A Behavioral Approach to Mental Disorders

With considerable misgivings, I have decided that, due to advancing age and ongoing deterioration in my health, I am no longer able to write posts or respond to comments. From my personal perspective, I deeply regret having to make this decision. I’ve been writing posts for the last 13 years, and during that time I’ve made no secret of my opposition to psychiatric principles and practice. Having to quit the field at this stage leaves me with a profound sense of incompleteness. There is still so much work to be done, to which my only contribution will be cheering from the sidelines. ...

INTRODUCTION On March 21, 2022, Daniel Morehead, MD, psychiatrist, published an essay on Psychiatric Times titled: The DSM: Diagnostic Manual or Diabolical Manipulation? Subtitle: “Nobody likes the DSM”. This is Episode 2 of his defense of psychiatry. Here’s the first paragraph: "It is hard to overstate the torrents of criticism that have rained down upon the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). This poor, beleaguered document has been repeatedly and energetically attacked from all sides on a routine basis. It is not only the usual critics of psychiatry who have excoriated its approach—patients and family members, journalists, members of the academy, sociologists, psychologists, psychiatrists, National Institute of Mental Health (NIMH) directors, and even DSM task force chairs themselves have come down heavily against it on both general and specific grounds.2" ...

INTRODUCTION On March 17, 2022, the very eminent and illustrious psychiatrist Ronald Pies, MD, published a piece on return.life. The article is titled The Myth of the Chemical Imbalance. Subtitle: What psychiatrists really believe about mood disorders. The gist of the article is that psychiatry, as a profession, never endorsed the chemical imbalance theory of depression. This has become an almost constant obsession of Dr. Pies which has attracted a good deal of compelling criticism from members of the anti-psychiatry movement, to which Dr. Pies addresses no meaningful or cogent response. Indeed, his responses have consisted of little more than a re-writing of the same old invalid material, laced generously with his customary and pretentious diversions into Greek history, the difference between a theory and a hypothesis, and other interesting but irrelevant material. I have personally discussed and refuted Dr. Pies’ various contentions on these matters, but like the Energizer Bunny, he keeps going on. Readers can find my various posts on these topics on Mad in America or on my own site. Search for Dr. Pies. ...

On February 15, 2022, Daniel Morehead, MD, a psychiatrist and director of training at Tufts Medical Center in Boston, published an article in Psychiatric Times. The title is Just Because We Do Not Know Everything Does Not Mean We Do Not Know Anything. The article is designated Episode 1 of a new series, and the subtitle is “Exploring how to approach the criticisms of psychiatry.” INTRODUCTION Perhaps the most noteworthy thing about this piece is the title: Just Because We Do Not Know Everything Does Not Mean We Do Not Know Anything. There is, I suggest, an implication here that psychiatry has been accused of not knowing anything. I’m fairly familiar with most of the criticisms that have been levelled against psychiatry, but I have never heard or read any criticism of psychiatry that entailed allegations of such profound ignorance. I think the vast majority of psychiatry’s critics would acknowledge that psychiatrists know how to tie their shoes, drive their cars, conduct themselves in social situations, etc… So why would Dr. Morehead choose to open his affirmation of psychiatry – his defense of his chosen profession – with this undermining caricature of his profession’s critics? ...

INTRODUCTION The Colorado News Collaborative is a coalition of more than 160 news outlets across the state. One March 21, 2022, they ran a piece titled Investigation finds patterns of ’life-threatening’ prescription errors at Colorado mental health center. The sub-title is: State agencies sought to keep report secret despite ongoing concerns about Mind Springs. Authors of the article are Christopher Osher of the Colorado Springs Gazette and Susan Greene, Colorado New Collaborative. ...

INTRODUCTION According to its About page, "The ENIGMA consortium is an international effort by leaders worldwide. The Consortium brings together researchers in imaging genomics, neurology and psychiatry, to understand brain structure and function, based on MRI, DTI [Diffusion Tensor Imaging], fMRI, genetic data and many patient populations. The best return on our research investments will come from combining our data to achieve the large samples necessary to detect the modest gene effect sizes that we now know are the rule rather [than] the exception for complex traits. ...

On February 10, 2022, Joe Pierre MD, Psychiatrist, VA West Los Angeles Healthcare Center, and Clinical Professor, UCLA, posted the following short entry on his Twitter stream: "Cancer is a normal and understandable reaction to environmental trauma." This innocent-looking assertion is a glib and fallacious counter to those of us in the anti-psychiatry movement who for years have been saying and writing similar things about psychiatry's so-called "mental illnesses". The tweet is followed by the hashtag #dropthedisorder, followed by a question mark. Drop the Disorder is a Facebook group based in the UK headed by Lucy Johnstone, Jo Watson, Jacqui Dillon and Nollaig McSweeney. Essentially what Dr. Pierre is asserting is this: ...

Continuing my response to a paper by Awais Aftab, MD, titled It’s Time for Us to Stop Being So Defensive About Criticisms of Psychiatry. I published Part 1 of this post on January 27, 2022. Because the post was becoming lengthy, I decided to split it into two parts. This is Part 2. Part 1 ended with this quote from Dr. Aftab’s paper: "Morehead references the 2012 paper by Phillips et al on conceptual and definitional issues in psychiatric diagnosis.20 This article highlights some of the most prominent names in philosophy of psychiatry and reveals the philosophical difficulties that surround the notion of mental illness and the elusiveness of a satisfactory definition. This has been a topic of interest to me for many years, and my own philosophical work in this area reflects the conceptual inadequacies of our notion of mental illness.21" ...

INTRODUCTION On January 6, 2022, Awais Aftab, MD, a psychiatrist and clinical professor at Case Western, published a piece in Psychiatric Times. The title is It’s Time for Us to Stop Being So Defensive About Criticisms of Psychiatry. Dr. Aftab’s paper is essentially a response to another paper, published also in Psychiatric Times. This latter paper is titled It’s Time For Us To Stop Waffling About Psychiatry, by Daniel Morehead, MD, director of training for the general psychiatry residency at Tufts. Dr. Morehead acknowledged the generous assistance he received from Ronald Pies, MD, in the writing of the article. ...

INTRODUCTION On June 22, 2021, Vivian Pender, MD, then the newly elected President of the APA, published an article on Psychiatric News titled Addressing Social Determinants of Mental Health. Psychiatric News is the APA’s own online journal. Here are the first two paragraphs: "According to the World Health Organization, 'A person’s mental health and many common mental disorders are shaped by various social, economic, and physical environments operating at different stages of life. Risk factors for many common mental disorders are heavily associated with social inequalities, whereby the greater the inequality, the higher the inequality in risk.' In other words, people don’t necessarily start with the same opportunities or resources (inequity), and social factors further divide us. This suggests that our psychiatric patients suffer from biopsychosocial determinants that could have been prevented in the first place." ...