Al Galves, Ph.D.

What are the negative emotions?

Anger
Jealousy
Fear
Guilt
Sadness
Anxiety
Others?

Wayne Ramsay, J.D.

“The opinion that mental illness does not exist has been advanced by, among others, psychiatrist Thomas Szasz, sociologists Thomas Scheff and Erving Goffman, and psychologist Theodore Sarbin”.¹  In his testimony before the Mental Health Committee of the New York State Assembly (state legislature) on May 18, 2001, neurologist John Friedberg, M.D., said this:

Don't Be Fooled By Fake News

Chuck Ruby, Ph.D., Psychologist

There is a pernicious problem in the media that has existed for some time, namely, "fake news." But unlike the political rantings intended to mislead the public and denigrate the sources of opposition information, this kind of fake news is truly fake and that claim can be demonstrated.

The fake news I am referring to is the multitude of claims made by mental health researchers that show up in professional journal articles and popular news headlines, but that have no empirical basis. Instead, many times the results of research are presented in language that gives the impression of impactful scientific discovery supporting the reality of mental illness, as illness. It serves to mislead and misinform both lay and professional audiences. This is unethical and counter to the principles of "do no harm" and "informed consent."

A typical example was a very recent article published in The Journal of Clinical Endocrinology and Metabolism with the title, "Antidepressants reduced risk of mortality in patients with diabetes mellitus: a population-based cohort study in Taiwan". This title is clearly stating that antidepressant drugs were the causative factor in reducing deaths among diabetes patients. It is also implying the value, safety, and effectiveness of the drugs for the treatment of depression. However, if one looks at the study's methodology and results, it is clear this is fake news.

Because the study was retrospective and the people were not randomly assigned to groups, with one of the groups being prescribed antidepressants and the other not, causation cannot be determined. Correlation is the only conclusion possible. Thus the oft cited caution: "Correlation does not equal causation."

The study found that people who are prescribed antidepressant drugs had a lower risk of death. The relative risk figures ranged from .20 to .73, meaning the risk of death for those taking the drugs was between 27% and 80% lower than those not taking the drugs. Using a 9% risk of death for diabetes patients over 10-years, this would mean those who take antidepressants would lower their risk to between 2% and 7%. Such a finding gives the impression that the drugs are beneficial, not only for depression but also for reducing mortality.

However, to be intellectually honest, the only thing that can be concluded with this data is that antidepressant drug use is correlated with lower mortality among diabetes patients. It cannot be concluded that "Antidepressants reduced risk of mortality...." [Italics added] as is stated in the article's title.

Let's look further into the data to see the real news. According to the researchers, the higher mortality non-drug group was composed of more people who were: male (lower life expectancy than women), elderly (more likely to die), and poor (less access to medical care). The non drug group also had a higher incidence of heart failure and more severe complications from diabetes (perhaps because of being male, older, and poorer?).

These factors are given only cursory attention in the article. The researchers point them out, yet they don't appear to place much significance in them. Still, they can clearly explain why on average those in the non-drug group died earlier than those in the drug group, independently of whether or not antidepressants were used. At the very least, these factors cast significant doubt on the researchers final conclusion as stated in the article's title.

So, the correlation between antidepressant use and mortality may very well be bogus. The real correlation is very likely between mortality and these other factors. The apparent correlation between antidepressant use and mortality is meaningless. The next time you see headlines claiming bold medical findings, especially those related to mental illness, take the time to consider how most of those studies are based on correlations, not sound evidence of causation.

A popular website humorously demonstrates this problem of "spurious correlations." At this site you can see several examples of apparently strong correlations between two variables that have no true causative relationship. For instance, there is a .95 correlation (unheard of in medicine or the social sciences) between per capita cheese consumption and dying by becoming tangled in your bedsheets. If we took the approach of the above antidepressant and mortality study researchers, we would conclude that eating cheese causes us to die by getting entangled in our sheets! What a financial hit to the cheese industry but a boon to other completing snack companies.

Other meaningless but very strong correlations shown on this site are:

• the number of people who drown by falling into a pool and the number of Nicolas Cage films. Watching Nicolas Cage films causes people to fall into pools and die.
• U.S. spending on science, space, and technology, and the number of suicides from hanging, strangulation, and suffocation. Increased spending on science, space, and technology causes people to commit suicide by hanging, strangulation, and suffocation.
• the per capita consumption of margarine and the divorce rate in Maine. If you want to stay married in Maine, don't eat margarine.

Incidentally, a troublesome finding of the antidepressant/mortality study, and that wasn't reflected in the title, is that one of the seven psychiatric drugs tested was correlated with a 48% increased risk of death. The drug is called a reversible inhibitor of monoamine oxidase A (RIMA), which increases the effects of serotonin, norepinephrine, and dopamine in the brain. This drug is said to offer "a multi-neurotransmitter strategy for the treatment of depression." 

Only one short sentence in the antidepressant/mortality article mentions this potential danger of RIMA, but says nothing else about it. It is also given trivial mention in the concluding remarks: "Most ATDs but not RIMA were associated with significantly reduced mortality among population with comorbid DM and depression." [Italics added] Notice that statement didn't say that RIMA increased the risk of death. Why wasn't the article entitled, "Newly developed drug for depression shown to increase risk of death."?

Be careful what you read. Don't trust the headlines as they are usually written in a way to grab attention, not fully summarize the matter. Moreover, don't unquestionably trust the mental health industry as its leaders have a political and financial agenda that many times outweighs any interest in accurately portraying research results. Be informed and take the time to learn the truth.

