merely a matter of psychiatrists seeing what they expect to see.  Once the “diagnosis” has been made, psychiatrists and other mental health workers actually begin a process that consists essentially of training the individual in how to “be schizophrenic”.  This process entails “educating” the client on the “symptoms and course of the illness”, and encouraging him to self-identify with the label.

NEUROANATOMICAL CHANGES

Dr. Reidbord doesn’t specify which changes he has in mind.  The main change of this nature that comes to my mind is brain shrinkage, but I think that there is broad consensus at present that this is more a function of extended use of neuroleptic drugs than any putative underlying disease process.

. . . . . . . . . . . . . . . . 

ANALOGY TO AIDS AND HIV

The analogy to AIDS prior to the discovery of HIV is unconvincing.  All the “symptoms” of the various psychiatric disorders that Dr. Reidbord mentions are behaviors, feelings, or thoughts.  And for each, there are plausible and eminently credible explanations from psychology, sociology, and indeed from ordinary experience and common sense.  But the symptoms of AIDS are clearly indicative of biological dysfunction. These symptoms include:

  • Fever
  • Chills
  • Rash
  • Night sweats
  • Muscle aches
  • Sore throat
  • Fatigue
  • Swollen lymph nodes
  • Mouth ulcers

It would be quite a stretch to conceptualize this cluster of symptoms as anything other than a biological malfunction.  But it is entirely plausible to think of “schizophrenia” in this way.  And indeed, Dr. Reidbord himself is restrained in his conclusion:

“Even though schizophrenia cannot be diagnosed under the microscope or on brain imaging, it is plausible that a biological mechanism eventually will be found.  ” [Emphasis added]

In my view, it is considerably more plausible that such a biological mechanism will not be found. This is particularly the case in that more than a hundred years of highly-motivated and generously funded searching for this “holy grail” of psychiatry has to date found nothing.

. . . . . . . . . . . . . . . . 

But all of this, important as it is, is not the main point of Dr. Reidbord’s paper.  Let’s go on.

“Lately, however, some big names in psychiatry have taken a more ideological stance, declaring that psychiatric disorders in general are brain diseases — right now, no further proof needed.  Dr. Charles Nemeroff, widely published professor and chairman of psychiatry at the University of Miami Miller School of Medicine, writes:

In the past two decades, we have learned much about the causes of depression. We now know from brain imaging studies that depression, like Parkinson’s disease and stroke, is a brain disease.

Dr. Thomas Insel, recent director of the National Institute of Mental Health (NIMH) wrote:

Mental disorders are biological disorders involving brain circuits…

Psychiatrist and Nobel laureate Dr. Eric Kandel says:

All mental processes are brain processes, and therefore all disorders of mental functioning are biological diseases.

These claims by prominent psychiatrists agitate critics.  No biomarker for any psychiatric disorder has yet been identified. Genetic vulnerabilities have been discovered, but nothing resembling a smoking gun.  Functional brain imaging reveals biological correlates of mental impairment, not etiology, and no such imaging can diagnose a specific psychiatric condition.  Our best account for most mental disorders remains a complex interaction of innate vulnerability and environmental stress, the ‘diathesis-stress model’.  These psychiatric leaders know the research as well as anyone. How can they call psychiatric disorders brain diseases without scientific proof?”

At this point, readers might be thinking that, despite his earlier comments on biological brain dysfunction, Dr. Reidbord is arguing on our side of the debate.  But wait!  The argument progresses.

“The brain mediates all mental activity, normal or not.  Consequently, any psychiatric intervention — or influential life experience — acts upon the brain.  This is not a new discovery.”

 “It is a philosophical position, monism as opposed to Cartesian dualism, not a scientific finding.”

 “Psychiatric ‘brain disease’ is neither an exaggeration nor a lie.  It does not require scientific proof — and brain imaging has neither strengthened nor weakened the case.  For as long as one is not a philosophical dualist, it is surely true.  In theory, all psychology can be reduced to electrochemical events in brain cells. All psychopathology can be reduced to aberrant electrochemical events, i.e., brain disease.”

Dr. Reidbord is entirely correct in stating that the brain mediates all mental activity.  It also mediates all physical activity.  I cannot lift a finger, shed a tear, recall my mother’s face, hum a tune, feel sad, or even absent-mindedly scratch my ear, without the corresponding neural activity occurring within my brain, and eliciting the thought, feeling, or action in question.

Dr. Reidbord is also correct in stating that, in theory, all psychology can be reduced to electrochemical events within and between brain cells.  In theory, a super-neurologist could identify exactly what happens in a child’s brain when the child learns that two plus two is four; or what happens in a person’s brain when he/she becomes depressed or happy or plays the piano, etc… But the key phrase here is: “in theory”.  This is because, firstly, the complexity and miniaturization of the brain’s circuitry probably precludes the possibility that this kind of detailed super-analysis will ever be feasible. Secondly, and more importantly, a detailed micro-analysis of an event can never capture the kind of qualitative factors that emerge from a macro-analysis.

Take, for instance, the action of a five-year-old boy kicking his teacher in the shin.  Let us pose the question:  Why did he do that?

Our super-neurologist – in theory – could give us a complete account of the entire neurochemical sequence, from the activation of the first sensory neuron to the activation of the last muscle fiber.  In theory, this account, which would run to millions (perhaps billions) of words, would, if accurate, constitute a complete and accurate answer to the question posed above.

A psychological assessment of the incident, however, might conclude that the boy had been raised in a violent home, had never been trained in effective anger control, routinely reacted violently when confronted or given instructions, and that the teacher had told him to stop running around the classroom and to sit down. So he had kicked her.

A sociological perspective might note that the frequency of such attacks in classrooms was increasing generally, and might note associations between this kind of violence and parental conflict, unemployment, cultural background, etc.

