David Walker, Ph.D.

This is a reprint of an email I sent to NPR after they published an article about ecstasy and PTSD. The article showcased a woman who felt she benefited from this novel "treatment." In response, I wrote a brief blurb to NPR characterizing the story as “bullshit.” I was surprised to receive a note back asking if I could move beyond harsh language to explain my objections. This was my response.

NPR Public Editor
Re: My Complaint

Dear Elizabeth:

As I did not expect to hear back from NPR, I did not elaborate on the use of my term, "bullshit," in relation to the recent article on MDMA for PTSD. You may be surprised to hear that I was not just emoting but applying the word in deference to Princeton philosopher Harry Frankfurter’s description of any system that refuses to explain itself while trying to circumvent or overpower its skeptics. Specifically, Dr. Frankfurter called bullshit “a greater enemy of truth than lies.” In 2016, Australian critical psychiatrist Niall McLaren elaborated on this same idea in his article, “Psychiatry as Bullshit” for Ethical Human Psychiatry and Psychology, a journal for which I serve as an advisory editor. So what I said is what I meant.

Over the last decade, fractures have developed in the bio-reductionist ideology that dominates the U.S. mental health system. I can summarize them to you as follows: challenges to SSRI antidepressant and psychiatric drugs generally in regards to efficacy and linkages to violence and suicide; poor science across the entire realm of biological psychiatry and behavioral genetics; and the frequent use of psychiatric taxonomy to explain itself.

Shortly before the DSM-5 was released in 2013 by the American Psychiatric Association, the National Institute of Mental Health announced it would no longer use DSM labels like PTSD, ADHD, Bipolar, etc., in its research. The public was not sufficiently advised by the media, including by NPR, that this was a fracture in this system. In truth, this shift had to do with the exceptionally poor scientific validity and reliability of psychiatric labels - labels that continue to this moment to stigmatize, limit employment, housing, and self-worth for millions of Americans.

That NIMH made this move in the hopes of further isolating some sort of underlying brain pathology or chemical process, using its ample dollars by which to substantiate the very old mythologies of psychiatric icon Emil Kraepelin, is a chimera biological psychiatrists have been allowed to chase for over sixty years at public expense without result. The DSM-IV, for example, was positioned by its authors as “Neo-Kraepelinian” in its underlying philosophy.

NPR may be unaware that in 2013 the British Psychological Society and over fifty mental health organizations across North America and around the world objected formally to the DSM-5. At least this was never a topic your reporters chose to cover.

“Trauma” at the brain level is entirely a cultural metaphor. The “traumatic stress” identified in brain scans to which your reporters so often refer is, in reality, “diffuse stress” we would see in anyone experiencing violence, loss, or hardship. It is not “abnormal,” and it is entirely non-specific in relation to PTSD or Bipolar or any other psychiatric label. In fact, most DSM labels correlate with activity at the brain level when a person is under stress, a finding which is completely unsurprising.

No DSM label can be specifically depicted through neural research or any other biological research – except, of course, conditions brought about by substantiated brain diseases like the dementias or toxin exposures such as alcohol, amphetamine, or psychiatric drugs themselves. The “HPA axis,” the amygdala, being “triggered,” the fight-flight response, are simply a cultural language for intense emotional pain, defined subjectively.

The historical roots of PTSD go back to American psychiatry’s complicity in marginalizing and segregating people considered “moral imbeciles” with “psychopathic constitutions.” It is in psychiatry’s best interests to maintain its charade of locating the “weak” and susceptible as a target “population” for its “treatments,” as Smith Jeliffe and William Alanson White did back in 1910, in finding them among the classes “of the juvenile delinquents, of the recidivist type of criminal, of the paupers and prostitutes, of the ne’er-do-wells, the black sheep of the family, and at the higher levels, of erratic half-genius, half-crazy persons with brilliant spots here and there, but without continuity, whose efficiency is materially impaired and who live often a more or less wandering existence.”