Morality-Driven Illnesses

Chuck Ruby, Ph.D., Psychologist

Here we go again!

In response to political pressure, The World Health Organization's legislative body just ratified a June 2018 proposal to redesignate "gender incongruence" (called "gender dysphoria" in the DSM) so that it is no longer a mental illness.¹ This change will be reflected in the 11^th edition of the International Classification of Diseases (ICD). While I applaud any effort to depathologize natural human variation in interests and preferences, is this really how it works? Mental illnesses are voted in an out of existence because of political pressure and changes in ideas about morality? Well, yes, that is precisely how it works. 

The advocates of this change claim it "...was taken out from the mental health disorders because we had a better understanding that this wasn't actually a mental health condition and leaving it there was causing stigma."² But we don’t identify real illnesses this way. Instead, we study the problem to determine what is causing the symptoms. It is only after we have a good theoretical hypothesis for, or actually find, the bodily defect responsible for the symptoms that we dub it an illness. We don’t merely claim that we have a “better understanding” of it without providing any scientific evidence or critical reasoning. It seems that "a better understanding" in this case means that they just thought it was a good idea to do it that way.

So how do we define mental illness? The ICD defines it as "a clinically recognizable set of symptoms or behaviour associated in most cases with distress and with interference with personal functions."³ (I wonder why just in "most cases"). The DSM's definition is far more convoluted than the ICD's, but it still seems to include just about anything that causes distress and interference in social functioning. Since it is clear that bucking the conventional ideas and behaviors about gender is going to attract righteous indignation and cause distress for the person, why wouldn't gender incongruence be considered a mental illness regardless of political pressure?

Further, keep in mind that gender incongruence was not completely removed from the ICD with the World Health Organization’s vote. Instead, it was only removed from the section dealing with mental illness but it was added to the section entitled "conditions related to sexual health." This was done in order to "...reduce the stigma while also ensuring access to necessary health interventions...."⁴ It is there along with the paraphilias, sexually transmitted diseases, and premature ejaculation. But how does removing gender incongruence from the mental illness section and placing it into the real illness section reduce the stigma? And why would we need a separate category identifying "necessary health interventions" that only transgender people suffer unless it is because of their transgender status? Doesn't this just worsen and perpetuate the stigma?

There have been other examples of this kind of shell game of eliminating mental illness by moral decree. For instance, during antebellum America, "dysaesthesia aethiopica" and "drapetomania" were discarded as mental illnesses.⁵ These had been used to diagnose slaves' laziness and their urges to escape their masters, respectively. They were considered serious mental illnesses at the time and slave owners must have been quite worried that they would contagiously spread throughout plantation life. But we now rail against the blatant racist morality upon which they were founded. 

This is also what happened in 1930s Germany when Dr. Hans Asperger came to the Nazi party's aid to designate the inappropriateness of socially reticent children as "autistic psychopathology."⁶ With this mental illness Dr. Asperger explained why those children didn't want to join the Hitler Youth and gave a reason for the Third Reich to euthanize some of them. We have heard echoes of this mental illness throughout the subsequent decades in the familiar name "Asperger's disorder," until it was removed from the DSM in 2013 and incorporated into the more serious designator "autism spectrum disorder" (by a vote).

Lest you think these examples were due to uninformed or prescientific minds of the times, there are more recent examples. For instance, the American Psychiatric Association (APA) asked its members in attendance at its 1973 annual convention to vote on whether homosexuality was a mental illness. The resulting tally was 3,810 in favor of its illness status and 5,854 votes against. Consequently, the "homosexuality" designator was removed from the DSM as a mental illness.⁷  However, even though "homosexuality" was no longer considered a mental illness, those same people who had earlier been diagnosed with homosexuality could still be diagnosed with "sexual orientation disturbance," "ego-dystonic homosexuality," or other diagnostic categories that reflect the difficulties inherent in living a gay lifestyle, especially openly. It is absurd to vote on whether homosexuality is a mental illness, it is even more absurd that 40% of those voting believed it was an illness. And this is science?

In the 1980s, "masochistic personality disorder" was considered for inclusion in the DSM. This disorder was thought to be the cause of (mostly women) allowing themselves to be abused by others (mostly men). Because of its glaring bias against women, the DSM committee proposed adding another disorder called "sadistic personality disorder" to balance out the situation with a mental illness that was equally biased against men. Fortunately, both were eventually dropped from consideration. The DSM task force that debated this issue included the wife of the task force chair. At one point she noted that one of the proposed symptoms for the disorder applied to her. In response, the chairman removed the symptom from the list.⁸ Even though masochistic personality disorder was dropped, there was a diagnosis remaining in the DSM section on conditions needing "further study." It was "self-defeating personality disorder," which mirrored the diagnostic criteria of masochistic personality disorder. Can it be more obvious?

All mental illness diagnoses suffer from this very same problem, including gender dysphoria. They aren't diagnoses of true illnesses. Instead, they are designators for experiences and behaviors that are considered by DSM or ICD committee voting members to be abnormal because they are in conflict with appropriate ways of living. This is reflected in the branch of psychology that deals with mental illness - abnormal psychology. But there is more to it than just being abnormal (it would require a whole chapter to explain the phantom concept of abnormality). There is also an element of contempt and disgust that is reflected in popular comments about those labeled with mental illnesses, such as, "He's not right in the head," and "Something is wrong with her." We don't see similar comments about right and wrong regarding true illnesses such as cancer and diabetes, unless the illness has to do with a moral failing such as with sexually transmitted diseases.

