Alternative perspective on psychiatry’s so-called mental disorders PHILIP HICKEY, PH.D.
I am a licensed psychologist, presently retired. I have worked in clinical and managerial positions in the mental health, corrections, and addictions fields in the United States and England. My wife and I have been married since 1970 and have four grown children.
The phrase “mental health” as used in the name of this website is simply a term of convenience. It specifically does not imply that the human problems embraced by this term are illnesses, or that their absence constitutes health. Indeed, the fundamental tenet of this site is that there are no mental illnesses, and that conceptualizing human problems in this way is spurious, destructive, disempowering, and stigmatizing.
The purpose of this website is to provide a forum where current practices and ideas in the mental health field can be critically examined and discussed. It is not possible in this kind of context to provide psychological help or advice to individuals who may read this site, and nothing written here should be construed in this manner. Readers seeking psychological help should consult a qualified practitioner in their own local area. They should explain their concerns to this person and develop a trusting working relationship. It is only in a one-to-one relationship of this kind that specific advice should be given or taken.
Steven Reidbord MD is a board-certified psychiatrist who practices in San Francisco. He writes a blog called Reidbord’s Reflections. On December 12, 2015, he posted an article titled Are psychiatric disorders brain diseases? It’s an interesting and thought-provoking piece, with many twists and turns.
Here are some quotes, interspersed with my comments and reflections.
"Of the conditions deemed inherently psychiatric, some seem rooted in biological brain dysfunction. Schizophrenia, autism, bipolar disorder, and severe forms of obsessive compulsive disorder and melancholic depression are often cited. It’s important to note that their apparently biological nature derives from natural history and clinical presentation, not from diagnostic tests, and not because we know their root causes. Schizophrenia, for example, runs in families, usually appears at a characteristic age, severely affects a diverse array of mental functions, looks very similar across cultures, and brings with it reliable if non-specific neuroanatomical changes. Even though schizophrenia cannot be diagnosed under the microscope or on brain imaging, it is plausible that a biological mechanism eventually will be found. (The same type of reasoning applied to AIDS before the discovery of HIV, and to many other medical diseases.) A similar argument can be made for other putatively biological psychiatric disorders."
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Dr. Pies on the Dearth of Civility
On December 3, 2015, Ronald Pies, MD, published Campus Protests, Narcissism, and the Dearth of Civility on Psychiatric Times.
The article is subtitled: What can we do, as a society, to reduce the levels of incivility and narcissism that appear to be on the rise?
Here are some quotes:
"…I believe we are witnessing the gradual but steady erosion of civility in American culture."
"As a psychiatrist, however, I am also interested in the psychological development of the child, and why some children seem to develop along a trajectory that leads to intense narcissism—the fertile soil, in my view, upon which incivility thrives. Indeed, there is good evidence that narcissism has been increasing among our young people in recent decades—a factor that cannot be overlooked as we view incivility on the college campus. Leaving aside various technical and psychoanalytic definitions of the term, we can think of narcissism, broadly, as the attitude that proclaims, 'I should be able to do whatever the hell I please, and if other people don’t like it, that’s just too bad!'"
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Robert Spitzer's Legacy
Robert Spitzer, MD, the architect of DSM-III (1980), died of heart disease on Christmas Day, 2015, at age 83.
Most major media outlets published obituaries in which Dr. Spitzer was praised on the grounds that he had brought scientific rigor to psychiatry by naming and defining the various psychiatric illnesses.
Here are a few illustrative quotes:
"Dr. Robert L. Spitzer, who gave psychiatry its first set of rigorous standards to describe mental disorders, providing a framework for diagnosis, research and legal judgments — as well as a lingua franca for the endless social debate over where to draw the line between normal and abnormal behavior — died on Friday in Seattle." (New York Times, December 26)
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Bipolar 2 research
I am a 58 year old male.
I was born into a dysfunctional family with issues of shame and guilt. I believe that this affected my psychological state. I had severe Asthma and I was unintentionally put in front of an open fire and out in a cold street in my pram where I was exposed to leaded petrol car fumes.This was very traumatic possible PTSD. we also had a long haired dog. All these things were my triggers for asthma for years to come. We were a poor family in those days and would eat a lot of bread.Flour etc. I had skin prick testing for my Asthma allergies and was sensitive to most things.
