A Behavioral Approach to Mental Disorders

BACKGROUND Those of us on this side of the debate, who criticize psychiatry for medicalizing and drugging virtually every problem of human existence, sometimes ask the question: If all these problems are truly illnesses of the brain, then why are they not being treated by neurologists? The standard psychiatric response to this question has been: neurology deals with nervous system illnesses that result in problems of movement, sensation, physical pain, etc.; psychiatry deals with nervous system problems that result in disordered thinking, feeling, and general behavior. Psychiatry has never produced the proof that these latter problems are caused by illnesses of the brain/nervous system, but that’s a separate issue. ...

I’ve mentioned the CATIE study before. CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) was a NIMH-funded double blinded, randomized controlled trial comparing the effectiveness and side effects of newer-generation neuroleptics versus an older neuroleptic. CATIE-AD was a part of CATIE. The AD stands for Alzheimer’s disease. CATIE-AD was published in the New England Journal of Medicine in October 2006. The results of the study were as follows: "There were no significant differences among treatments with regard to the time to the discontinuation of treatment for any reason" ...

BACKGROUND At the APA annual convention in San Francisco in May of this year, Chad Puffer, DO, of the Mayo Clinic, presented a poster display titled ECT Use in Adolescents at the Mayo Clinic. The poster was reported by Caroline Cassels of Medscape.com, a month later (ECT in Kids: Safe, Effective, Robust and …Underutilized), and drew critical comment a week later (July 2) from Kelly Patricia O’Meara of CCHR International. I didn’t spot any of this until last week, when it came up on the Twitter feed from DxRevision Watch and Peter Kinderman. ...

Courtesy of Carl Elliott via Twitter, I’ve recently read Dr. Lieberman’s latest post on Psychiatric News. It’s called – believe it or not – Time to Re-Engage With Pharma? dated August 1, 2013. And it’s classic Dr. Lieberman sleight of hand. His opening statement, for instance, reads: "Drug companies aren’t held in high esteem by the public these days." This may or may not be true. But note what he's done. The issue here is the long-standing and corrupt relationship between psychiatry and the manufacturers of drugs. But from his first sentence, Dr. Lieberman has taken psychiatry out of the equation. He has also lumped the makers of legitimate medicines in with the makers of psychiatry’s drugs. ...

There’s an editorial by Henry Nasrallah, MD, in last month’s edition of Current Psychiatry. Dr. Nasrallah is the journal’s editor-in-chief. The title of the article is Haloperidol clearly is neurotoxic. Should it be banned? Haloperidol is marketed under the brand name Haldol, but its patent has long expired, and a generic version is available and inexpensive. Here’s a quote from Dr. Nasrallah’s article: "If clinicians who use these decades old drugs were to keep up with medical research and advances in knowledge, we would realize what a travesty it is to use a brain-unfriendly drug such as haloperidol when we have many safer alternatives. A massive volume of knowledge has emerged over the past 15 years about the neurotoxicity of older neuroleptics, especially haloperidol—knowledge that was completely unknown before. Second-generation antipsychotics have been shown to be much safer for the brain than their older-generation counterparts (although they are not more efficacious)." ...

BACKGROUND Obviously there are many points of contention between mainstream biological psychiatrists on the one hand, and those of us who condemn this system as spurious and destructive. Much of what I’ve written on this website over the past four years has been an elucidation of these differences. Today I would like to focus on just one of these differences: disempowerment of clients in the psychiatric system, and empowerment within frameworks that are more psychosocial/behavioral in nature. ...

Duncan Double, MD, one of the founding members of the UK’s Critical Psychiatry Network, has written a compelling and insightful critique of Dr. Lieberman’s most recent article. Dr. Double’s article is titled Is APA prepared to engage with critical psychiatry? Definitely worth a read.

There was an interesting article Big pharma mobilising patients in battle over drugs trials data in last Sunday’s Guardian, a UK newspaper. It was written by Ian Sample, the Guardian’s science correspondent. Here are the two opening sentences: "The pharmaceutical industry has 'mobilised' an army of patient groups to lobby against plans to force companies to publish secret documents on drugs trials." "Drugs companies publish only a fraction of their results and keep much of the information to themselves, but regulators want to ban the practice. If companies published all of their clinical trials data, independent scientists could reanalyse their results and check companies' claims about the safety and efficacy of drugs." ...

Courtesy of Talla Trialogue on Twitter, I recently read an article in journal.ie on this topic. Kathleen Lynch, Minister of State for Disability, Equality, Mental Health and Older People, has reportedly stated that “…the law will be changed so that unwilling patients will no longer be forced to receive ECT.” At present, if an individual refuses ECT, his refusal can be overridden by the signatures of two psychiatrists. However, not everyone is in favor of the ban on forced ECT. There’s an article by Marie Feely, Proposed ban on Involuntary ECT criticized published in irishmedicalnews in January 2012. The article reports on a survey of consultant psychiatrists published in December 2011. Ms. Feely writes: ...

Last week, thanks to a tweet from Ginger Breggin, I came across an article by Jeffrey Lieberman entitled Psychiatry: Nothing to Be Defensive About. Dr. Lieberman is president of the APA, and has gone on record more than once as saying that all these dreadful criticisms of psychiatry are very unfair, and that psychiatrists are good guys who have the high moral ground. Well, he’s back, and his current article is about on a par with previous efforts. ...