But just how do we distinguish between this kind of normal (right) and abnormal (wrong) mental functioning and behavior? If we dig down beneath the layers of medical disguise, we inevitably find the answer. The kind of abnormality associated with mental illness and the commonly held contempt about it is based on morality, not science. This includes the most recent example of how moral standards were the basis for identifying gender incongruence as a mental illness until this month, when a different set of moral standards were used to justify eliminating it as a mental illness. This move was not science and it does nothing to address the larger problem of allowing the medical and mental health industry to dictate appropriate morals.

¹https://www.hrw.org/news/2019/05/27/new-health-guidelines-propel-transgender-rights
² https://www.cnn.com/2019/05/28/health/who-transgender-reclassified-not-mental-disorder/index.html, paragraph 5.
³ World Health Organization. (1994). The ICD-10 Classification of Mental and Behavioural Disorders.p. 11. Retrieved from: https://www.who.int/classifications/icd/en/bluebook.pdf.
 ⁴ https://www.cnn.com/2019/05/28/health/who-transgender-reclassified-not-mental-disorder/index.html, paragraph 5.
 ⁵ Cartwright, S. (1851). Diseases and Peculiarities of the Negro Race. DeBow's Review,11.
 ⁶ Sheffer, E. (2018). Asperger’s Children: The Origins of Autism in Nazi Vienna. New York: W. W. Norton & Company.
 ⁷ Burton, N. (2015, September). When homosexuality stopped being a mental disorder: Not until 1987 did homosexuality completely fall out of the DSM. Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/hide-and-seek/201509/when-homosexuality-stopped-being-mental-disorder.
 ⁸ Kutchins, H. & Kirk, S. (1997). Making Us Crazy: DSM: The Psychiatric Bible and the Creation of Mental Disorders. New York: Free Press.

R. L. Cima, Ph.D.

As long as I live, I shall balk at having psychoanalysis swallowed by medicine. - Sigmund Freud

WHO’s Counting

Within the last 70 years, with the assistance of a trillion dollar worldwide pharmaceutical business and their partners in academia – and a willing populace – human beings are being drugged into “balance” to treat fictitious brain diseases in astronomical numbers.  In 2018, the World Health Organization (WHO) estimates 300 million people around the world have depression disorder, 60 million have bipolar disorder, and another 23 million have schizophrenia disorder and other psychoses1 - all of them in need of psychiatric medication.  According to WHO, it’s likely that accurate numbers are significantly higher as poorer countries have no way to record mental illness.  Leading the way – the United States. 

The Journal of the American Medical Association (JAMA) reported in 2017 more than 40 million adults were prescribed one or more psychiatric prescriptions in America (2013).2 Race, you should know, is a factor.  One in five white adults, one in ten black adults, one in twelve Hispanic adults, and one in 20 Asian adults are prescribed psychiatric medications.  By gender, the difference is as significant.  Nearly twice as many women (20.8%) are taking psychotropics than men (11.9%).  Age matters too.  About one in ten 18-39 year-olds are psychiatric patients, nearly one in five 40-59 year-olds, and, out in front by a wide margin, a solid one fourth of adults between the ages of 60-85 are prescribed psychiatric medications.  By the way, why is “mental illness” dependent on race, gender and age?  How does the psychiatric medical model (PMM) scientist explain this? 

Children

There are 75 million children in the United States in 2019.³ Nearly 17 million are diagnosed with a brain disease.  The Center for Disease Control (CDC) reports 6.1 million children have been diagnosed with ADHD disorder, 4.5 million with a behavior disorder, another 4.4 million with anxiety disorder, and 1.9 million with depression disorder.⁴ And why are nearly one in five children being drugged?  The American Academy of Child & Adolescent Psychiatry (AACAP) declares there are eleven psychiatric symptoms and disorders for which psychiatric medication may be prescribed for children.  The list includes bedwetting, anxiety, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, depression disorder, eating disorder, bi-polar disorder, psychosis, autism spectrum disorders, severe aggression and sleep problems.⁵  

Toddler & Infants Too

From the New York Times, May 2014:

“About 15,000 American toddlers 2 or 3 years old, many on Medicaid, are being medicated for attention deficit hyperactivity disorder, according to data presented Friday by an official at the federal Centers for Disease Control and Prevention.”⁶

From Medical Daily, December 2015:  

“The report shows that psychotropic drug prescriptions among babies nearly doubled in one year, from 13,000 prescriptions in 2013 to 20,000 in 2014, despite the lack of evidence that shows they are effective and safe for young children . . .  psychiatrists often prescribe these drugs . . . for behavioral issues like unusual aggression, temper tantrums, or lethargy.”⁷

What Are We Taking – and Why Are We Taking Them?

From PsychCentral, here of the top 25 psychiatric drugs that were sold in America – and the reasons we take them – in 2016:⁸

Knot in the Mood

More than 338 million prescriptions were written just for anti-depressant medications in 2016, by far the winning diagnosis.  And depression isn’t as simple as you may think.  There are all kinds of depression including atypical depression, bipolar disorder I, bipolar disorder II, catatonic depression, cyclothymia, depressive personality disorder, double depression disorder, dysthymia, melancholic depression, minor depressive disorder, postpartum depression, premenstrual dysphoric disorder, psychotic major depression, recurrent brief depression, and last, but not least, seasonal affective disorder, affectionately known as SAD.  