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Psychiatry and Crime
In DSM-III-R, the APA defined a mental disorder as:
"…a clinically significant behavioral or psychological syndrome or pattern that occurs in a person and that is associated with present distress (a painful symptom) or disability (impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. In addition, this syndrome or pattern must not be merely an expectable response to a particular event, e.g., the death of a loved one. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the person. Neither deviant behavior, e.g., political, religious, or sexual, nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the person as described above." (p xxii)
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Psychiatry: A Protected Cartel
On December 27, 2015, Richard Lewis, a regular contributor to Mad In America, posted on that site Deafening Silence: What Happens When the Whistle Blows and Nobody Hears? Here are the first two paragraphs:
"What happens when someone finally 'blows the whistle,' exposing potential harm and possible death caused by today’s mental health system? Is there any government agency or designated persons who are prepared to hear the whistle or even investigate and/or act on the nature of a serious complaint? Are all whistle blowers fired, or are some just ignored and easily dismissed as just an isolated voice in the wilderness? Just how broken is 'Broken'? Is it even worth the effort of going through official channels to file formal complaints within the current ‘System’? Here is my story and I will let you ponder some of the possible answers to these provocative questions.
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Allen Frances Still Trying to Excuse Psychiatry's (and his own) Role in the ADHD 'Epidemic'
On November 9, 2015, Allen Frances, MD, posted an interesting article on the Huffington Post’s Blog. The article is titled Why Are So Many College and High School Kids Abusing Adderall.
The gist of the article is that the “excessive use of ADHD medication” is a more legitimate target for a war on drugs than the ongoing war with the drug cartels.
The Huffington Post article is unusual, in that most of it is written by Gretchen LeFever Watson, PhD. Dr. Frances wrote the introduction, ending with “I have invited Dr Gretchen LeFever Watson, a clinical psychologist and public health researcher, to describe this growing problem.” Dr. Watson wrote the main body of the piece; and Dr. Frances finished up with some brief concluding remarks.
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Another Life Story
As third born of four children, I was pretty much invisible. My brother, 3 years older than me, would come home from school and we would play school and he would teach me everything he learned that day. I was five, he was eight. I idolized my big brother. I followed him everywhere.
When I was in the first grade, my brother died, my parents got a divorce, a new man moved into the family, and we all moved to another city. For a six year old, it was just too much for me. I became a total introvert. I seldom spoke at home….only when asked a direct question. My sisters…one four years older, one four years younger …. totally ignored me. Both my sisters were pretty and popular, but not very bright. (I was the exact opposite.) They both flunked a grade….older sister flunked 7th grade, younger sister flunked 3rd grade…..how does someone flunk 3rd grade? They went to 9 different schools, just like I did….but I had a hard time always being the new kid in class.
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My Response to Dr. Pies' Response
On November 18, 2015, Dr. Pies sent his response to my November 17 article to MIA. MIA posted it, and forwarded a copy to me. It reads:
“I have read Dr. Philip Hickey’s 8400+ word treatise, and I have only the following to say with regard to the two key points at issue:
Notwithstanding my omission of quotation marks in my original Medscape article [1]—for which I take responsibility—the fact remains: I have never believed or argued that the so-called chemical imbalance theory (which was never really a theory) is merely a “little white lie.” It is that point of view—not merely typed words on the page—that has been falsely and carelessly attributed to me. I have never received a dime from any pharmaceutical company or private agency with any verbal or written understanding that I would “promote” (elevate, popularize, hype, etc.) a particular drug. If any of the papers I wrote or co-authored over a decade ago had the effect of putting a drug in a favorable light, it was because the best scientific evidence available at that time supported the drug’s benefit. Nothing in Philip Hickey’s belaboring of half-truths, innuendos and guilt by association demonstrates otherwise. Sincerely,
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Dr. Pies Is Back
This morning, I received, by way of a forward from MIA, the following from Dr. Pies.
. . . . . . . . . . . . . . . .
I have read Dr. Philip Hickey’s 8400+ word treatise, and I have only the following to say with regard to the two key points at issue:
1. Notwithstanding my omission of quotation marks in my original Medscape article [1]—for which I take responsibility—the fact remains: I have never believed or argued that the so-called chemical imbalance theory (which was never really a theory) is merely a “little white lie.” It is that point of view—not merely typed words on the page—that has been falsely and carelessly attributed to me. 2. I have never received a dime from any pharmaceutical company or private agency with any verbal or written understanding that I would “promote” (elevate, popularize, hype, etc.) a particular drug. If any of the papers I wrote or co-authored over a decade ago had the effect of putting a drug in a favorable light, it was because the best scientific evidence available at that time supported the drug’s benefit. Nothing in Philip Hickey’s belaboring of half-truths, innuendos and guilt by association demonstrates otherwise. Sincerely,
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