The critical point here is that although each account is describing the same incident, there are qualitative differences between them that are critically important.  The neurological account, no matter how complete and thorough it is, could never capture the uniquely human dimensions of the interaction, any more than the psychological account could capture the extraordinary complexity of human biology.  The issue here is not which account is correct, but rather which account is more suited for a given purpose.  If the purpose is to understand human biology, then the neurological account is more helpful.  But if the purpose is to understand the child’s actions and develop corrective measures, then the psychological account is clearly the preferred approach.

And this, of course, takes us straight to the heart of the psychiatric hoax:  that all significant problems of thinking, feeling, and/or behaving constitute brain diseases and are best ameliorated by modulating neurological activity.

Which in turn takes us to Dr. Reidbord’s conclusion in the above quote:

“All psychopathology can be reduced to aberrant electrochemical events, i.e., brain disease.”

And unlike his earlier premises, this conclusion is false.

The best way to illustrate this fallacy is with some examples, but first let’s clarify the language.  “Psychopathology” is a complex term, subject to diverse interpretation.  So rather than try to define this term, let’s use the APA’s Diagnostic and Statistical Manual as a starting point, and accept, for discussion’s sake, that any “diagnosis” or “symptom” listed in the manual constitutes “psychopathology”.

Childhood temper tantrums, for instance, are listed in the DSM as “symptoms” of oppositional defiant disorder, disruptive mood dysregulation disorder, and intermittent explosive disorder.  Therefore, according to Dr. Reidbord, temper tantrums of the severity and frequency specified for these “diagnoses”, “can be reduced” to aberrant electrochemical events.  The phrase “can be reduced to” in this context clearly means “can be conceptualized as”, or “are caused by”.  And the phrase:  “Aberrant electrochemical events, i.e. brain disease”, clearly means:  a malfunction in neurological equipment.

But in fact, a child can acquire the habit of throwing temper tantrums without any neurological malfunction.  Generally speaking, there are two principal ways in which a child can acquire this, and other, habits: learning from results; and learning from imitation/coaching.

LEARNING FROM RESULTS

If a child throws a temper tantrum, and the tantrum produces a positive result (e.g. a parent yielding to his demands), then, other things being equal, there is an increased probability that temper tantrums will become habitual, especially if they continue to produce the same kind of outcome.  This is not a function of aberrant electrochemical events in the brain cells.  In fact, it is exactly the opposite:  a perfect example of the normal human learning apparatus operating flawlessly.  It is not an example of something going wrong in the brain, rather it is an example of something going right.  We humans learn from the results of our actions, an obvious fact that has been verified experimentally countless times, and in addition accords perfectly with common sense and general observation.  And we acquire functional, productive habits in exactly the same way and by means of the same cognitive apparatus as counter-productive and problematic habits.  Acquiring the temper tantrum habit is particularly easy, in that babies are born with an anger apparatus which needs little encouragement to express itself in rage and aggression.  In fact, the opposite is the case:  teaching anger control is the challenge.

LEARNING BY IMITATION/COACHING

Imitation is another major component of our normal learning apparatus.  The child acquires skills and habits through imitating, at first his parents and siblings, and later individuals outside the home.

It is self-evident that through imitation and coaching a child can acquire habits that are useful and helpful; but it is equally obvious that he can also acquire habits that are destructive and counter-productive.  Through imitation a child can, for instance, learn to fear objects that are dangerous, but through precisely the same mechanism, he can learn to fear harmless objects such as spiders, closed-in spaces, open spaces, cats, hypodermic needles, air travel, dogs, heights, elevators, social gatherings, etc… All of these fears are “psychopathological” in the sense specified above, but all can be acquired, through imitation, by a person with a perfectly normal-functioning brain, provided the fear in question is being modeled by a significant person in the child’s life.  It is fallacious to assume brain pathology based solely on the fact that the acquired behaviors/feelings are counter-productive or distressful.

Similar observations can be made with regards to every “symptom” listed in the DSM.  Habits of paranoid speech, incessant speech, over-eating, self-deprecating speech, grandiose speech, rule-breaking, cruelty, violence, stealing, suicidal threats, suicidal gestures, apathy, etc., can all be acquired by a person with a normally-functioning learning apparatus, either through learning from results or learning by imitation, or both.  In the absence of specifically identified and credibly causative brain pathology, this is the most reasonable and parsimonious way to conceptualize the acquisition of these kinds of habits.

In his ground-breaking monograph, “The Jack-Roller” (1930), Clifford Shaw provides graphic, first person accounts of how a child can acquire the habit of stealing in this way.  For example:

“On the trips with William, I found him to be a rather chummy companion.  I regarded him, not as a brother, but rather as a boy friend from another home.  He was five years my senior.  He sort of showed it in his obvious superiority.  But I didn’t seem to notice that fault.  He was a ‘mamma’s boy’ at home, but oh, Lord, how he changed on our trips!  He taught me how to be mischievous; how to cheat the rag peddler when he weighed up our rags.  He would distract the peddler’s attention while I would steal a bag of rags off the wagon.  We would sell the rags back to the victimized peddler.  He also took me to the five and ten cent store on Forty-seventh Street, and would direct me to steal from the counter while he waited at the door.  I usually was successful, as I was little and inconspicuous.  How I loved to do these things!  They thrilled me.  I learned to smile and to laugh again.  It was an honor, I thought, to do such things with William. Was he not the leader and I his brother?  Did I not look up to him?  I was ready to do anything William said, not because of fear, but because he was my companion.  We were always together, and between us sprang up a natural understanding, so to speak.

