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.
A DISCUSSION REGARDING THE EVOLUTION OF A SOCIAL MOVEMENT
by Philip A. Kumin
For anyone privy to the dynamics of the discussion surrounding the manifest destiny of the mental patients’ movement one thing is clear; those founding activists who survive are aggrieved at the loss of their native movement. In almost any venue in which these activists air their grievances, there is an aggregate atmosphere of nostalgia and bitterness. The perceived loss of vitality of this movement of the 1970’s is mourned. For sure, that decade was a landscape fertile for the launching of social movements, including one of deinstitutionalized and disgruntled mental patients. What then comes next?
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Dr. Pies' Non-Apology
INTRODUCTION
On June 23, 2020, Awais Aftab, MD, a clinical professor of psychiatry at Case Western, interviewed Ronald Pies, MD, also a psychiatrist, and a professor at Tufts and SUNY.
During the interview, Dr. Aftab stated:
"I have followed the controversy surrounding 'chemical imbalance' with some interest over the years, including the multiple articles you have written on this issue. Generally, I agree with you that the chemical imbalance was never accepted as the 'truth' by academic psychiatry or by our professional organizations. It was likely an advertisement strategy by pharmaceutical companies that took on a life of its own. However, I am not sure I am ready to exonerate our profession. At best, it seems like we were silent spectators, watching as this misleading idea spread like wildfire in the society (including among our patients and patient advocacy groups), doing little to nothing to correct these public misperceptions. At worst, it seems like at least some of us were participants. Ken Kendler writes in a 2019 JAMA Psychiatry commentary, 'I would commonly see patients who would say some version of "my psychiatrist said I have a chemical imbalance in my brain."'10 I have had a very similar experience myself. Either way, surely as a profession, we could have done a better job of educating our patients and the public?"
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Dr. Pies and The Chemical Imbalance Deception
INTRODUCTION
For the past several years, the eminent and scholarly Ronald Pies, MD, psychiatrist, of SUNY Upstate Medical and Tufts Universities, has labored the point that psychiatry has never endorsed the simplistic chemical imbalance theory of “mental illness”. As various anti-psychiatry bloggers, including myself, began to accumulate a great many instances of prominent psychiatrists doing just that, Dr. Pies began digging himself in on this particular topic. In Nuances, Narratives, and the “Chemical Imbalance” Debate (April 2014, Medscape), he wrote:
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Is Anti-Psychiatry Harmful?
INTRODUCTION
On September 9, 2020, Jonathan Stea, PhD, Tyler Black, MD, and Joseph Pierre, MD, published a piece on MedPage Today. The article is titled Why Anti-Psychiatry Now Fails and Harms.
Dr. Stea is a clinical psychologist and adjunct assistant professor at the University of Calgary.
Dr. Black is the psychiatric medical director of British Columbia Children’s Hospital. He is also a clinical instructor in psychiatry at the University of British Columbia.
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CENSORSHIP IS A NO-NO
by Philip A. Kumin
I’m a self-taught author, and a good one at that. I tried for years to get my well written vignettes published in almost every publication imaginable including the great, the wonderful Rolling Stone Magazine. I sought merely to partake of the joy of creative writing while simultaneously publicizing the existence and history of an unheard of, but thoroughly libertarian, movement of former mental patients. I soon came to see that since I was revealing myself to be one of those activist patients in each piece I’d written, I was being censored accordingly. For years afterwards, I couldn’t conceive of any rational, substantial reason why this was being done to me or any of the other patient authors, whom I had heard we’re also being censored.
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Celebrating the Anti-Psychiatry Movement
Say not the struggle nought availeth, The labour and the wounds are vain, The enemy faints not, nor faileth, And as things have been, they remain. . . . . . . . . . . . . . . . .
[But] not by eastern windows only, When daylight comes, comes in the light, In front the sun climbs slow, how slowly, But westward, look, the land is bright.