Is there a common denominator for all of these chemicals?  Of course, and it’s easy to see.  All 25 chemicals address the same innate, unavoidable, uncomfortable, and sometimes-hard-to-shake-life-altering-human-experience:  mood.  And yes, that includes ADHD, including the effect ADHD has on the mood of others.  Ok, you may notice, schizophrenia is about consciousness, not mood.  Nonetheless, the PMM provides treatment for schizophrenia and other aspects of consciousness with the same mood medications:  tranquilizers.  Anything else these chemicals have in common?  Yes, of course, and it’s easy to see too.  Twenty-two of them are central nervous system depressants (CNSD), and three of them are central nervous system stimulants (CNSS).  What’s that about and why is it important?

Lost In the Shuffle

Rhône-Poulenc, a French pharmaceutical company, was developing antihistamines for nausea and allergies in the late 1940’s.  Scientists noticed some chemical compounds exhibited exceptional sedative effects.  Dr. Henri Laborit, a French surgeon, called this effect artificial hibernation, and described it as “sedation without narcosis.”  By 1951 Laborit was conducting clinical trials of the newest compound – chlorpromazine (CPZ) –  for use as an anesthetic booster for surgery patients.  He proclaimed CPZ the “best drug to date” in calming and reducing shock during surgery.  Known as "Laborit's drug" among colleagues⁹, by 1953 CPZ was released for use in the operating room.  

Laborit was also a persistent advocate for clinical trials for psychiatric patients using this new wonder chemical.  His persistence was rewarded.  On January 19, 1952, CPZ was administered to a manic patient named Jacque.  Jacque’s improvement was reported to be “dramatic.”  After three weeks – and 855 mg of CPZ – Jacque was released from the hospital.  Word spread quickly about this “breakthrough.”  Dr. Pierre Deniker¹⁰, another French surgeon, ordered CPZ for a clinical trial at the Sainte-Anne Hospital Center in Paris.  His findings were even more dramatic.  Often doubling Laborit’s doses, Deniker found CPZ had much more than sedative effects.  His patients showed “remarkable improvement in thinking and emotional behavior.”  By the end of 1952, Deniker abandoned old, ineffective, and harmful shock methods and began to treat mental illness with CPZ.  

Soon after, Kline & French Pharmaceuticals (today's GlaxoSmithKline) purchased the rights to CPZ from Rhône-Poulenc.  By 1954, Smith-Kline & French received FDA approval to market CPZ as Thorazine to treat schizophrenia.  The world’s first psychiatric medication was created – and marketed.  Advertisements and professionals soon were boasting how “Thorazine helps to keep more patients out of mental hospitals.”  Please remember, hospital beds were required because psychiatric patients needed time to recover from electrocution, the surgeon’s knife, or chemically induced, months'-long comas.  While a chorus of public outcries about the inhumane treatment of psychiatric patients had already begun to empty the beds of these tortuous asylums, psychiatric scientists and drug company marketers attributed this exodus to the “dramatic” success of Thorazine.

Then, in October 1955, Deniker’s Saint-Anne Hospital Center convened the first international Thorazine (CPZ) conference.  Attendees included scientists from Austria, Belgium, Brazil, Canada, Cuba, France, Germany, Great Britain, Holland, Luxembourg, Peru, Portugal, Spain, Sweden, Switzerland, Turkey, United Kingdom, United States and Venezuela.  Soon to follow were thousands of papers from scientists around the world publicizing their own “dramatic” successes with Thorazine for an ever-widening variety of brain disorders, affecting millions of patients.  By 1957, Laborit, Deniker (and Heinz Lehmann) were awarded the prestigious Albert Lasker Award for their contributions to the clinical development and use of Thorazine - dubbed “the world’s first anti-psychotic medication.”¹¹     

During the 1950’s and 1960’s, the pharmaceutical ads for Thorazine were ubiquitous.  Thorazine was prescribed for bursitis pain, cancer pain, emotional stress, anxiety, nausea and vomiting, “management of menopausal patients,” child behavior disorders, acute alcoholism, severe asthma, depression, hiccups, catatonic schizophrenia, schizoaffective conditions, epileptic clouded states, agitation in lobotomized patients, confusional states, senile psychoses, gastrointestinal disorders, psoriasis, and more.¹² By 1964, fifty million people around the world had used Thorazine.¹³

In his book The Creation of Psychopharmacology (2002)¹⁴, David Healy, the renowned British psychiatrist, professor, scientist, author – and current director of an ECT clinic in Wales – proclaims the discovery of Thorazine as significant to medicine as the discovery of penicillin.  As important, he asserts, Thorazine was also the first profitable psychiatric medication for pharmaceutical companies.  He marks the convergence of these two events – a wonder treatment and profitability – as the genesis of what he termed “biological psychiatry,” and the 1980 publication of DSM-III as bonding psychiatry to the biological cause of mental illness, forever.  Healy also details the prodigious growth of pharmaceutical companies and their promotion strategies, including coordination with academia to find new mental illnesses, and to manufacture the medications to treat them.  

There were huge profits in the making for this burgeoning “take-a-pill-for-it” market, and Big Pharma began to flourish.  By the end of the 1960’s pharmaceutical companies had created dozens of “new and improved” medications for a growing number of new mental illnesses.  By then, Thorazine was regarded as just another, less effective medication, now criticized by its competitors for its notorious side effects.  And what were these “new and improved” medications from Big Pharma?  More tranquilizers.

Was the discovery of Thorazine really as significant as penicillin?  Yes, it was – if you are a proponent of the PMM.  Dr. Healy is, and he has company.  So is 94%¹⁵ of the general public and, presumably, 99+% of professionals.  However, if you are PMM antagonist, then Thorazine was – nothing more and nothing less – the world’s first tranquilizer, and a precursor to the hundreds of tranquilizers to follow.