One day my stepmother told William to take me to the railroad yard to break into box-cars.  William always led the way and made the plans.  He would open the cars, and I would crawl in and hand out the merchandise.  In the cars were foodstuffs, exactly the things my stepmother wanted.  We filled our cart, which we had made for this purpose, and proceeded toward home.  After we arrived home with our ill-gotten goods, my stepmother would meet us and pat me on the back and say that I was a good boy and that I would be rewarded”

And stealing is psychopathology:  a “symptom” of “conduct disorder”, “kleptomania”, and “antisocial personality disorder”, but I suggest it is clear that there is nothing wrong with the narrator’s neuro-cognitive apparatus.  He isn’t learning the behaviors approved by the dominant culture.  But he is learning the rules of the smaller group to which he belongs and feels connected.

The habits of thinking, feeling, and behaving mentioned above make perfect sense when viewed from the individual’s perspective, but appear counter-productive and dysfunctional from the perspective of so-called “normality”.  But within the context of psychiatry’s intractable commitment to the medical model, the search for a “diagnosis” precludes any search for meaning or sense in the “patient’s symptoms”.  For psychiatry, the “patient” is “sick”.  His brain is assumed, without evidence, to be broken.  There is no meaning or sense to his “symptoms”.  And in this way, psychiatry has locked itself in a cocoon of comforting but destructive and condescending certainty, which they show no inclination to leave.

. . . . . . . . . . . . . . . . 

At this point, Dr. Reidbord’s paper takes another interesting twist:

“Without elucidating the causative mechanisms, however, this reductionism amounts to little more than political rhetoric.  Calling psychiatric disorders brain diseases serves no clinical or research purpose, it only serves political ends: bringing psychiatry into the fold as a ‘real’ medical specialty, impressing Congress and other funding sources, perhaps allaying stigma.  As a tactic it smacks of insecurity and self-aggrandizement, wholly unbefitting a serious medical specialty.”

To which I would certainly agree, adding only that the reductionism also constitutes an invalid inference, as outlined above.

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

“Freud’s psychoanalysis acts on brain cells, and ultimately alters chemical bonds in those brain cells.  We could rename psychoanalysis and psychotherapy ‘verbal neuromodulation.’  But to what end?  A reductionistic account of this sort, festooned with pseudoscientific verbiage, has no practical significance.

Brain research is a young field.  It should be vigorously pursued for what will surely be learned.  If history is any guide, many conditions currently considered psychiatric will eventually be explained biologically — and ironically, they will no longer be psychiatric conditions, as was the case with Huntington’s disease, brain tumors, lead poisoning, and many other diseases that now belong to other medical specialties.

Stumping for psychiatry as clinical neurobiology will be justified when basic research in this area affects clinical practice. Until then, ‘brain disease’ is only a philosophical technicality, a spin, to give our clinical work and the institution of psychiatry an air of scientific credibility.  Particularly in light of how diseases leave psychiatry once they are well understood, the field should embrace uncertainty, not preempt it with the premature use of brain disease language.”

So what we’ve got here is an interesting and curious mix of very commendable honesty and professional self-interest coupled with the oft-heard psychiatric assertion that sometime in the future the brain pathologies will be discovered.  In the meantime, Dr. Reidbord contends that promoting clinical neurobiology is not justified, and will not be justified until basic research affects clinical practice.

But, in my view, Dr. Reidbord misses the essential point:  that the “real-illness-just-like-diabetes” assertion has been, and continues to be, widely and avidly promoted by psychiatry, and that clinical practice is already based almost entirely on the false contention that all problems of thinking, feeling, and/or behaving are best conceptualized as neurological illnesses.  It is extremely rare to encounter, or even hear about, a psychiatrist who offers any kind of “treatment” other than drugs or high voltage electric shocks to the brain.  On his website, Dr. Reidbord tells us that his clinical practice “skews towards dynamic psychotherapy” and that he has “a healthy skepticism of commercial influences on medical practice.”  Again, this is commendable but rare.

Dr. Reidbord downplays the practical significance of the “aberrant electrochemical events” falsehood by calling it a philosophical position rather than a scientific finding.  But from either perspective, it is problematic.  From the former it is fallacious (as shown earlier); from the latter it is non-existent (such research does not exist).  Nevertheless, it is widely promoted within psychiatric circles, and is routinely used to medicalize non-medical problems, and to legitimize the use of dangerous drugs to “treat” an ever-increasing range of human problems.

. . . . . . . . . . . . . . . . 

And, incidentally, in another interesting twist in the paper, Dr. Reidbord actually seems to be saying something very similar to this:

“Freud could then have made it a point to declare, as Drs. Insel and Kandel do now, that all mental disorders are biological diseases.  No additional science was required even a century ago.

He didn’t because there was nothing to gain.  The best treatments at the time were psychological, not biological.  There was no grant money at stake, no research agenda to support.  The status and livelihood of early psychoanalysts did not depend on their treatment being biological.”

In other words, if I’m understanding Dr. Reidbord correctly, psychiatry is positing the brain disease concept today because it is good for business.  And in this, of course, he is absolutely correct.  But, ironically, by asserting the falsehood that “all psychopathology can be reduced to aberrant electrochemical events, i.e. brain disease” Dr. Reidbord is himself contributing to, and legitimizing, the hoax.

 

  • Anonymous

    Good article, pathetic source material and pathetic guy to be talking
    about though. Anyway, his ridiculous belief in pathologizing the thoughts, feelings and behaviors of others wouldn’t matter if he wasn’t willing to use state violence to force his quack psychiatry religion on others. I’ve found evidence he is an occasional practitioner of forced psychiatry,and avowed suicide prohibitionist, see his candid admission here: so go and see this guy for ‘therapy’ at your own risk, lest you be hauled off in handcuffs from his office,

    https://www.psychologytoday.com/blog/sacramento-street-psychiatry/201401/do-patients-avoid-psychiatrists-fear-legal-holds

    Here is a choice quote from this piece of work,

    “A patient who believably voices, or behaviorally telegraphs, intent to die or to kill others should expect a trip to the psychiatric ER for further evaluation in a secure setting.”

