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.
This issue has been debated for years, but was finally considered to have been put to rest by NIMH’s 2004 Treatment for Adolescents with Depression Study (TADS). This study essentially “found” that fluoxetine (Prozac) was effective in treating depression and did not involve an increased risk of suicide.
Robert Whitaker’s most recent post points out that TADS actually found that adolescents treated with fluoxetine had a markedly higher risk for suicidal activity than those who received a placebo. Robert also outlines the various statistical and methodological ploys that were used to conceal this finding and to sanitize the final report.
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More about Antidepressants and Placebos
The debate is over. Antidepressants are only very marginally more effective than placebos. And yet the “depression-is-an-illness” lobby continues to grasp for straws.
Fiona Godlee, editor of the British Medical Journal, recently cited “evidence” of the efficacy of antidepressants. For a critique of the Godlee article go to Duncan Double’s website “Critical Psychiatry.”
Surprise finding! - Antidepressants are only very marginally more effective than placebos.
What this means in effect is that people are “curing” their own depression (gasp), and perhaps don’t really need the mental health practitioners (double gasp).
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Gender Identity Disorder Is Not An Illness
In 1973 the APA removed homosexuality from its list of “diagnoses,” and in its place they created a new “diagnosis” – gender identity disorder.
The essential feature of this so-called illness is a marked and persistent rejection of one’s biological gender and a repeated desire to be of the opposite gender.
I’ve touched on these issues in the posts on homosexuality. So I won’t repeat that material here. There is a recently reported development, however, that warrants some attention. A recent Associated Press article out of Chicago reports that sex-changing treatment for children is “on the rise.” This report was picked up by media outlets all over the country, and probably overseas.
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Another Good Book by Stephen Ray Flora
A few weeks ago I recommended Taking America Off Drugs by Stephen Ray Flora. Well, he has also written The Power of Reinforcement (State University of New York Press, 2004), and this also is well worth reading.
Reinforcement is a crucial concept in psychology, and in this book Dr. Flora clarifies the matter and dispels the misinformation.
Buy it; read it; keep it close.
What's New? APA Threats, Xanax, Etc.
Daniel Carlat’s blog carries an interesting item. It seems that a lady named Suzy Chapman started a site called dsm5watch, in which she expressed criticism of the DSM. Well, the APA didn’t like this and sent her a cease and desist letter, claiming that the string “DSM-5” is trademarked, and that she was infringing their rights. She complied, changing the name of her site to dxrevisionwatch.
What I find interesting here is that the APA claim to be interested in public comment. I guess as long as it doesn’t get too critical.
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Grand Rounds at codeblog: tales of a nurse
Gina has taken time from her busy schedule as an Intensive Care Nurse to host Grand Rounds this week - the seventh time she has hosted GR. Stop by when you get a chance, and you’ll find some good reading material.
Another Good Book
Taking America Off Drugs by Stephen Ray Flora
A few weeks ago, in a comment, A Behaviorist Fan recommended the above book to me. It came out in 2007, and I don’t know how I missed it at the time. But I’ve read it now and it’s a superb piece of work.
Definitely a must buy and must keep close at hand. Stephen analyses the various “diagnoses” listed in DSM. He points out their behavioral nature, and describes how they can be ameliorated with relatively simple behavioral techniques.
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Heroin Addiction is Not an Illness
A couple of weeks ago I heard a piece on NPR: “What Vietnam Taught Us About Breaking Bad Habits.” It’s an interesting story. It tells how in 1971, researchers found that about 20% of the American soldiers in Vietnam were addicted to heroin. This was shocking news to the Pentagon and to President Nixon, who promptly created a new government department – the Special Action Office of Drug Abuse Prevention. This was the beginning of the so-called War on Drugs.
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More on ADHD
Last week Reuters ran an article by Toni Clarke: “Insight: Shortage of ADHD Drug Adderall seen persisting.”
Here are the first five paragraphs:
“A shortage of Adderall, which is used to treat attention deficit hyperactivity disorder, shows little sign of easing as manufacturers struggle to get enough active ingredient to make the drug and demand climbs.
Adderall, a stimulant, is a controlled substance, meaning it is addictive and has the potential to be abused. The Drug Enforcement Administration tightly regulates how much of the drug's active pharmaceutical ingredient (API) can be distributed to manufacturers each year.
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Forensic Psychiatry
Recently National Public Radio ran a program on California’s state psychiatric hospitals. There has reportedly been an enormous increase in patient violence in recent years, including the murder of a female employee in October 2010.
Staff are demanding that some remedial measures be undertaken. Committees are meeting; politicians are giving speeches. But the violence continues.
Reportedly the state is spending more than $500 per day per patient – that’s more than $180,000 per year! But the violence continues.
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