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.
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.
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Are The Second Generation Neuroleptics Good For the Brain?
There’s an editorial by Henry Nasrallah, MD, in last month’s edition of Current Psychiatry. Dr. Nasrallah is the journal’s editor-in-chief. The title of the article is Haloperidol clearly is neurotoxic. Should it be banned? Haloperidol is marketed under the brand name Haldol, but its patent has long expired, and a generic version is available and inexpensive.
Here’s a quote from Dr. Nasrallah’s article:
"If clinicians who use these decades old drugs were to keep up with medical research and advances in knowledge, we would realize what a travesty it is to use a brain-unfriendly drug such as haloperidol when we have many safer alternatives. A massive volume of knowledge has emerged over the past 15 years about the neurotoxicity of older neuroleptics, especially haloperidol—knowledge that was completely unknown before. Second-generation antipsychotics have been shown to be much safer for the brain than their older-generation counterparts (although they are not more efficacious)."
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Medical Model vs. Psychosocial/Behavioral Model
BACKGROUND
Obviously there are many points of contention between mainstream biological psychiatrists on the one hand, and those of us who condemn this system as spurious and destructive. Much of what I’ve written on this website over the past four years has been an elucidation of these differences.
Today I would like to focus on just one of these differences: disempowerment of clients in the psychiatric system, and empowerment within frameworks that are more psychosocial/behavioral in nature.
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Another Critique Of The Good Dr. Lieberman
Duncan Double, MD, one of the founding members of the UK’s Critical Psychiatry Network, has written a compelling and insightful critique of Dr. Lieberman’s most recent article. Dr. Double’s article is titled Is APA prepared to engage with critical psychiatry? Definitely worth a read.
Pharma Mobilizing Consumer Groups Over Drug Trials Data
There was an interesting article Big pharma mobilising patients in battle over drugs trials data in last Sunday’s Guardian, a UK newspaper. It was written by Ian Sample, the Guardian’s science correspondent. Here are the two opening sentences:
"The pharmaceutical industry has 'mobilised' an army of patient groups to lobby against plans to force companies to publish secret documents on drugs trials."
"Drugs companies publish only a fraction of their results and keep much of the information to themselves, but regulators want to ban the practice. If companies published all of their clinical trials data, independent scientists could reanalyse their results and check companies' claims about the safety and efficacy of drugs."
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Involuntary Shock Treatment To Be Banned in Ireland
Courtesy of Talla Trialogue on Twitter, I recently read an article in journal.ie on this topic.
Kathleen Lynch, Minister of State for Disability, Equality, Mental Health and Older People, has reportedly stated that “…the law will be changed so that unwilling patients will no longer be forced to receive ECT.”
At present, if an individual refuses ECT, his refusal can be overridden by the signatures of two psychiatrists.
However, not everyone is in favor of the ban on forced ECT. There’s an article by Marie Feely, Proposed ban on Involuntary ECT criticized published in irishmedicalnews in January 2012. The article reports on a survey of consultant psychiatrists published in December 2011. Ms. Feely writes:
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Dr. Lieberman Is Back! More Of The Same
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.
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Agitation and Neuroleptics
Sandra Steingard, MD, is a practicing psychiatrist who from time to time posts articles on Robert Whitaker’s Mad in America website.
Dr. Steingard apparently prescribes psychotropic drugs in her practice, but she is by no means a pill-for-every-problem practitioner, and her articles are always interesting and thought-provoking.
Dr. Steingard posted A Paradox Revealed – Again on Mad in America on July 7, 2013. In this article she mentions the recent study by Lex Wunderink et al, which found that people being treated for first episode psychosis were doing a great deal better functionally after seven years if their neuroleptic drugs had been discontinued or reduced relatively early in the process, as compared to individuals who were retained on the drugs for two years.
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The CAFE Study: Dr. Lieberman's High Moral Ground
BACKGROUND
The CAFE Study, conducted by Jeffrey Lieberman, MD, et al between 2002 and 2005, has been the subject of much comment. Carl Elliott, in particular, has written extensively on the matter, including his article The Deadly Corruption of Clinical Trials in Mother Jones.
In order to address the issues involved in the CAFE study, we must first take a brief look at the CATIE study. This was also conducted by Dr. Lieberman et al (not the same et al as CAFE, but with some overlap). CATIE was conducted between 2001 and 2004.
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Psychiatry Is Intrinsically Flawed and Rotten
On Twitter yesterday, Robert Stamatakis commented:
"I have to ask, I don't understand. Do you work in the UK? Your descriptions of psychiatry are nothing I recognize. These descriptions of psychiatry are nothing like the practice I see on a daily basis."
I am certainly a very outspoken critic of psychiatry, and in that regard Robert's question/challenge is a fair one, to which I will try to respond. My primary criticism of modern psychiatry – and indeed the criticism that underpins all the others – is that its fundamental concepts are spurious.
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