    The usual self-absolving euphemisms, being rounded up, manhandled, and caged in a building is a ‘trip’ to the locked state psychiatry detention center / prison / cage building he’s choosing to call ‘the psychiatric ER’, absolving himself of being the one who initiates the aggression, the subject of the initiation of forced psychiatry should have ‘expected’ it, this ‘trip to’ somewhere, where the loss of more freedoms than one loses in jail, a forced drugging torture chamber, will be called a ‘secure setting’. Oh and of course they are a ‘patient’, even if they no longer want to be one, they are one, if he says they are. Nothing says respect for medical ethics like reserving the right to violently force people into a doctor- ‘patient’ relationship they don’t want. Nothing but the stock-standard justificatory rhetoric we’ve come to expect from these garden variety psychiatric thugs.

    This is all in an article which opens with one of the most laughable sentences I’ve ever seen in years of reading psychiatrist-perpetrators talk about the rationale for their violence against the victims of forced psychiatry,

    “Often I’ve reassured patients that ideas or feelings, however destructive or horrific, never in themselves lead to involuntary commitment. Patients are free to divulge fantasies of mass murder, elaborate suicide scenarios, gruesome torture, etc. without risk of being locked up.”

    How utterly idiotic would you have to be to put yourself at risk of this violent agent of the state’s whims and subjective interpretations? One moment this thought policeman has told you that you’re ‘free’ to ‘divulge fantasies of mass murder’, the next he’s decided you’ve ‘believably voiced’ something, or ‘behaviorally telegraphed’ something worthy of you losing all of your civil and human rights forthwith at the hands of armed goons he’ll sic on you.

    Just another pathetic waste of space, this guy, someone competent enough to get into med school, but not competent enough to see that throwing your life down the toilet practicing a pathetic pseudoscience is as ‘illogical’ as any thought he’s ever branded someone ‘psychotic’ for daring to think. Just another life-wasting joker who was gullible enough to swallow this ridiculous quackery, the delusional religion of psychiatry, that people who are feeling and thinking differently to the way most people around you happen to be feeling and thinking today, are ‘objectively medically out of order’ (according to… what? psychiatry’s mere authority, apparently). Same old story, he should have become a real doctor and put his medical education to actual practical use practicing real medicine, helping old ladies or something, instead of sullying his humanity and that of others by branding and name-calling them ‘mentally disordered’ based on his quackery cartel’s confected checklist of behaviors.

    His article was a useful prop for this blog though, a very good article from you Hickey. It’s not a ‘hoax’ when it’s the fervently held ideology of fanatics, and the true mark of a fanatic is whether they are willing to initiate violence in the name of their beliefs, visiting this guy and walking out of his office in handcuffs with your head pushed into a squad car to be taken away to be locked in a cage and forcibly drugged because you said the wrong thing, or ‘behaviorally telegraphed’ something to him, is all the evidence you need of his fanaticism, and his willingness to initiate aggression and violence against those sitting in a chair opposite him in his ‘doctors’ office, a ‘doctors’ office strangely bereft of any diagnostic equipment no doubt, because psychiatrists don’t practice real medicine, but sadly the MD on the wall, the doling out of pills, and the stolen lexicon, the use of the words ‘treatment’ and ‘diagnosis’ and ‘symptom’ are usually enough to hoodwink most of psychiatry’s quarry. For those who don’t buy this quackery, well of course psychiatrists always have the option of simply snapping their fingers, calling in the goon squad, and initiating violence to dominate the doubter.

    It is interesting though, the forgettable hit parade of psychiatric mediocrity this blog draws its examples from, I think it is a good thing to focus on these nobodies, instead of the usual ‘thought leaders’ from time to time. It shows us the inanity, the ‘poverty of thought’ of the ‘average psychiatrist’. Pretty dumb stuff… ‘every thought is biologically based if you reduce it enough therefore every thought declared out of order by psychiatry is a brain disease’… very, very tedious stuff. You’ve got more patience than me to be breaking it all down for blog articles like this, but well done, it’s a keeper this article and the points about learning, in this article, are very good. Learning is key.

  • johnnybe

    What a great article–so well written– so on the ball–people are brought up to believe talking sick–seeing sick–giving it wings–and practising it– “is sick”—is unsafe thinking–is misery– and many have been taught– it isn’t in our family– we don’t go there–we don’t talk it or think it- because we give it life when we do–we had the same message for suicide–might not be right for some people and the way they or their family think or work it—but we back burner it -or dismiss it as the negativity it probably is- probably because we don’t go there–simple– the KISS principle– any focus on misery– poisons to fix it– isn’t accepted in our family- even in our neighbourhood– i was so lucky — we look away- we just don’t go there – and we set that example conscientiously– with love and care– because we know — or believe its for miseries– miseries we don’t like–instilled –and proud of it– kept strong because of it–we pick our socks up– and get on with it–leaving it behind where it belongs-with misery people–let them look at it–imagine it–live it if they like–just as long as we don’t join them–that’s the key—call it what you or the next bloke like– but that’s been their lesson– and its stuck– and that lesson has kept them safe in their life–in their thinking head– and feeling heart– until they– like most highly investigative people– especially young ones- took some mind altering drugs– that messed with their thinking– and even then– they still had that message and lesson to keep them safe– to bring them back home safe with–after they slept off their drug effected minds–which they don’t know–because they’ve never been there before–if only they’d known– they wouldn’t be locked up in a bin full of sick see-errs–and forced to take what caused them their troubles in the first place- mostly- that is until they ended up in a psyche ward– where the people caring for you– only talk and think sick—- and then start calling you nasty names in tag form—- nasty –because they’re simply not true-and you intrinsically cant buy it-nastiness dressed up as paternal science- its not in you to accept or even consider—and, which is already making and keeping you sick-worse- certainly not helping– anyway the one bonus is– outside of these highly imaginative misery people making you feel sick–is– you really really understand the damage drugs can cause now— but what happens next is like all your nightmares come true– hypocrisy at its highest level–to you– the very people who accept you had “enough insight”– to turn up– and who are drugging the crap out of you now –very uncomfortably- and coercively–in spite of you telling them that–reporting that– are giving you–“forcing” into you– what you’ve only just learnt from that experience- are the cause of your hospital visit — drugs—and exactly what you need to stay away from– drugs– the cause of your troubled mind–drugs–drugs- outside of what you felt was missing, or not good enough in your life–your teenage–par for the course- troubled thinking-feeling- that took you to drugs to try and improve– or maybe find out why–or simply investigate–the difference now is– your now saying to them –“their drugs” are harming you too- but -is a statement or thought-feeling-which now amazingly– is your UN-insight-fullness– its suddenly not the in-sight-fullness– you turned up with — or the insight– you had, knowing the harm of the drugs in your body, and the effect on your mind, of those drugs, when you turned up– but now, all of a sudden– your an idiot,– an UN-insightful one too- who wouldn’t /doesn’t–know what’s good for you –or bad for you—gee I wonder how that changed all of a sudden. loved this thought provoking article– I was writing something on Balance– its more about insight–the tool, that’s used to force drug- or electrocute people– with/by/ — im going to put it in here– its still on subject i think– i know im pretty full on — but please understand–im here because like a lot of other people being treated by mental health/psychiatry– forced care– isn’t care to everyone — to some people it isn’t care at all– its abuse- and ongoing– if it wasn’t ongoing– i wouldn’t be here– no one would have to be–

