A Behavioral Approach to Mental Disorders

Last Saturday our local newspaper ran an article called “Mental Health Needs Reform.” It was written by a psychologist, and the main thrust of the piece was that if “serious mental health care reform” is not implemented, we will see more mass murders similar to those at Aurora and Newtown. The article contained several unwarranted assumptions, and recommended that mental hospitals “rebuild facilities for treating those patients.” My position, of course, is that there are no mental illnesses, and that cold-blooded killers are not sick in any meaningful sense of the term, but are, rather, individuals who have not internalized an age-appropriate respect for the lives and welfare of other human beings. ...

Critical Psychiatry Network is a group of British psychiatrists who are developing and promoting concepts that question and criticize the assumptions that underlie present-day psychiatric practice, not only in Britain, but also in the US and other developed countries. Critical Psychiatry challenges the notion that the various DSM “diagnoses” are biologically-based illnesses, and adduces a great deal of evidence to the contrary. They stress the cultural/social aspect of psychiatric diagnosing. For instance, they point out that a “diagnosis” of ADHD is a cultural construct which provides schools and parents with a socially acceptable method of dealing with difficult children (rather than an identification of an illness). ...

Prior to about 1994, childhood bipolar disorder was virtually unheard of. DSM-III-R (1987), in the section on manic episode, states, “…studies indicate that the mean age at onset is in the early 20s. However…a sizable number of new cases appear after age 50.”(p 216) Of course a mean age of onset in the early 20’s could include young children. The section on major depressive episode, however, contains the following: “The average age of onset is in the late 20s, but a major depressive episode may begin at any age, including infancy.” (p 220) ...

In the wake of the Connecticut mass murders of last month, a great deal of attention, official and otherwise, is being focused on the “mentally ill.” Politicians of all persuasions are proclaiming that we need more funding for the so-called mental health services, and predictably, the various practitioners and centers are lining up with their hands outstretched. The spurious logic, of course, is never identified, or if it is, it gets lost in the rhetoric. Mental illness is presented (and accepted) as the proximate cause of the violence. If one were to ask a mental health practitioner why an individual was so crazy and acted so brutally, the reply would be: Because he has a mental illness. But if one were to press the matter and ask: How do you know he has a mental illness? the only possible response is: Because he is so crazy and acted so brutally. The only evidence for the so-called illness is the very behavior it purports to explain. ...

I’ve come across an article by psychologist Bruce Levine, PhD, How the “Brain Defect” Theory of Depression Stigmatizes Depression Sufferers. Dr. Levine convincingly debunks the brain defect theory, and also the notion that the illness theory destigmatizes depression. Here are some quotes: “Americans have been increasingly socialized to be terrified of the overwhelming pain that can fuel depression, and they have been taught to distrust their own and other’s ability to overcome it. This terror, like any terror, inhibits critical thinking. Without critical thinking, it is difficult to accurately assess the legitimacy of authorities. And Americans have become easy prey for mental health authorities’ proclamation that depression is a result of a brain defect.” ...

I ended a recent post arguing that psychiatrists should not have a leadership role in whatever kind of helping program eventually replaces the present mental health system, which is crumbling at the seams, conceptually and practically. So the question arises – which profession is suited to a leadership role. Of course, this begs the question – do we need any kind of formal helping system at all. Perhaps what we should be doing as a society is strengthening the natural mutually-helpful bonds that already exist within our culture. I can see a lot of merit in that position, and it may be that this is what will eventually happen. But I don’t think it can happen right away. ...

Late adolescence and early adulthood is arguably the most difficult period of life. Transitioning from childhood to adulthood entails many challenges. The young person (male or female) is expected to emancipate successfully from parents; launch a career; and find a partner – all in the space of a few short years. Some individuals cope remarkably well. Others squeak through, and a small minority “crash and burn.” The latter group usually return home. ...

There is an interesting article in last month’s issue of the British Journal of Psychiatry. The article, titled Psychiatry beyond the current paradigm, was authored by Pat Bracken, an Irish psychiatrist, and 28 other British and Irish psychiatrists. The gist of the piece is that the current psychiatric paradigm, which the authors describe as “applied neuroscience,” is not supported by the evidence and needs to be abandoned. Here are some quotes: ...

All murders, of course, are brutal, tragic acts, but the planned cold-blooded slaughter of 20 little children and six teachers is particularly heinous. The Newtown murders, coming as they do in the wake of a long string of similar incidents, raise serious questions about American society. Besides the outpouring of grief and sympathy, the two most common themes in the media are gun control and the strengthening of the so-called mental health services. Of course the mental health industry is raising no objection to the latter. ...

Robert Whitaker’s website, Mad in America, is abuzz lately with articles challenging the medical model that underlies DSM and psychiatric “treatment” in general. Recently there was an article by Alice Keys, MD, called “Do Diagnoses Injure People?” Of course I believe emphatically that they do, and I read the article. Much of the content is valuable, and I encourage readers to take a look. There was one aspect of the piece, however, that I found troubling. Dr. Keys made the point that psychiatric diagnoses can be dangerous, but then mitigated this considerably by making the same assertion about medical diagnoses in general. Whilst there may be a measure of truth to this assertion, it is misleading, in that it creates the impression that psychiatric “diagnoses” are just as valid as real medical diagnoses, which is simply not the case. ...