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Dr. Pies: Still Going Wrong
"For e'en tho' vanquished, he could argue still;" From The Deserted Village (1770) by Oliver Goldsmith
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On June 23, 2020, Awais Aftab, MD, psychiatrist, published an interview with Ronald Pies, MD, also a psychiatrist, in Psychiatric Times. The interview was titled The Battle for the Soul of Psychiatry: Ronald W. Pies, MD. I critiqued Dr. Pies' responses here. In the light of a more recent publication by Dr. Pies, I would like to recall some comments concerning the notorious chemical imbalance deception that the learned doctor made in the earlier interview.
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A Psychiatrist Critiques Psychiatry, And Does A Great Job!
Overland describes itself as Australia’s only radical literary magazine. It was founded in 1954, and publishes a quarterly print journal (essays, stories, and poetry) and an online magazine (cultural commentary).
In the current issue, Winter 2020, there is an excellent article by Samuel Lieblich, a consultant psychiatrist working in the Greater Melbourne Area. The essay is titled Ignorance is Bliss.
Here are the first two paragraphs:
"By now there is enough criticism of the mental health business out there that it seems to me most engaged readers have been informed about the problems: psychiatry makes a false equivalence of the brain and the person, psychiatry pathologises some of the normal problems of human life, psychiatrists enforce highly constrained norms of thought and behaviour, and psychiatrists don’t value patients’ autonomy. There is still however a lot of confusion about the status of the things that psychiatrists treat. These are by no means illnesses, and the medications doctors use to treat them are by no reasonable measure effective. I am going to have to risk setting up a straw man here, but the majority of people don’t believe the claims I’ve just made, even though they have been exposed to the same claims many times. Marcia Angell when she retired as head of the New England Journal of Medicine wrote a pair of scathing reports in the New York Review of Books to the effect that psychiatry is a pseudoscience; and these same claims are repeated in bestselling books like The Emperor’s New Drugs, and magazine articles too numerous to mention. If one moves carefully through the scientific evidence one finds too that a ‘chemical imbalance’ has never been substantiated for any of the things that have been called a ‘mental illness’, and that the prescription of medications for psychiatric problems is always tendentious. The abundance of scientific support for these claims is only equalled by the total absence of their accommodation in the practice of psychiatry and the lay discourse about mental health. Although science does not really support the use of many psychopharmaceuticals in the ways they are represented to be supported, and although there is no acceptable measure by which most of the things treated by psychiatrists qualify as illnesses, the cultural position of the medical profession and their medicines is such that even a scientific refutation of a medical claim appears unscientific. This position of the doctor as super-scientific is perpetuated and co-opted by pharma for profit, and by the state for the purposes of social control. Capital aggrandises the psychiatrist, whose job is to condition the citizens to their labour, or to excise a tax in the form of pharmaceuticals payments. Either way capital wins and we all play along because we have been so immiserated by budget austerity, social precarity and casualised over-employment that the only comfort we can afford is to indulge in a fantasy.
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Dr. Aftab Interviews Dr. Pies
On June 30, 2020, Awais Aftab, MD, psychiatrist, published an interview with Ronald W. Pies, MD, also a psychiatrist, in Psychiatric Times.
As an interview, the piece is somewhat unusual in that Dr. Aftab, as interviewer, does not confine his role to asking questions, but actually contributes substantially to the dialogue. So the piece is more like a conversation than an interview, and both parties express their positions fairly freely on the topics discussed.
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Is Psychiatry Dangerous?
On August 26, Shayla Love, senior staff writer, published a piece on VICE, an online magazine. The article is titled The Movement Against Psychiatry: The contentious debate of whether to fix—or completely overthrow—the way we treat mental illness.
In her article, Ms. Love provides abundant quotes from people on both sides of the issue, including Awais Aftab, MD, an American psychiatrist, currently Clinical Assistant Professor of Psychiatry at Case Western Reserve University in Cleveland, Ohio, and Attending Psychiatrist at Northcoast Behavioral Healthcare. This agency is operated by the Ohio Department of Mental Health and Addiction Services (Ohio MHAS).
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