Myth of Mental Illness

INTRODUCTION Earlier this year, Alan Schwarz, an investigative reporter for the New York Times, published his latest book: ADHD Nation. The blurb on the jacket states: "More than 1 in 7 American children get diagnosed with ADHD—three times what experts have said is appropriate—meaning that millions of kids are misdiagnosed and taking medications such as Adderall or Concerta for a psychiatric condition they probably do not have. The numbers rise every year. And still, many experts and drug companies deny any cause for concern. In fact, they say that adults and the rest of the world should embrace ADHD and that its medications will transform their lives. ...

On October 12, 2014, the eminent psychiatrist Allen Frances, MD, participated in a panel discussion at the Mad In America film festival in Gothenburg, Sweden. After the festival, he wrote an article – Finding a Middle Ground Between Psychiatry and Anti-Psychiatry – for the Huffington Post Blog, summarizing the positions he had discussed at the festival. The article was re-published on MIA on October 26, 2014. The article is ostensibly an attempt to find common ground between psychiatry and its critics, but the piece contains numerous distortions and omissions which I think need to be identified and discussed. ...

On April 5, Allen Frances MD, published an article on the Huffington Post blog. The title is Can We Replace Misleading Terms Like ‘Mental Illness,’ ‘Patient,’ and ‘Schizophrenia’ It’s an interesting piece, and it raises some fundamental issues. Here are some quotes from the article, interspersed with my comments. "Those of us who worked on DSM IV learned first-hand and painfully the limitations of the written word and how it can be tortured and twisted in damaging daily usage, especially when there is a profit to be had." ...

In January 2014, the journal Research on Social Work Practice published a special issue: A Critical Appraisal of the DSM-5: Social Work Perspectives. There were many excellent articles in this volume, some of which I have highlighted in earlier posts. One of the very outstanding articles is The Diagnostic and Statistical Manual of Mental Disorders as a Major Form of Dehumanization in the Modern World, by Eileen Gambrill, PhD, a graduate school Professor at the School of Social Welfare, University of California, Berkeley. ...

On July 15, I wrote a post called Psychiatry Debunks the ‘Myths.’ In that article I focused on the myth-debunking of Cognitive Psychiatry of Chapel Hill, but in researching the topic for that post, I came across a psychiatry resident named Shan (no last name) who blogs on a website called Exploratory Encephalotomy. With regards to the name of the website, Dr. Shan explains on his About the blog page: "…'exploratory encephalotomy' implies opening up somebody’s brain in order to search for something. To the best of my knowledge, it’s not a real medical procedure yet…" ...

Psychiatry has always had its share of critics, but in the past two decades these criticisms have increased in frequency and intensity. Psychiatry's underlying concepts are being denounced as spurious to the point of inanity, and its practices are being accurately and forcefully exposed as destructive, disempowering, and stigmatizing. Psychiatry has no rational or logical response to these criticisms. Its leadership and its rank and file remain stubbornly blind to the arbitrariness and invalidity of its so-called diagnoses, the unquestioning adoption of which distorts their perceptions of people and their problems. ...

In 2006, Laurence Jerome, a Canadian psychiatrist, and two colleagues wrote a paper titled What We Know About ADHD and Driving Risk: A Literature Review, Meta-Analysis and Critique. It was published in the Journal of the Canadian Academy of Child and Adolescent Psychiatry in August, 2006. The primary result of the meta-analysis was: "Current data support the utility of stimulant medication in improving driving performance in younger ADHD drivers." The study is lengthy and well-referenced, but in keeping with standard psychiatric practice, it conceptualizes and presents ADHD as a "…common psychiatric disorder…" with symptoms of "…inattention, impulsiveness and hyperactivity…" In other words, they present ADHD as something that a person has rather than as something that a person does. The problem with this approach is that it creates the impression that meaningful or significant correlations/effects have been found, where in fact all that has happened is an elucidation of the terms used. For instance, the authors refer to a study by Fried et al. (2006) and state: ...

On February 28, Awais Aftab, MD, a psychiatrist working in Qatar, published an interesting article on Psychiatric Times. The article, which is titled Mental Illness vs Brain Disorders: From Szasz to DSM-5, is an attempt to validate the concept of “mental illness” and, in particular, claims to refute the position of the late Thomas Szasz, MD, that mental illness is a spurious concept. The validity or otherwise of the concept of mental illness is fundamental to psychiatry’s claim to legitimacy, and for this reason, Dr. Aftab’s article deserves close scrutiny. ...

A couple of months ago I wrote an article concerning ECT which generated some controversy. One of the issues that came up was the relationship between biological explanations of human activity and more global explanations, which, for want of a better term, I’ll call person-centered explanations. Any human activity can be viewed from different levels of abstraction. Suppose, for instance, that I am sitting in my living room reading a book. Then I put the book down, stand up, and go outside. If the question were to be asked: why did he put the book down and go outside? A wide range of perspectives and answers are possible. One could, for instance, focus on the fact that I am a biological organism, and one could develop a detailed and comprehensive flow sheet of every muscle movement, every heartbeat, every sensory input, neural impulse etc., that had occurred from the moment that I put the book down until I was standing outside. Such an account might be more or less detailed. There would, of course, be physical limitations on the amount of information of this sort that is attainable, but from a theoretical point of view, one could compile a detailed, complete, and accurate biological account of the actions in question. And such an account would be a valid response to the question: why did he put the book down and go outside. ...

BACKGROUND On December 23, I wrote a post called DSM-5 - Dimensional Diagnoses - More Conflicts of Interest? In the article I sketched out the role of David Kupfer, MD, in promoting the concept of dimensional assessment in DSM-5, and I speculated that at least part of his motivation in this regard might have stemmed from the fact that he is a major shareholder in a company that is developing a computerized assessment instrument. I ended the piece with a general criticism of psychiatry: ...