    Balance– We are balanced – objective people– who honestly believe true and proper care is not coercive. Not to anyone–to us It’s the same as smacking– its what parents do when they’re not clever people/parents/but angry parents– when they cant manage-or care just with love- in spite of their claims to the contrary. its weak and wrong– trouble starts in the heart and goes to the brain in a religious society–and even to those of/in a secular society–that we live in–i believe.

    ((((Australia’s population is still predominantly religious, although the number of people identifying as having no religion is growing. In the 2011 Census, 68.3% of the population had a religion and 61.1% of Australians identified as Christian.))))

    In science it starts in the head and stays in the head–the heads into the head basically-ego based–((one half of the mental health equation))—if the heart thinks its got something to say to science in science–the head in science–thinks for the heart-talks for the heart–thinks its the hearts decider–the heart doesn’t matter– because the head decides everything separately.–in a non caring feeling– but thinking society– the heads the king. My opinion–

    when the humble heart, thinks for the head and the heart–because its where kindness resides–care and love– –as well as all the hurt –emotional hurt–that caused all the bad thinking –in the brain- to interfere in a persons life– their emotions –to their thinking — the hearts trying to get in touch-send love– peace to the brain–to help the brain cope- and that’s all that’s needed-9/10-in anyone–love-care-and the security from that love-care- its the brain that has to listen to the heart–the guiding light–and the cause of darkness, in a compassionate caring loving society— the hearts the king.the heads the queen. That’s my belief anyway.

    we- know some people need psychiatry–check
    .
    we- know some people are advantaged by it–check

    we-know some people don’t need psychiatry–check

    we- know some people are disadvantaged by psychiatry–check

    we- know some people are harmed by the drugs–check

    we- know some people are helped by the drugs–check

    we- know some people don’t trust the science–check

    we- know some people do trust the science–check

    we-know they cant biologically prove- imbalance-or balance–mental illness or disease- –check

    we- know some people have been sad for twenty years and more on forced drugs– in spite– they report being unhappy and debilitated with/by/on–check– So debilitated in fact they have to throw a bomb (electrocution) in there– to try and sort the poly substance mind mix up- they’ve caused –out of there– see if they can hope for the- best reset they can get– and at the same time, hope they don’t blow up the wrong shit– too much.
    A 50/50% hope at best.

    we -know some people have been happy for twenty years and more on forced drugs they report being happy with.–check

    we-know, they think they’re doing good– and mean well– and are for some people–check

    we- know, they’re(psychiatrists) also bad to, and for some people-but they(psychiatry) think they’re doing good- they mean well– and at the same time, are bad for some people– in fact–in the same way, the drugs are bad for some people-good for some people–check.

    im clever too– just more in a heartfelt way. – My opinion-feeling-thinking.

  • johnnybe

    I only just realised the point I was making in my previous post–isn’t only the one point I could have made in relation to the post and that point–that being– a person being insightful when they turned up- and UN-insightful when the psychotropics have been injected– what I just realised, or jumped out is–(((UN-insightful when the psychotropics have been injected–))) on one hand the hypocrisy of the imaginer and the assesment from that hypocritical imagination/judgement– not even explained right there– but the fact that if they’re all off a sudden UN-insightful– but turned up insightful– how did they get UN-insightful– especially when they’ve slept off the temporary drug psychosis they turned up with– what’s left?

  • S Randolph Kretchmar

    Wow! This reply is almost as good as Phil’s article. Bravo!

  • Phil_Hickey

    Anonymous,

    Thanks for your support, and for the interesting additional information.

  • bulbous1

    As concerns some of the problems listed in this article, given the rampant scapegoating that goes on at school (and in leisure time) it’s little wonder so many grow up terrified, angry, depressed, and vengeful towards the world.

    Amongst children, a Hobbesian war of all against all obtains owing to the greater store of (demonic) vitality pulsing through the child’s veins, whence springs their merciless cruelty and ruthlessness, their arrogance and intolerance. Persecuting a child conscripted into the role of scapegoat is amongst children a principle of social cohesion, allowing all the little buggers to discharge the anger, hatred and frustration stemming from their innumerable conflicts with each other and adults. When everyone is at war with each other, there needs to be some scapegoat around whom all the combatants can unite, putting aside their differences and displacing all their anger onto he. This is especially so amongst children because of their greater vitality and egotism; and because of the lack of any other centripetal forces such as those that bring adults together and allow them to live together without wringing each others necks.

