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.
There’s a new post on Peter Kinderman’s blog. It’s called Time for a paradigm change, and it’s dated September 2. The article is based on a speech that Dr. Kinderman gave to North Wales Clinical Psychology Programme, Annual Stakeholders’ Meeting on the same date.
Here are some quotes:
"But mental well-being is fundamentally a psychological and social phenomenon, with medical aspects. It is not, fundamentally, a medical phenomenon with additional psychological and social elements."
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ECT: Hypotheses About Mechanisms of Action
There’s a new article on Frontiers in Psychiatry. It’s titled Electroconvulsive treatment: hypotheses about mechanisms of action. The authors are Roar Fosse, Division of Mental Health and Addiction, Vestro Viken State Hospital Trust, Lier, Norway, and John Read, Institute of Psychology, Health, and Society, University of Liverpool, UK. Thanks to Mick Bramham on Twitter for the link.
The authors reviewed a large number of human studies in which the brains of people receiving shock treatment were observed using EEG, PET, SPECT, and fMRI.
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Are Psychiatric 'Diagnoses' Defamatory Statements?
There’s an interesting article by Sonja Grover, PhD, CPsych, of Lakehead University, Ontario, Canada. It’s titled: Reification of psychiatric diagnoses as defamatory: Implications for ethical clinical practice. Thanks to Becky on Twitter for the link.
It’s an old article (2005), but definitely deserves another look. It was published in the journal Ethical Human Psychology and Psychiatry.
Here’s the abstract:
"While the mental health professional generally has beneficent motives and an honest belief in the DSM diagnoses assigned to clients, such diagnoses may yet be defamatory when communicated to third parties. Mental health diagnoses invariably lower the individual's reputation in the eyes of the community. At the same time, DSM diagnoses are but one out of a myriad of possible interpretive frameworks. DSM descriptors for the client's distress thus cannot be said to capture the essence of the client's personhood. When a diagnosis is published as if it captured a definitive truth about an individual psychiatric client, it is, in that important regard, inaccurate. That is, such a communication meets the criterion for a reckless disregard for the truth or an honest belief but without reasonable basis insofar as it is considered to be anything more than a working hypothesis. Hence, in certain cases, DSM labeling may constitute defamation."
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More Lame Excuses from Dr. Lieberman
It’s that time of the month, and Dr. Lieberman has written another post, Change, Challenge and Opportunity: Psychiatry in Age of Reform and Enlightenment, on the APA’s website, Psychiatric News.
He tells us that these are changing times, and that he, for one, is choosing to see these changes as positive. He leads with a quote from Bob Dylan:
"The line it is drawn, The curse it is cast The slow one now, Will later be fast As the present now, Will later be past"
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ECT – Benefits Are Short-lived
Last Monday (August 26), Lauren Spiro published a post on Mad in America. The post is titled The Today Show and ECT: The Full Story & Informed Consent. Here’s the gist of Lauren’s article.
On August 20, the Today Show ran a segment on ECT (electric shock “treatment”). Lauren contends that the coverage was not balanced, but was pitched heavily in favor of shock “treatment.” Lauren provides a link to the segment, and also a transcript. I have watched the video, and read the transcript, and I agree that the coverage was very much pro-ECT, and that side effects were trivialized.
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Poverty and Cognitive Performance
There’s an interesting article, Poverty Impedes Cognitive Function, by Anandi Mani et al in the current issue of Science.
Here’s the abstract:
"The poor often behave in less capable ways, which can further perpetuate poverty. We hypothesize that poverty directly impedes cognitive function and present two studies that test this hypothesis. First, we experimentally induced thoughts about finances and found that this reduces cognitive performance among poor but not in well-off participants. Second, we examined the cognitive function of farmers over the planting cycle. We found that the same farmer shows diminished cognitive performance before harvest, when poor, as compared with after harvest, when rich. This cannot be explained by differences in time available, nutrition, or work effort. Nor can it be explained with stress: Although farmers do show more stress before harvest, that does not account for diminished cognitive performance. Instead, it appears that poverty itself reduces cognitive capacity. We suggest that this is because poverty-related concerns consume mental resources, leaving less for other tasks. These data provide a previously unexamined perspective and help explain a spectrum of behaviors among the poor. We discuss some implications for poverty policy."
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SSRI's and Postpartum Hemorrhaging
There’s an interesting study in the British Medical Journal (August 2013). It’s called Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States, and it was written by Kristin Palmsten et al.
The study examined nationwide Medicaid data from 2000-2007, and followed 106,000 pregnant women aged 12-55 who had been given a “diagnosis” of a mood or anxiety disorder.
The women were categorized into four mutually exclusive groups on the basis of information obtained from Medicaid’s pharmacy dispensing data. The criterion for categorization was exposure to SRI’s or to Non-SRI’s and the groupings were:
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The Ethics of Disclosing Financial Relationships
Recently, Carl Elliott posted a link to a statement written by Jonathan Moreno, PhD, a renowned bioethicist at the University of Pennsylvania.
Dr. Moreno’s statement was in reference to an Oregon court case. The Oregon Department of Justice had accused two cardiologists of concealing information from patients. Apparently the cardiologists had put heart implants into patients without informing the patients that they (the cardiologists) had financial ties to the manufacturer of the implants.
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The Living-With-Parents Blues
Despite the general rise in economic indicators over the past year or two, there are still many young adults who, for economic reasons, have had to move back in with their parents. A proportion of these people become depressed.
Depression is the normal human reaction to loss, disappointment, or a general sense of unfulfillment. Viewed in this light, it is not surprising that young people who have to move back in with their parents might be depressed.
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Madness Contested: An Outstanding Book
The book Madness Contested has recently been published by PCCS Books. It’s a collection of articles, edited by Steven Coles, Sarah Keenan, and Bob Diamond.
The book is a remarkable piece of work. It covers just about every contentious concept in the present “mental illness” debate, and brings to bear an abundance of new insights and up-to-date research findings.
There are 21 articles plus an introduction by the editors.
Here’s the name of each article with a brief quotation from each:
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