A Lost Cause

Take a look at this chart of the top ten diagnosed brain disorders, and their causes:

There are a total of 713 medications manufactured by drug companies for the top ten brain disorders, for which there are no known causes.  How is that possible?  By the way, these are just the top ten diagnoses.  You can see the entire list of "Medications for Psychiatric Disorders" at www.drugs.com.¹⁶ Please be warned.  If you are looking for a cause for any of the brain disorders of the PMM, you will be disappointed.  There are none.  

So, do you wonder too?  What in the hell are they treating?  

Jacque to the Future

When Jacque took his first dose of CPZ in 1952, everything changed in psychology and psychiatry.  In just a few decades, psychological diagnoses became medical diagnoses, needing medical oversight, medical solutions, and medical doctors to do so.  Now, a psychiatric medical patient sees a medical doctor for psychiatric medication to address a brain disorder.  Behaviors once considered understandable responses to the challenges of life by psychology became “symptoms” to the doctors of the PMM, and the “symptoms” became evidence of the underlying medical deficiency, derangement, disease, disorder, disability, disturbance, or dysfunction (the 7 D’s of the PMM).

We are approaching 50 million men, women, children, toddlers and infants in the United States who are taking pills for brain disorders.  And business is booming.  Psychiatric medications – the majority tranquilizers, a handful of stimulants, and an occasional analgesic – now number in the thousands, more created every year.  Not a single cure, and not a single cause for any of the ever-growing brain disorders of the PMM.  

Did I mention business is booming?  

Welcome to Zombieland

Psychiatry entered the last half of the 20th Century on an upnote, despite a horrendous track record for the first 50 years.  The PMM scientists created a new, simple, humane, and easily administered treatment solution for mental illness, and by the 1960’s big pharma was making money hand over fist.  Only one thing was missing to unify this marriage.  Healy’s “biological psychiatry” needed a coherent, science-based, peer-reviewed theory to explain how all these miracle drugs worked.    

Well, they found one.  It’s about bad brain parts.  And a Zombie comes with it.

NEXT TIME:  Part 4:  The Dope About Dopamine – and Other Ridiculous Notions    

“When the doors to that dorm opened up a strange group of men would exit. They would seem to be in a hurry, but unable to coordinate their movements. Their heads would hang down and half expressions would ripple across their faces. They would run their hands over their heads over and over, and open and close their mouths while sticking their thick tongues out. Their gait was particularly peculiar, with stiff legs dragging their feet along, all the while seeming about to topple. We called this the ‘thorazine shuffle.’” - John Lash - Behind the Thorazine Shuffle, the Criminalization of Mental Illness (2012)¹⁷

Wayne Ramsay, J.D.

The word “schizophrenia” has a scientific sound that seems to give it inherent credibility and a charisma that seems to dazzle people.  In his book Molecules of the Mind–The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin calls schizophrenia and depression “the two classic forms of mental illness.”¹ According to the cover article in the July 6, 1992 Time magazine, schizophrenia is the “most devilish of mental illnesses.”² This Time magazine article says “fully a quarter of the nation's hospital beds are occupied by schizophrenia patients.”³ Books and articles like these and the facts to which they refer (such as a quarter of hospital beds being occupied by so-called schizophrenics) delude most people into believing there really is a disease called schizophrenia. Schizophrenia is one of the great myths of our time.

In his book Schizophrenia–The Sacred Symbol of Psychiatry, psychiatry professor Thomas S. Szasz, M.D., says “There is, in short, no such thing as schizophrenia.”⁴In the Epilogue of their book Schizophrenia–Medical Diagnosis or Moral Verdict?, Theodore R. Sarbin, Ph.D., a psychology professor at the University of California at Santa Cruz who spent three years working in mental hospitals, and James C. Mancuso, Ph.D., a psychology professor at the State University of New York at Albany, say:

We have come to the end of our journey. Among other things, we have tried to establish that the schizophrenia model of unwanted conduct lacks credibility. The analysis directs us ineluctably to the conclusion that schizophrenia is a myth.⁵

In his book Against Therapy, published in 1988, Jeffrey Masson, Ph.D., a psychoanalyst, says “There is a heightened awareness of the dangers inherent in labeling somebody with a disease category like schizophrenia, and many people are beginning to realize that there is no such entity.”⁶ Jim van Os, professor and chair of the Department of Psychiatry at Maastricht University Medical Center in the Netherlands, states this conclusion in the February 2, 2016 British Medical Journal: “'Schizophrenia’ does not exist.”⁷

Rather than being a bona-fide disease, so-called schizophrenia is a nonspecific category which includes almost everything a human being can do, think, or feel that is greatly disliked by other people or by the so-called schizophrenics themselves. There are few so-called mental illnesses that have not at one time or another been called schizophrenia. Because schizophrenia is a term that covers just about everything a person can think or do which people greatly dislike, it is hard to define objectively. Typically, definitions of schizophrenia are vague or inconsistent with each other. For example, when I asked a physician who was the Assistant Superintendent of a state mental hospital to define the term schizophrenia for me, he with all seriousness replied “split personality–that’s the most popular definition.” In contrast, a pamphlet published by the National Alliance for the Mentally Ill titled “What Is Schizophrenia?” says “Schizophrenia is not a split personality.” In her book Schizophrenia: Straight Talk for Family and Friends, published in 1985, Maryellen Walsh says this:

Schizophrenia is one of the most misunderstood diseases on the planet. Most people think that it means having a split personality. Most people are wrong. Schizophrenia is not a splitting of the personality into multiple parts.⁸