    Hence the tragic plight of misfits at school.

    All of this could conceivably lead to great problems, so that a career as mental patient may simply be a logical progression from one as school scapegoat. This might explain some of the problems currently framed as brain illnesses.

    Some might say, “if that’s the case, why doesn’t everyone go on to become a mental patient?”. From a psychiatric perspective, the answer is that they do not suffer from a mental illness; from a behaviorist perspective, perhaps that they have been properly trained; from a libertarian perspective, most likely that the individual who became a mental patient has made bad choices and has failed to exert himself to the full.

    There is sometimes truth in the latter two, I would surmise, but are nevertheless largely facile. The differential lines along which individuals develop can largely be explained by the countless chance circumstances that bear upon the formation of a man, circumstances with which we are mostly unacquainted when judging him and whose protestations testifying to such influences – assuming he is himself aware of them – are easily drowned out by the gavel-pounding of all the self-appointed judges of the world towering over them, booming forth in stentorian tones their peremptory verdicts, and with an unshakable, Rhadamantine sense of their justness.

    “Within the soul a thousand events take place, a thousand dispositions are being formed which make of each individual a world and its make of each individual a world and its history. To know another perfectly would be the work of as lifetime; what then does one think knowing men means? Governing them, that is possible, but understanding them, only god can do that. ”

    Madame de Stael

    “It is never possible to know all the ways and all the differences in which the spirit of individuals, according to differences in circumstances, adapts or is able to adapt, for the same reason as it is not possible to know all the possible circumstances that may occur, that can influence the spirit of individuals, nor all those which have actually influenced this or that individual, nor their reciprocal combinations, nor their minute differences which produce not insignificant differences of character, etc. The greatest knowledge it is possible to have of man, then, is to know perfectly and rationally that men cannot ever be known properly, because man is indefinitely variable in individuals, and the individual in himself. ”

    Leopardi

    Regarding the use of dangerous drugs, it really should occasion no surprise that “the mentally ill” are treated so bad. We find it harder to forgive those who suffer than those who author it. For the most part, the man who suffers at the hands of fate, fortune, and man, as if in paradoxical reparation of the wrongs perpetrated against him, must then suffer all the more. Mistreating people for the miseries and misfortunes visited upon them is a part of the heritage of the species, a heritage our society faithfully preserves, be it through the invidious labeling and abuse.of the miserable and the wretched; the judgments lavished most liberally on them by those who love to kick others when they are down (and who are apt to discharge their frustrations on easy targets); or in the general exclusion of such people from social life.

    As an example of my point, in Israel many Holocaust survivors ended up being “treated” in Augean psychiatric “hospitals” as if they were suffering from brain diseases. From the death camps to the psychiatric ward! No asylum in this world outside of the grave.

    Nor do they get much sympathy or support from people outside these dens of iniquity, such as the gavel-banging fanatics of certain ideological persuasions who dismiss any who fall short of the goals they set and the principles and precepts they lay down for the general observance as “failures” and “losers”, as if there were some consensus omnium sapientium (an agreement amongst all the wise) regarding life and how it should be led informing their own world view and upon which their judgements rests. What a swarm of fools there are gathered about a man, telling him how to live and judging him!

    Just like every fool feels compelled to vent his worthless opinions on art – and proportionately all the more so the more worthless their opinions are – and in spouting such a profusion of bollocks nevertheless sees himself as the arbiter elegantiae, so every fool is urged on by the full force of his folly to vent his opinions on life and how it should be led, some times on the pretext of helping others, even though it is only themselves they are helping.

    People telling you how to do this, do that, how to dress, how to cut your hair, what to listen to, what to watch, how to smell, how to think, how to feel etc.

    Every fool is telling you how to live, and if you don’t live like them, you’re a failure, you “need to get a life”, or some such other obscene bit of tripe. Under a truly providential dispensation such a man would drop dead immediately he uttered such stupidity. The presumption of these people. Nothing more vexatious than to see some complete nullity telling others how to live whilst judging them for falling short of the goals that, in their fanaticism, they set for the rest of the world.

    From the tyrant to the beggar, its fanatics all down the line.

    To paraphrase La Rochefoucauld, every man has the strength to bear the burden of others. The human spirit conforms broadly to the same law that the body operates under, dictating that under a burden too great for its bulk to bear, it buckles and breaks. Nevertheless I will grant that from a certain situational, constitutional and experiential remove it is easy to imagine overcoming the difficulties others are facing, and accordingly to judge them in their failure after we have so successfully, triumphantly, circumvented those difficulties we don’t have to face.

    The rich judge the poor; the strong judge the weak; the fortunate, the unfortunate; the content, the miserable; and so and so and so forth, and often mistreat them accordingly.

    In the case of some mental patients, the problem, I would surmise, is not so much their experiences per se, but the dialectic with their environment, to which some are better adapted, be it by dint of a boorish, bovine sensibility, or a skin sufficiently thick enough and heart hard enough to withstand the trials and tribulations of life, in contradistinction to which there are certain freakish aberrations of an incongruously poetical and artistic nature, given to flights of fancy and feeling in which they envisage and experience states in the comparison wherewith the vulgar world which they inhabit suffers.

    Due to their greater sensitivity, their emotional life can be compared to Aeolian harps so badly tuned that the passage through the strings of the unfavorable winds of fortune, fate, and circumstance extracts only the most discordant melodies, because whilst the human heart may always be out of tune with the world to some extent, with some it is so poorly adapted to it, its existence so absurd, so incongruous, its owner finds himself in the same unfortunate company as the rest of Nature’s laughingstocks, of whom the world is but a sinister mockery (I’m talking of the deformed, the saintly, artists, and other freaks like myself and all the week specimens whose only purpose in being born was to be preyed upon and empower Nature’s favorites).

