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.
Mental Health Europe (MHE) is a non-governmental organization “… committed to the promotion of positive mental health and well-being, the prevention of mental health problems, the improvement of care, advocacy for social inclusion and the protection of the human rights of (ex)users of mental health services and their families and carers.” It is composed of associations, organizations, and individuals who are active in the mental health field, including users and ex-users of services, volunteers, and professionals. MHE subscribes to the following values: dignity and respect; equal opportunities; freedom of choice; non-discrimination, social inclusion, democracy and participation. You can read more about them here.
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Neuroleptics for Children
Of all the evils perpetrated by American psychiatry in the past 60 years, the administration of neuroleptic drugs to children is arguably the worst. And it is a practice that is growing each year.
The essential purpose of these drugs is to make people more docile and more easily managed by destroying brain tissue. The side effects are devastating.
Recently Gabrielle Carson, MD, a psychiatrist at Stony Brook Children’s Hospital, wrote a paper on The Dramatic Rise in Neuroleptic Use In Children: Why Do We Do It and What Does It Buy Us? You can see Dr. Carlson’s commentary here. (Thanks to yobluemama2 on Twitter for flagging the article.)
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Different Perspectives
On June 1, 2012, I wrote a post titled There Are No Mental Illnesses.
Yesterday a comment came in on this post. Here’s a quote:
"When my brother was thirty years old, he started to see objects, which was far away, like hawk. His "mind" wanted to understand it, so he started to think he became a cybrog. Doctor said: you are ill". When I saw strange things, I said to myself: "Well, I see strange things" that's all. And I'm healthy..."
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The Problem with DSM
There’s an interesting article in the NY Times Sunday review. You can see it here. It was written by Sally Satel MD, a psychiatrist, currently a resident scholar at the American Enterprise Institute.
The article is called: “Why the Fuss Over the DSM-5?” Dr. Satel’s central point is that psychiatrists only treat symptoms anyway and pay little attention to the DSM. She expresses the belief that the manual’s diagnoses are “…passports to insurance coverage, the keys to special education and behavioral services in school and the tickets to disability benefits.”
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Thomas Insel's Paper – Still Under Attack
It’s widely known that Thomas Insel, MD, Director of NIMH, recently proclaimed that the DSM’s diagnostic categories are invalid, and that this agency would no longer use these categories as the basis for research. But he went on to reaffirm his agency’s commitment to a biological model of “mental illness” and to funding research into biological causes of these problems. He has since issued a joint statement with Jeffrey Lieberman, President Elect of APA, which makes it clear that they’re still the best of friends, but he didn’t really recant his earlier statement.
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Dr. Insel Changes His Mind
Well, as I guess everybody knows by now, Dr. Insel has changed his mind. On April 29, he stated that the weakness of DSM “…is its lack of validity.” He went on to express the view that his agency, NIMH, (the US government’s mental health research arm) “…cannot succeed if we use DSM categories…” You can see his full statement here.
This statement was widely interpreted as a significant rift between NIMH and the APA. But apparently they’ve made up their differences and are pals again. On May 13, just two weeks after his divorce statement, Dr. Insel and Dr. Lieberman, APA president elect, have issued a joint statement in which they express the belief that the DSM “…represents the best information currently available for clinical diagnosis of mental disorders.” Patients, families and insurers, we are told, “…can be confident that effective treatments are available and that the DSM is the key resource for delivering the best available care.” It’s hard to believe that this is the same DSM that he earlier criticized as lacking validity!
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Talk Therapy for Schizophrenia
There’s an interesting article on Vermont’s Seven Days. It’s called Burlington’s HowardCenter Tries a New Approach to Treating Mental Illness: More Talk, Fewer Meds. You can see it here. (Thanks to Steven Coles on Twitter for the link.)
Apparently Vermont’s Department of Mental Health is promoting a “new” kind of treatment for psychosis: talk therapy. The project leader is Dr. Sandra Steingard, who for most of her career accepted the orthodox view of schizophrenia and the need for neuroleptic drugs.
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It's a Great Day for Humanity
Today, after two years of deliberation, the Division of Clinical Psychology (which is part of the British Psychological Society) issued a Position Statement on the Classification of Behavior and Experience in Relation to Functional Psychiatric Diagnosis. It is subtitled “Time for a Paradigm Shift.”
The DCP summarizes its paper as follows:
"The DCP is of the view that it is timely and appropriate to affirm publicly that the current classification system as outlined in DSM and ICD, in respect of the functional psychiatric diagnoses, has significant conceptual and empirical limitations. Consequently, there is a need for a paradigm shift in relation to the experiences that these diagnoses refer to, towards a conceptual system not based on a ‘disease’ model."
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The Empire Strikes Back: APA Responds to NIMH
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.
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SSRI's During Pregnancy and APGAR Scores
There’s an interesting article on this topic by Hans Jensen et al, in the February 21, 2013 issue of the British Journal of Psychiatry. You can see an abstract here.
The authors conducted a register study on all pregnant women in Denmark from 1996 to 2006, linking data from the Medical Birth Register, the Psychiatric Central Register, and the National Prescription Database.
They found that the
"… use of SSRIs during pregnancy increases the risk of a low Apgar score independently of maternal depression."
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