What I mean is that the soldier who suffers due to voters electing hawkish leaders who put him or her into combat will be blamed as “disabled” for reacting emotionally to war’s brutality and hardship, just as women who are raped, first by a violent perpetrator and then again by a justice system that fails to hold perpetrators accountable, will carry in their bodies the emotional stigmata of American society’s unwillingness to protect them, children facing epidemic sexual abuse in this country will be asked to do the same, and Katrina survivors will hold the original lack of accountability of the Army Corps of Engineers in managing Louisiana levees aimed at poor people.

The list goes on and on, and PTSD - which originated out of Post-Vietnam Syndrome, and was feared as a label by many vets for its potential to take a morally sick society off the hook while blaming the veteran - has become just that and is now widely applied where once we had Rape Syndrome and Battered Child Syndrome. At least those labels depicted a point of origin for personal anguish… but this has never been the actual goal of contemporary psychiatry. Instead, this guild has actively sought to obscure the true sources of emotional pain and upheaval coming out of social conditions by cooking them down into alleged “brain disorders” and “chemical imbalances.” And NPR has moved unquestioningly along with the psychiatric guild and its propaganda for as many decades as this effort has been underway.

So when I turn to the recent MDMA article, I find NPR colluding with psychiatry once again in redefining the horrific violence, loss, and tragedies faced by a young woman as a problem of her overactive amygdala. The drug itself is positioned as a “treatment” that “allows” her to speak of her painful experiences to a trusted professional who adds another “treatment” consisting of words and support. That MDMA “tamps down activity in the amygdala, a part of the brain that processes fear” leading “to a state characterized by heightened feelings of safety and social connection” is a very elaborate way of saying it’s a sedative.

Thus, what the article is really saying is that taking a sedative so as to be able to talk about terrible events in one’s life might make it easier – but of course, we’re dealing with the need to obscure the language by using pseudoscientific brain research metaphorically. Thus, PTSD, a metaphor in itself, goes into “remission” through the use of MDMA, which through its sedating properties, miraculously allows people to talk more easily about the kinds of violence in their lives that American society ignores, stigmatizes, or responds to unjustly.

The only thing required of the “PTSD sufferer” is accepting the ideological reality of their alleged “lifelong condition,” allowing themselves to be labeled and stigmatized, and submitting their bodies to psychopharmacological experimentation. Fortunately, “unlike street drugs, which may be adulterated and unsafe, researchers use a pure, precisely dosed form of the drug.” In other words, they sell better MDMA than what you can get on the street.

Heavy sigh. In my own practice as a psychotherapist, I deliberately seek to avoid the bullshit inherent in this kind of language. This is because the clients seeking my collaboration are often struggling with trying to climb out of various self-medicating behaviors and addictions, street and psychiatric, your MDMA article promotes. They’ve often been duped by psychiatry’s promotion of so-called “anti-psychotics,” “anti-depressants,” and “anti-anxiety” drugs – and they are dealing with intense withdrawal syndromes, drug-related emotional syndromes, sexual dysfunction, and other issues. Ah, but these are not topics you choose to cover.

That is, they are often dealing with a greater enemy of truth than lies – a system that refuses to explain itself while trying to circumvent or overpower its skeptics.

NPR has acted as a lackey for this system for many years now. I hope my complaint is better explained to you now. Your journalistic irresponsibility has duped and hurt many people. Please let me know if you have any questions.

Sincerely,

David Edward Walker PhD
Seattle WA

Harry G. Frankfurt, On Bullshit (Princeton, NJ: Princeton University Press, 2005), 61.

Niall McLaren, “Psychiatry as Bullshit,” Ethical Human Psychology and Psychiatry 18, no. 1 (2016): 48–57, doi: 10.1891/EHPP.18.1.

Smith E. Jellife and William A. White, Disease of the Nervous System (Philadelphia, PA: Lea & Febiger, 1935), 910–11.