    Yet I digress. In this world, every man must himself sometimes make reparations for the wrongs he suffers. The history of institutional psychiatry is another chapter in the time and tradition-honored inhumanity with which victims of man’s inhumanity are treated, though in truth there is nothing “inhuman” about “man’s inhumanity to man”, which suggests there is something aberrant about cruelty and oppression, when in point of fact the ideal of “humanity” is honored more in the breach than in the observance, betrayed so much that it would be better to talk of “man’s humanity to man”.

    Some people, naive people, think that through the simple dissemination of knowledge awareness will be raised leading to some sort of national outcry. Yet it is not merely that people don’t know, but that they don’t want to know, which is what Burt Lancaster’s character in “Judgement in Nuremberg” said of the German people apropos of the inescapable reality of the Holocaust.

    Most people, in every age, are too busy pursuing their own interests and making their accommodations with the powerful, too busy trying to enjoy themselves, to give a rats arse about what’s happening to others. Anything else is mostly a vain and silly pretense. Men are quite willing to countenance injustice and abuse, until it happens to them. It’s doubtful that I’d be taking any interest in this subject if I hadn’t been adversely affected by psychiatry.

    In the (second-rate) theater of life, such is the versatility of self-love and self-interest, they easily adapt themselves to just about any role to which they are assigned by circumstance and the ever-accreting proprieties of society. What we call the love of justice and truth is but the love of ourselves and our own interests – save perhaps a few individuals – and the high-minded nonsense of men led on by their passions, impulses and appetites, under the illusion that it is their so-called principles leading them so.

    These people whereof I previously spoke, the eternal optimists, labor under the same misapprehension as does the protagonist of Ibsen’s “The Enemy of the People”, Dr Stockmann, who naively assumes that alerting society to the pollution at the source of its prosperity will instigate a popular revolt, animated by some mythical love for justice or truth, both of which rarely lend currency to ideas in the marketplace thereof. If they did, human history would have followed a quite different course, pregnancy would be prohibited under pain of the pillory, and men would everywhere ritually imprecate Nature and the heavens for having authored such a lame excuse for a world, to which the words “beautiful” and “providential” are as ill- as they oft-applied.

    Men are only interested in the truth insofar as it either does not bear negatively upon their interests, passions, desires, and appetites, or advances them. Perhaps not a universal principle, but likely a general one. All human life presupposes a large measure of error and falsehood.

    “Sorrow is knowledge; they who know the most
    must mourn the deepest o’er the fatal truth,
    the tree of knowledge is not that of life.”

    Lord Byron

    Yet everywhere men preen themselves on their supposed love of truth, and praise others likewise, indulging the vice of self-praise under cover of virtue (for what we praise most in others is what most corresponds to ourselves, lauding other people for their “thoughtfulness”, for how “inspiring” they are(n’t), etc., when what we really mean to say is, “I agree”, or, “congratulations on being like me!”).

    The “love of justice” is mostly the love of self.

    Men are usually more outraged in being told about an injustice than they are about the injustice itself.

    The measure of those who don’t love justice and truth is roughly proportionate to the amount who profess such a love.

    Men are not creatures of principle. In their thoughts, and in their lives, men will go whithersoever their appetites, passions, and desires lead them, to all of which they give a high-minded name so that they may lead them on all the better.

    Society is not merely ignorant, but indifferent, for it is composed almost entirely of individuals who are almost completely self-serving. Hence the futility of even trying to reform it. Men can blame systems all they like, but you cannot mend a broken foot by altering the shoe.

    What goes on behind the bricks and mortar of the mental “hospital”, for example, has been known for a long time, and people couldn’t give a damn.

    “Morality tells us that conscience may not be heard – but that it always speaks against cruelty and injustice. In fact conscience blesses cruelty and injustice – so long as their victims can be quietly buried.”

    John Gray

    This truth is borne out in every age, and every society. Institutional psychiatry is so useful because of the service it renders in burying alive victims of cruelty and injustice, be it in the mental hospital, or under the mythology of the DSM. No wonder there is such an outcry demanding the homeless be removed from the streets; it’s because we don’t want to be reminded of their existence, and the tragedy and injustice it often discloses.

    The many prostitutes writing on this issue, selling themselves and strutting their stuff on the sidewalk of the written word, fellating the mass phallus, cannot afford to acknowledge such things lest they alienate their audience, potential or otherwise, yet when it comes to humanity, most of what is true is, alas, for the most part it would seem, unacknowledgeable.

  • Anonymous

    One of the best. Very good.

    ” Men are quite willing to countenance injustice and abuse, until it
    happens to them. It’s doubtful that I’d be taking any interest in this
    subject if I hadn’t been adversely affected by psychiatry.”

    So true.

  • Maximus Peperkamp

    Dear Philip,

    Thank you for your wonderful blog. I am a psychology instructor and refer all my students to your blog. They find it very useful.

    I have worked many years in mental health. I distinguish between Sound Verbal Behavior (SVB) and Noxious Verbal Behavior (NVB) and explain to people who struggle with mental health issues that their negative private speech (their thoughts and feelings) is caused by NVB public speech, in which the speaker’s voice is experienced by the listener as an aversive stimulus. In SVB, by contrast, the speaker’s voice is perceived as an appetitive stimulus by the listener.

    NVB public speech causes NVB private speech. Nothing can be done with NVB private speech. The person with NVB private speech needs SVB public speech, because only that will result in SVB private speech.

    It is remarkable how strongly people with mental health problems respond to the SVB/NVB distinction.They almost instantaneously get it! It immediately relieves them because they makes clear that their behavior is caused not by them, but by their environment.