In the Foreword to the second edition of the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders (DSM-II), Ernest M. Gruenberg, M.D., D.P.H., Chairman of the American Psychiatric Association's Committee on Nomenclature, said:

Consider, for example, the mental disorder labeled in the Manual as ‘schizophrenia,’... Even if it had tried, the Committee could not establish agreement about what this disorder is.”⁹

The third edition of the APA's Diagnostic and Statistical Manual of Mental Disorders, published in 1980, commonly called DSM-III, was also quite candid about the vagueness of the term. It said: “The limits of the concept of Schizophrenia are unclear”¹⁰ The revision published in 1987, DSM-III-R, contains a similar statement: “It should be noted that no single feature is invariably present or seen only in Schizophrenia.”¹¹  DSM-III-Ralso says this about a related diagnosis, Schizoaffective Disorder:

The term Schizoaffective Disorder has been used in many different ways since it was first introduced as a subtype of Schizophrenia, and represents one of the most confusing and controversial concepts in psychiatric nosology.¹²

In Frances Farmer– Shadowland, a biography of a once well-known actress who became an involuntarily committed mental patient, William Arnold observes that “since the term schizophrenia was coined in 1911 it has had a thousand different meanings to a thousand different psychiatrists.”¹³

Particularly noteworthy in today's prevailing intellectual climate in which mental illness is considered to have biological or chemical causes is what the 1987 edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-III-R says about such physical causes of this catch-all concept of schizophrenia:  It says a diagnosis of schizophrenia “is made only when it cannot be established that an organic factor initiated and maintained the disturbance.”¹⁴ Underscoring this definition of “schizophrenia” as non-biological is the 1987 edition of The Merck Manual of Diagnosis and Therapy, which says a (so-called) diagnosis of schizophrenia is made only when the behavior in question is “not due to organic mental disorder.”¹⁵

Contrast this with a statement by psychiatrist E. Fuller Torrey, M.D., in his book Surviving Schizophrenia: A Family Manual, published in 1988. He says “Schizophrenia is a brain disease, now definitely known to be such.”¹⁶  If schizophrenia is a brain disease, it is organic. However, the official definition of schizophrenia maintained and published by the American Psychiatric Association in various editions of its Diagnostic and Statistical Manual of Mental Disorders specifically excludes organically caused conditions from the definition of schizophrenia. In Surviving Schizophrenia, Dr. Torrey acknowledges “the prevailing psychoanalytic and family interaction theories of schizophrenia which were prevalent in American psychiatry”¹⁷ that would seem to account for this.

In 1988, in Nature, genetic researcher Eric S. Lander of Harvard University and M.I.T. summarized the situation this way:

The late US Supreme Court Justice Potter Stewart declared in a celebrated obscenity case that, although he could not rigorously define pornography, ‘I know it when I see it.’ Psychiatrists are in much the same position concerning the diagnosis of schizophrenia.  Some 80 years after the term was coined to describe a devastating condition involving a mental split among the functions of thought, emotion and behaviour, there remains no universally accepted definition of schizophrenia.¹⁸

In Surviving Schizophrenia, Dr. Torrey quite candidly concedes the impossibility of defining what “schizophrenia” is.  He says:

The definitions of most diseases of mankind has been accomplished.... In almost all diseases there is something which can be seen or measured, and this can be used to define the disease and separate it from nondisease states. Not so with schizophrenia! To date we have no single thing which can be measured and from which we can then say: Yes, that is schizophrenia. Because of this, the definition of the disease is a source of great confusion and debate.¹⁹

What puzzles me is how to reconcile this statement of Dr. Torrey’s with another he makes in the same book, which I quoted above and which appears more fully as follows:

Schizophrenia is a brain disease, now definitely known to be such. It is a real scientific and biological entity, as clearly as diabetes, multiple sclerosis, and cancer are scientific and biological entities.”²⁰

How can it be known that schizophrenia is a brain disease when we do not know what schizophrenia is?

The truth is that the word schizophrenia, like the words “pornography” and “mental illness”, indicate disapproval of that to which the word is applied and nothing more. Like “mental illness” or “pornography”, “schizophrenia” does not exist in the sense that cancer and heart disease exist but exists only in the sense that good and bad exist. As with all other so-called mental illnesses, a diagnosis of “schizophrenia” is a reflection of the speaker’s or “diagnostician’s” values or ideas about how a person “should” be, often coupled with the false (or at least unproven) assumption that the disapproved thinking, emotions, or behavior results from a biological abnormality. Considering the many ways it has been used, it’s clear “schizophrenia” has no particular meaning other than “I dislike it.” Because of this, I lose respect for mental health professionals when I hear them use the word schizophrenia in a way that indicates they think it is a real disease. I do this for the same reason I would lose respect for a person’s perceptiveness or intellectual integrity after hearing him or her admire the emperor’s new clothes. While the layman definition of schizophrenia, internally inconsistent, may make sense in some situations, using the term “schizophrenia” in a way that indicates the speaker thinks it is a real disease is tantamount to admitting he doesn’t know what he is talking about.

Many mental health “professionals” and other “scientific” researchers do however persist in believing “schizophrenia” is a real disease. They are like the crowds of people observing the emperor’s new clothes in Hans Christian Andersen’s short story. They are unable or unwilling to see the truth because so many others before them have said it is real. A glance through the articles listed under “Schizophrenia” in Index Medicus, an index of medical periodicals, or an Internet search, reveals how widespread the schizophrenia myth has become. Because these “scientists” believe “schizophrenia” is a real disease, they try to find physical causes for it. As psychiatrist William Glasser, M.D., said in 1976: “Schizophrenia sounds so much like a disease that prominent scientists delude themselves into searching for its cure.”²¹ This is a silly endeavor, because these supposedly prominent scientists can’t define “schizophrenia” and accordingly don't know what they are looking for.

