A Behavioral Approach to Mental Disorders

Christopher Lane recently published an interesting article on Psychology Today. The article covers a number of topics, including the APA’s proposal to include “hypersexual disorder” in the upcoming DSM-5. The implications of this proposed “diagnosis” are that if you think about sex too much or engage in sexual activity too much, then you have a mental illness. Back in the 60’s, when I was at college, I would frequently find myself chatting with a group of fellow students on a wide range of topics, including sex. Often someone would cite the old statistic that the average young adult male thinks about sex 171 times a day (or whatever), to which the chorus of replies was always – “no way; it’s much more often than that.” ...

About a week ago an article appeared on the ‘net concerning an attempt by parents to ban ice cream vendors from a playground in Brooklyn, New York. The piece was reprinted in the New York Post. Apparently some of the parents are upset because the arrival of the vendors stimulates requests for ice cream from the children, which results in confrontation and bitterness. Responsible parents everywhere will recognize the dilemma. Ice cream has little or no nutritional value, but children like it. So do we stand our ground or do we give in? ...

The central theme of this blog is that the APA’s so-called diagnostic system is spurious and destructive. It is destructive of the individuals that get caught in its net and destructive socially in that it undermines those values of resourcefulness and efficacy which are essential ingredients of a successful society. Psychiatrists have become tawdry drug pushers. To this end they have prostituted their medical affiliations and have avidly promoted the big lie: that ordinary human problems are in fact illnesses best “treated” by drugs. ...

Recently I was listening to NPR on the car radio. The program was about so-called obsessive compulsive disorder, and a woman was describing her difficulty in this area. I didn’t record her actual words, but it went something like this: I have all these checks and rituals that I have to do each day. And it’s beginning to put a strain on my marriage. Sometimes my husband wants to go somewhere but I can’t go until I finish my checks. ...

Yesterday I received the following email from a reader. “What’s your stance on eccentricity? How do you relate to the general view in the APA that deviation from cultural norms is pathological? And, have you ever read about David Weeks? I consider myself an eccentric person with many quirks and some fetishes. While I have many friends who share the same interests or many of them, I still feel a little bad about psychiatrists labeling eccentricity with SPD or Schizoid personality disorder. I am 19, and my friends are from the 18-25 years of age, and we share a common love for anime and cartoons. Maybe not always the same but sometimes we share two or more common cartoons. Some of them also are collectors of stuffed animals and figurines like me, and some of them engage in masturbation with those objects as me. ...

I recently received the following email from a reader: “I was wondering what your thoughts were on intrusive thoughts and anxiety problems or what some people call pure ocd. I have had problems for as long as I can remember. There is so much information out there it gets confusing. I don't believe these are illnesses I believe alot is learned or habitual. I am alot better thanks to my own hard work, but intrusive thoughts are one of the harder things to shake. Thank you.” ...

There was a nice article in the Lancet last month. The article posed the question: “When should grief be classified as a mental illness?” The author criticized the APA’s draft version of DSM-5 for blurring the distinction and for making it more likely that people in bereavement will be “diagnosed” as depressed and, of course, “treated” with prescription drugs. There has been a good deal of criticism against the APA on this issue, and it is likely that the final version of DSM-5 will reflect some retreat in this matter. ...

In 1997 I worked part-time for a nursing home. This facility had an open-door policy and had a reputation in the state for being able to accommodate even the most difficult and unmanageable clients. Some of this reputation was attributable to their generous administration of major tranquilizers, but in addition there was a high level of acceptance and compassion among the staff, and there is no doubt in my mind that this was a major factor in their success. ...

This issue has been debated for years, but was finally considered to have been put to rest by NIMH’s 2004 Treatment for Adolescents with Depression Study (TADS). This study essentially “found” that fluoxetine (Prozac) was effective in treating depression and did not involve an increased risk of suicide. Robert Whitaker’s most recent post points out that TADS actually found that adolescents treated with fluoxetine had a markedly higher risk for suicidal activity than those who received a placebo. Robert also outlines the various statistical and methodological ploys that were used to conceal this finding and to sanitize the final report. ...

The debate is over. Antidepressants are only very marginally more effective than placebos. And yet the “depression-is-an-illness” lobby continues to grasp for straws. Fiona Godlee, editor of the British Medical Journal, recently cited “evidence” of the efficacy of antidepressants. For a critique of the Godlee article go to Duncan Double’s website “Critical Psychiatry.” Surprise finding! - Antidepressants are only very marginally more effective than placebos. What this means in effect is that people are “curing” their own depression (gasp), and perhaps don’t really need the mental health practitioners (double gasp). ...