    If you want to know more about the two universal response classes SVB and NVB, please check out my blog: http://www.soundverbalbehavior.blogspot.com and let me know what you think. I look forward to reading your comments. .

    Kind greetings,

    Maximus

  • Jane

    Another brilliant article!

    Thank you.

  • lefflan

    “If I, for instance, believe that airplane contrails contain toxic substances that are being spread by the government as part of a sinister plan to render the citizens docile and debilitated,”

    I like how you subliminally put a conspiracy theory in the readers mind, from what I’ve understood it seems to be true.

  • Phil_Hickey

    Jane,

    Thanks for your support.

  • all too easy

    NEW YORK TIMES
    Scientists Move Closer to Understanding Schizophrenia’s Cause
    By BENEDICT CAREY JAN. 27, 2016

    I delight in confounding those who will never see that which enlightens scientists.

    “Scientists reported on Wednesday that they had taken a significant step toward understanding the cause of schizophrenia, in a landmark study that provides the first rigorously tested insight into the biology behind any common psychiatric disorder.

    More than two million Americans have a diagnosis of schizophrenia, which is characterized by delusional thinking and hallucinations. The drugs available to treat it blunt some of its symptoms but do not touch the underlying cause.

    The finding, published in the journal Nature, will not lead to new treatments soon, experts said, nor to widely available testing for individual risk. But the results provide researchers with their first biological handle on an ancient disorder whose cause has confounded modern science for generations. The finding also helps explain some other mysteries, including why the disorder often begins in adolescence or young adulthood.

    “They did a phenomenal job,” said David B. Goldstein, a professor of genetics at Columbia University who has been critical of previous large-scale projects focused on the genetics of psychiatric disorders. “This paper gives us a foothold, something we can work on, and that’s what we’ve been looking for now, for a long, long time.” You know who David B. Goldstein is, I’m sure.

    “The study, by scientists from Harvard Medical School, Boston Children’s Hospital and the Broad Institute, a research center allied with Harvard and the Massachusetts Institute of Technology, provides a showcase of biomedical investigation at its highest level. The research team began by focusing on a location on the human genome, the MHC, which was most strongly associated with schizophrenia in previous genetic studies. On a bar graph — called a Manhattan plot because it looks like a cluster of skyscrapers — the MHC looms highest.

    “The MHC is the Freedom Tower” of the Manhattan plot, said Eric S. Lander, the director of the Broad Institute. “The question was, what’s in there?”

    “Using advanced statistical methods, the team found that the MHC locus contained four common variants of a gene called C4, and that those variants produced two kinds of proteins, C4-A and C4-B.

    The team analyzed the genomes of more than 64,000 people and found that people with schizophrenia were more likely to have the overactive forms of C4-A than control subjects. “C4-A seemed to be the gene driving risk for schizophrenia,” Dr. McCarroll said, “but we had to be sure.”

    The researchers turned to Beth Stevens, an assistant professor of neurology at Boston Children’s Hospital and Harvard, who was an author of a 2007 study showing that the products of MHC genes were involved in synaptic pruning in normal developing brains. But how important was this C4 protein, exactly? Very important, it turned out: Mice bred without the genes that produce C4 showed clear signs that their synaptic pruning had gone awry, Dr. Stevens’s lab found.

    Taken together, Dr. Stevens said in an interview, “the evidence strongly suggested that too much C4-A leads to inappropriate pruning during this critical phase of development.”

    In particular, the authors concluded, too much C4-A could mean too much pruning — which would explain not only the thinner prefrontal layers in schizophrenia, but also the reason that the disorder most often shows itself in people’s teenage years or early twenties. “The finding connects all these dots, all these disconnected observations about schizophrenia, and makes them make sense,” Dr. McCarroll said.

    Carrying a gene variant that facilitates aggressive pruning is hardly enough to cause schizophrenia; far too many other factors are at work. Having such a variant, Dr. McCarroll estimates, would increase a person’s risk by about 25 percent over the 1 percent base rate of schizophrenia — that is, to 1.25 percent. That is not nearly enough to justify testing in the general population, even if further research confirms the new findings and clarifies the roles of other associated genes.

    Yet the equation changes when it comes to young people who are at very high risk of developing the disorder, because they are showing early signs — a sudden slippage in mental acuity and memory, or even internal “voices” that seem oddly real. This ominous period may last a year or more, and often does not lead to full-blown schizophrenia. The researchers hope that the at-risk genetic profile, once it has been fleshed out more completely, will lead to the discovery of biomarkers that could help clarify a prognosis in these people.

    Developing a drug to slow or modulate pruning poses another kind of challenge. If the new study shows anything, it is that synaptic pruning is a delicate, exquisitely timed process, and that it is still poorly understood. The team does not yet know, for example, why C4-A leads to a different rate or kind of pruning than C4-B. Any medication that tampered with that system would be a risky proposition, the authors and outside experts agreed.

    “We’re all very excited and proud of this work,” Dr. Lander said. “But I’m not ready to call it a victory until we have something that can help patients.”

    GENETICS and brain disorders. The linkage is clear.

  • Rob Bishop

    Abnormalism is to believe oneself defective.

  • Bradford

    First knee-jerk response? I don’t like your word choice. “Sound” sounds like “sounds like”, which sounds like something else. And the word I most expect to follow “noxious” is “weed”, as in “noxious weed(s)”….

  • Bradford

    Yes, the “linkage” being VERBAL.
    “all too easy” = supremely self-delusional…..

  • all too easy

    “Abnormalism is to believe oneself defective.” lil stevie know nutin

    “Abnormalism is to believe lil stevie ain’t defective.”
    “Abnormalism is to be lil stevie” the overbearing philosopher and “the” answer to all mankind’s problems; the self-absorbed, know-it-all, bozo, who lives in constant denial of his desperate yearning to be one of the guys.

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