According to three Stanford University psychiatry professors, “two hypotheses have dominated the search for a biological substrate of schizophrenia.” They say these two theories are the transmethylation hypothesis of schizophreniaand the dopamine hypothesis of schizophrenia.²² The transmethylation hypothesis was based on the idea that “schizophrenia” might be caused by “aberrant formation of methylated amines” similar to the hallucinogenic pleasure drug mescaline in the metabolism of so-called schizophrenics. After reviewing various attempts to verify this theory, they conclude: “More than two decades after the introduction of the transmethylation hypothesis, no conclusions can be drawn about its relevance to or involvement in schizophrenia.”²³

Columbia University psychiatry professor Jerrold S. Maxmen, M.D., describes the second major biological theory of so-called schizophrenia, the dopamine hypothesis,in his book The New Psychiatry, published in 1985: “...many psychiatrists believe that schizophrenia involves excessive activity in the dopamine-receptor system...the schizophrenic's symptoms result partially from receptors being overwhelmed by dopamine.”²⁴ But in the article by three Stanford University psychiatry professors I referred to above they say “direct confirmation that dopamine is involved in schizophrenia continues to elude investigators”²⁵ In 1987 in his book Molecules of the MindProfessor Jon Franklin said “The dopamine hypothesis, in short, was wrong.”²⁶

In that same book, Professor Franklin aptly describes efforts to find other biological causes of so-called schizophrenia:

As always, schizophrenia was the index disease. During the 1940s and 1950s, hundreds of scientists occupied themselves at one time and another with testing samples of schizophrenics’ bodily reactions and fluids. They tested skin conductivity, cultured skin cells, analyzed blood, saliva, and sweat, and stared reflectively into test tubes of schizophrenic urine. The result of all this was a continuing series of announcements that this or that difference had been found. One early researcher, for instance, claimed to have isolated a substance from the urine of schizophrenics that made spiders weave cockeyed webs. Another group thought that the blood of schizophrenics contained a faulty metabolite of adrenaline that caused hallucinations.  Still another proposed that the disease was caused by a vitamin deficiency. Such developments made great newspaper stories, which generally hinted, or predicted outright, that the enigma of schizophrenia had finally been solved. Unfortunately, in light of close scrutiny none of the discoveries held water.²⁷

Other efforts to prove a biological basis for so-called schizophrenia have involved brain-scans of pairs of identical twins when only one is a supposed schizophrenic. They do indeed show the so-called schizophrenic has brain damage his identical twin lacks. The flaw in these studies is the so-called schizophrenic has inevitably been given brain-damaging drugs called neuroleptics as a so-called treatment for his so-called schizophrenia. It is these brain-damaging drugs, not so-called schizophrenia, that have caused the brain damage. Anyone “treated” with these drugs will have such brain damage. Damaging the brains of people eccentric, obnoxious, imaginative, or mentally disabled enough to be called schizophrenic with drugs (erroneously) believed to have antischizophrenic properties is one of the saddest and most indefensible consequences of today’s widespread belief in the myth of schizophrenia.

Belief in biological causes of so-called mental illness, including schizophrenia, comes not from science but from wishful thinking or from desire to avoid coming to terms with the experiential and environmental causes of people’s misbehavior or distress. The American Psychiatric Association’s definition of “schizophrenia” as non-organic, and the repeated failure of efforts to find biological causes of so-called schizophrenia suggest “schizophrenia” belongs only in the category of socially or culturally unacceptable thinking or behavior rather than in the category of biology or “disease” where many people place it.

¹John Franklin, Molecules of the Mind – The Brave New Science of Molecular Psychology (Dell Publishing Co., 1987, p. 119

²July 6, 1992 Timemagazine, p. 53

³Id., p. 55

⁴Thomas S. Szasz, M.D., Schizophrenia–The Sacred Symbol of Psychiatry  (Syracuse University Press, 1988), p. 191

⁵Theodore R. Sarbin, Ph.D., and James C. Mancuso, Ph.D., Schizophrenia–Medical Diagnosis or Moral Verdict?(Pergamon Press, 1980), p. 221

⁶Jeffrey Masson, Ph.D.,Against Therapy(Atheneum 1988), p. 2

⁷Jim van Os, British Medical Journal, February 2, 2016, “`Schizophrenia’ does not exist” https://www.bmj.com/content/ 352/bmj.i375

⁸Maryellen Walsh, Schiz-o-phre-nia: Straight Talk for Family and Friends(Warner Books 1985), p. 41

⁹Ernest M. Gruenberg, M.D., D.P.H., Diagnostic and Statistical Manual of Mental Disorders (DSM-II) American Psychiatric Association 1968), p. ix

¹⁰American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-III, 1980), p. 181.

¹¹American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), p. 188

¹²Id., p. 208

¹³William Arnold, Frances Farmer– Shadowland(Berkley Books 1982), p. 125

¹⁴DSM-III-R, p. 187

¹⁵Merck Manual of Diagnosis and Therapy, 1987, p. 1532

¹⁶E. Fuller Torrey, M.D.,Schizophrenia: A Family Manual(Harper & Row 1988), p. 5

¹⁷Id., p. 149

¹⁸Eric S. Lander, Nature, November 10, 1988, p. 105

¹⁹E. Fuller Torrey, M.D., Surviving Schizophrenia – A Family Manual (Harper & Row 1988), p. 73

²⁰Id., p. 5

²¹William Glasser, M.D., Positive Addiction(Harper & Row 1976) p. 18.

