Psychiatric "Spin"

Courtesy of Carl Elliott via Twitter, I’ve recently read Dr. Lieberman’s latest post on Psychiatric News. It’s called – believe it or not – Time to Re-Engage With Pharma? dated August 1, 2013. And it’s classic Dr. Lieberman sleight of hand. His opening statement, for instance, reads: "Drug companies aren’t held in high esteem by the public these days." This may or may not be true. But note what he's done. The issue here is the long-standing and corrupt relationship between psychiatry and the manufacturers of drugs. But from his first sentence, Dr. Lieberman has taken psychiatry out of the equation. He has also lumped the makers of legitimate medicines in with the makers of psychiatry’s drugs. ...

Last week, thanks to a tweet from Ginger Breggin, I came across an article by Jeffrey Lieberman entitled Psychiatry: Nothing to Be Defensive About. Dr. Lieberman is president of the APA, and has gone on record more than once as saying that all these dreadful criticisms of psychiatry are very unfair, and that psychiatrists are good guys who have the high moral ground. Well, he’s back, and his current article is about on a par with previous efforts. ...

BACKGROUND As I suppose everyone knows by now, psychiatry has been on the receiving end of some very serious criticism in recent years. The criticism has come from many sources, including: survivors of psychiatric “treatment,” non-psychiatric mental health practitioners, journalists, the general public, and even from some psychiatrists themselves. The content of the criticisms has been equally varied, and includes: that the concept of mental illness is fundamentally spurious and devoid of explanatory significance; that psychiatric “treatment” (i.e. drugging people) is ineffective, physically damaging and disempowering; that psychiatry has forged and continues to maintain corrupt and corrupting relationships with the pharmaceutical industry with regards to the peddling of drugs and the hijacking of research for commercial ends; etc… ...

DSM-5 was published on May 18, 2013, amidst great criticism. The fundamental criticism was, and is, that the problems listed in the manual are not illnesses in any ordinary sense of the term. Other critics focused on the pathologizing of normality, the expansion of the diagnostic net by the lowering of thresholds, and the lack of reliability of the so-called diagnoses. The response from the psychiatric community has been mixed. Some, probably most, psychiatrists are keeping their heads down, getting on with the business of selling pills, and hoping that the gravy train won't derail. Others are busy at damage control ...

BACKGROUND On 3-4 June, the Institute of Psychiatry in London hosted an international conference to mark the publication of DSM-5. On June 10, Sir Simon Wessely, a department head at the Institute, published a paper called DSM-5 at the IoP. The paper is a summary of the conference proceedings, and also, in many respects, a defense of DSM-5. The article touches on many issues that are central to the current anti-psychiatry debate, and for this reason, I thought it might be helpful to take a close look at the piece. ...

On May 27, David Brooks, a New York Times columnist, wrote a piece on psychiatry called Heroes of Uncertainty. It’s an interesting and somewhat contradictory article. Here are some quotes: "As the handbook’s [DSM-5] many critics have noted, psychiatrists use terms like 'mental disorder' and 'normal behavior,' but there is no agreement on what these concepts mean." "What psychiatrists call a disease is usually just a label for a group of symptoms." ...

BACKGROUND On 19 April, The Conversation ran an article titled Mental disorders: debunking some myths of the DSM-5, by Perminder Sachdev, MD. Dr. Sachdev is a psychiatrist, and was a member of the DSM-5’s Neurocognitive Disorders Work Group. He works at the School of Psychiatry, University of New South Wales, Australia. (Thanks to Dave Traxson on Twitter for the link.) ANALYSIS Let’s start with the title. “…debunking some myths of the DSM-5.” This sounds good. You might get the impression that he’s going to address the myth of mental illness – the myth that all human problems are illnesses and are best treated by drugs. But – alas – you would be mistaken. Dr. Sachdev lists four myths that he plans to debunk. He refers to these as the “…four key criticisms about DSM-5…” Let’s examine what he says about these one by one. ...

BACKGROUND On May 3, 2013, David Kupfer MD (DSM-5 Task Force Chair) responded to Thomas Insel’s April 29th unequivocal attack on the validity and usefulness of DSM. You can see Dr. Kupfer’s response here. Essentially Dr. Insel said that the categories set out in the DSM did not correspond to anything in the real world, and that NIMH would no longer be using these categories as the basis for their research program. This statement did not, however, represent any significant movement away from the biomedical model on the part of NIMH. In fact, if anything, it was a movement towards an even more deeply entrenched medical model. But it was a huge hit on DSM and on the APA, who tout the catalog as the basis to their claim to scientific credibility. ...