A Behavioral Approach to Mental Disorders

INTRODUCTION The bereavement exclusion was formally eliminated in the spring of 2013, with the publication of DSM-5. The exclusion was a provision in earlier editions, that a “diagnosis of major depressive disorder” could not be assigned to a bereaved person, even though he or she met the criteria, unless certain additional considerations were met. The history of its elimination provides an interesting example of psychiatry’s relentless expansion of its net. The issues involved take us right to the heart of the psychiatric hoax. ...

On July 25, 2017, Fredrik Hieronymus et al published a meta-analysis in Molecular Psychiatry. The study is titled Efficacy of selective serotonin reuptake inhibitors in the absence of side effects: a mega-analysis of citalopram and paroxetine in adult depression. Elias Eriksson, PhD, Head of the Department of Pharmacology, University of Gothenburg, Sweden, is the principal author, but as Fredrik Hieronymus is the first author listed, I will refer to the article as Hieronymus et al. ...

Two days ago, on July 9, Richard Lewis published on Mad in America a post in which he draws attention to the prolific worldwide prescribing of benzodiazepines, and the problems that this creates. The article includes a music video of a song which Richard has written and performs. The song is called Benzo Blue, and it “highlights the struggles of the millions of worldwide victims/survivors of prescribed benzodiazepine drugs such as Xanax, Ativan, Klonopin, and Valium.” ...

INTRODUCTION On May 5, 2017, Donald Goff, MD and seven other psychiatrists, including the very eminent Jeffrey Lieberman, MD, published an article in the American Journal of Psychiatry. The title is: The Long-Term Effects of Antipsychotic Medication on Clinical Course in Schizophrenia. Here’s the abstract: "Concerns have been raised that treatment with antipsychotic medication might adversely affect long-term outcomes for people with schizophrenia. The evidence cited for these concerns includes the association of antipsychotic treatment with brain volume reduction and with dopamine receptor sensitization, which might make patients vulnerable to relapse and illness progression. An international group of experts was convened to examine findings from clinical and basic research relevant to these concerns. Little evidence was found to support a negative long-term effect of initial or maintenance antipsychotic treatment on outcomes, compared with withholding treatment. Randomized controlled trials strongly support the efficacy of antipsychotics for the acute treatment of psychosis and prevention of relapse; correlational evidence suggests that early intervention and reduced duration of untreated psychosis might improve longer-term outcomes. Strategies for treatment discontinuation or alternative nonpharmacologic treatment approaches may benefit a subgroup of patients but may be associated with incremental risk of relapse and require further study, including the development of biomarkers that will enable a precision medicine approach to individualized treatment." ...

INTRODUCTION On August 8, 2013, the eminent psychiatrist Nassir Ghaemi, MD, MPH, published an article on Medscape. The title of the piece is The Psychological Fallacy in Psychiatry. The article is almost four years old. Ordinarily I don’t discuss material this dated, but the content of this article is particularly important, and worthy of discussion, belated as it is. NASSIR GHAEMI’S BIO According to his bio, Dr. Ghaemi: "…is an academic psychiatrist specializing in mood illnesses, depression and bipolar illness, and Editor of a monthly newsletter, The Psychiatry Letter (www.psychiatryletter.org). ...

Recently I came across a remarkable article From surviving to thriving: how does that happen. The authors are Mark Bertram and Sarah McDonald, and the piece was published in The Journal of Mental Health Training, Education and Practice, Vol 10, Iss 5, 2015. The work was conducted in the vocational service department of a large mental health center in London, UK. The authors’ purpose was: "...to explore what helped seven people in contact with secondary mental health services achieve their vocational goals, such as: employment, education, training and volunteering." ...

At the risk of stating the obvious, the anti-psychiatry movement is rapidly gaining momentum. We are attracting an increasing number of supporters, and our message is being picked up increasingly by the mainstream media. We have won the intellectual and moral battles hands down. We have demonstrated again and again that psychiatry is intellectually and morally bankrupt. We have shown that psychiatry is a hoax; that its "illnesses" are not illnesses; that its "diagnoses" are nothing more than vague, arbitrarily delineated, disempowering and stigmatizing labels with no explanatory value; that its "treatments" do more harm than good; that its coercive drugging and electric shocks constitute torture; and that its research is fraudulent. Psychiatry has no valid or rational response to any of these criticisms. Instead, they continue to trot out the same tired and unproven assertions, marginalize their critics, lobby government agencies to defend and fund their business, and promote their own interests using the kind of PR tactics that one commonly associates with the makers of soft drinks and hair shampoo. Psychiatry is a marketing hoax. They sell their “illnesses” and they sell their “cures”. In general, the way to neutralize a hoax is to expose it to the proper authorities. But with psychiatry this is not effective for three reasons. ...

Last month (February 2017), the journal BMC Psychiatry published a study by James Christian Jakobsen et al. The study is titled Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and Trial Sequential Analysis. The research was a meta-analysis – i.e. it combined the findings from several earlier studies. Here are the authors’ conclusions: "SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed by harmful effects." ...

On January 10, 2017, I put up a post titled The Biological Evidence for “Mental Illness”. It was published simultaneously on Mad in America. The post was a response to an earlier comment from Carolina Partners in Mental Healthcare PLLC, which included the assertion “mental illnesses have a long history of biological evidence.” In my January 10 article, I challenged this assertion and pointed out that no such evidence existed. The article generated some comments, most of which were favorable. There was one comment, however, from Michael, who asserted: ...

I have recently read Psychiatry Interrogated, subtitled “An Institutional Ethnography Anthology”. Ethnography is the branch of anthropology that deals with the systematic study of individual cultures. Institutional ethnography (IE), according to Wikipedia, is “a method of social research [that]… explores the social relations that structure people’s everyday lives, specifically by looking at the ways that people interact with one another in the context of social institutions (school, marriage, work, for example) and understanding how those interactions are institutionalized…For the institutional ethnographer, ordinary daily activity becomes the site for an investigation of social organization.” ...