A Behavioral Approach to Mental Disorders

I came across this on Yahoo! News. BOSTON (AP) — Gay rights groups say they're pleased the oldest Roman Catholic newspaper in the United States has retracted an opinion column suggesting the devil may be responsible for gay attraction. The column in the Boston archdiocese's The Pilot newspaper was titled "Some fundamental questions on same-sex attraction." It was written by an adviser at the U.S. Conference of Catholic Bishops. It said "scientific evidence of how same-sex attraction most likely may be created provides a credible basis for a spiritual explanation that indicts the devil." ...

I am writing this post in response to Jeanne’s last comment concerning the concept of sin. This takes us a little outside the normal orbit of this blog, and also outside my field. But since behaviorism is a way of looking at human activity, and sin is an alternative way of looking at the same phenomenon, it might be helpful to examine the concept a little and draw comparisons between the two perspectives. ...

In a recent comment on my last post Jeanne raised some important questions concerning homosexuality. These are issues where considerations of political correctness and religious dogma have stifled genuine discussion and dialogue. I will try to address these questions openly and straightforwardly. The sex or gender of a person expresses itself in five general ways. 1. Every cell of the body is recognizable under a microscope as male or female. 2. Anatomically: The male develops testicles; the female develops ovaries. These differences are discernible in the embryo within a few weeks of fertilization. ...

Post edited and updated January 2, 2013, to reflect clarifications as a result of interactions with the many people who have left comments. I thank them for their input. ******************** According to the American Psychiatric Association, until 1974 homosexuality was a mental illness. Freud had alluded to homosexuality numerous times in his writings, and had concluded that paranoia and homosexuality were inseparable. Other psychiatrists wrote copiously on the subject, and homosexuality was “treated” on a wide basis. There was little or no suggestion within the psychiatric community that homosexuality might be conceptualized as anything other than a mental illness that needed to be treated. And, of course, homosexuality was listed as a mental illness in DSM-II. (The DSM – Diagnostic and Statistical Manual – is the APA's standard classification of their so-called mental disorders, and is used by many mental health workers in the USA and other countries.) Then in 1970 gay activists protested against the APA convention in San Francisco. These scenes were repeated in 1971, and as people came out of the “closet” and felt empowered politically and socially, the APA directorate became increasingly uncomfortable with their stance. In 1973 the APA’s nomenclature task force recommended that homosexuality be declared normal. The trustees were not prepared to go that far, but they did vote to remove homosexuality from the list of mental illnesses by a vote of 13 to 0, with 2 abstentions. This decision was confirmed by a vote of the APA membership, and homosexuality was no longer listed in the seventh edition of DSM-II, which was issued in 1974. ...

Psychiatry likes to present itself as a helping profession, but even a cursory look at its history suggests otherwise. Here are some of the “treatments” that this pseudo-science has promoted for its pseudo-illnesses. STERILIZATION It is estimated that 65,000 people were sterilized in America under various eugenic statutes. This practice, which was used between the 1920’s and 1970’s, was aimed at “undesirables” which included the so-called mentally ill. HYDROTHERAPY This involved suspending the client in a cold bath for hours and even days at a time. It was widely practiced in the early decades of the twentieth century. ...

Daniel Carlat in his blog post of August 15 mentions, and critiques, a so-called blood test for depression marketed (for $745) by Ridge Diagnostics. The essence of Dr. Carlat’s criticism is that the test is not predictive of depression, but merely enables one to tell (with some degree of accuracy) whether or not a person is depressed. Dr. Carlat makes the point that you can tell this with more or less total accuracy simply by asking the person if he is depressed or by observing him for a few minutes of conversation. ...

In a comment on my post on Natural Correction, Nanu Grewal raised a question concerning the addressing of behavioral problems. This is a huge topic, and I feel the reply warrants a post. There are others who could do a better job than me, but here’s my take on it. Traditional behavior therapy starts with assessment. Take nail-biting as a fairly simple example. Observations are made for a week or so, and the frequency of the problem behavior is measured as accurately as possible. Next step is remediation. In this case, say, application of a foul-tasting preparation to the subject’s nails. Then more monitoring. Essentially what has occurred is that the problem behavior has been punished by the foul taste, and one expects to see the problem diminish in frequency to the point of extinction. Further monitoring would occur about a month later to ensure no return of the problem. ...

The central theme of this blog is that there are no mental illnesses and that the spurious medicalization of problems of living represents a tragic wrong turn in human history. In a comment on my last post, Nanu Grewal raised the question of a natural correction. In other words, does there come a point where the nonsense is so outrageous that some corrective force emerges which would undermine and even supplant the present illogical system. In my view this is an excellent question. ...

On June 23, the New York Review of Books, one of the most prestigious literary magazines in the country, published a piece by Marcia Angell. I’ve mentioned Dr. Angell before. She had been editor-in-chief of the New England Journal of Medicine and had come out strongly against the extent to which drug companies are controlling and directing medical research. Well in this recent article she reviews three books: The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch, PhD ...

The National Institute of Health (NIH) is an agency of the U.S. Department of Health and Human Services. It is the primary U.S. Government agency responsible for medical research. The NIH has 27 sub-departments, one of which is the National Institute of Mental Health (NIMH). The NIMH has an annual budget of $1.5 billion, which they use to support research through grants and in-house work. Several years ago the NIMH approved a $35 million grant for the STAR*D study (Sequenced Treatment Alternatives to Relieve Depression). The study was conducted “…to determine the effectiveness of different treatments for people with major depression who have not responded to initial treatment with an antidepressant.” This was to be the largest and longest study ever conducted to evaluate depression treatment, the results of which are now available. ...