²²Jack D. Barchas, M.D., et al., “Biogenic Amine Hypothesis of Schizophrenia”, appearing inPsychopharmacology: From Theory to Practice, Oxford University Press, 1977, p. 100

²³Id., p. 107

²⁴Jerrold S. Maxmen, M.D., The New Psychiatry(Mentor 1985), pp. 142 & 154

²⁵Barchas, et al. (note 22), p. 112

²⁶Franklin (note 1), p. 114

²⁷Id., p. 172

THE AUTHOR, Wayne Ramsay, is a lawyer whose practice has included representing psychiatric “patients”.

Chuck Ruby, Ph.D., Psychologist

In 2016, the Centers for Disease Control and Prevention (CDC) urged that children be screened for autism as early as three years old.¹ In 2018, the American Academy of Pediatrics (AAP) recommended that all teenagers be screened for depression.²  The National Alliance on Mental Illness (NAMI) also supports widespread mental health screening:

Mental health screenings are a key part of youth mental health. Approximately 50% of chronic mental health conditions begin by age 14 and 75% begin by age 24. At the same time, the average delay between when symptoms first appear and intervention is 8-10 years. Mental health screenings allow for early identification and intervention and help bridge the gap.³

To the ill-informed, these pronouncements appear to be of great public service. Who could argue the virtues of identifying mental health problems in our children as early as possible so that we could offer them assistance in avoiding a life of suffering?

However, to those willing to question the conventional wisdom, and think critically about the matter, quite a different picture emerges. Screening tools are dangerous to our children, but they are helpful to the mental health industry by increasing the potential market of consumers.

Whereas it is true that mental health screening is a cost-effective substitute for full psychological testing, it nonetheless presents a significant danger. This is the danger of false positives. A false positive is when a screening tool wrongly identifies a child as having a problem (e.g, the DSM definitions of depression, autism, anxiety, etc.) when, in fact, the child doesn't have that problem.

Keep in mind that childhood problems do exist, even if they aren't illnesses. So, for instance, a child experiencing traumatic circumstances might withdraw from the world and that self-imposed isolation can have devastating effects. But this is not an illness called "depression." It is an understandable problem and an expectable reaction to trauma.

The false positive problem occurs even with the most accurate of screening instruments. An instrument's accuracy is stated as sensitivity and specificity. Sensitivity is the rate at which the tool correctly identifies a person with the problem. Specificity is when the tool correctly identifies a person who doesn't have the problem. Sensitivity and specificity rates of .80 are considered "levels that are reasonably good for a screening instrument."⁴

But regardless of this "reasonably good" accuracy, when we screen for any low base-rate event, such as the problems that are subsumed under the label "mental illness," we will necessarily have a large number of false positives. This results in many, many children being identified as the target of psychiatric intervention when there is no real problem.

To see just how dangerous this is, let's look at the statistical nuts and bolts in the table below. Take a hypothetical population of 1,000 kids and screen them for depression with an instrument that has a .80 accuracy rate. According to the CDC, 3.2% of children between 3 and 17 years old have been diagnosed with depression.⁵ This is a 3.2% base-rate. With this data, we would get the numbers below.

* false positives

So out of 1,000 children and a 3.2% base rate of depression, there will be 32 children who actually are suffering from the problems labeled "depression" and 968 who aren't. A screening instrument with sensitivity and specificity of .80 will correctly identify 26 of the depressed kids. It will also correctly identify 774 of the non-depressed kids. However, it will wrongly identify 194 of the non-depressed kids as depressed. This is a 88% false positive rate (194 ÷ 220 = .88).

The significance of this cannot be overstated. When using a screening instrument like this, nearly 9 out of every 10 children who are identified as depressed wouldn't really be suffering from that problem. Nevertheless, they would still be subjected to the attention and potential treatment of the mental health system, with all of the accompanying stigma and other harmful effects, such as the prescription of unnecessary psychiatric chemicals.

And what do you think would happen when the children or their parents disagree with the professional's screening conclusion and become resistant to subjecting the child to treatment? Of course, it would very likely be seen as either a sign of anosognosia (lack of insight into one's illness) or as parental neglect in refusing to get treatment for their children.

This is frightening.

There are about 74 million children and adolescents living in the United States.⁶ When using screening instruments like this, imagine the untold number of kids who are not suffering from the problem but who would nonetheless be a target of the mental health industry. If all of them were screened with this tool, millions would be falsely targeted! And, if you are skeptical about whether our children would be subjected to these harmful screenings, just remember that the American Academy of Pediatrics recommended that all teenagers be screened for depression.

With the screening of real medical problems, such as cancer, there is a potential solution to this false positive problem. It is to conduct a more detailed examination of the patient with laboratory tests such as X-rays, CAT scans, and blood tests to determine if the disease is actually present.

But with the problems labeled "mental illness," there is no follow up to the screening instrument because there is no internal dysfunction that can be detected with a more detailed examination. Even more in-depth psychological testing wouldn't suffice since psychological tests are also screening instruments, they're just more complicated. But, they do not assess internal malfunctioning.

Mental illness diagnoses refer to problems only, not bodily disease processes that cause the problems. In fact, the formal diagnostic guidelines in the DSM are screening instruments themselves! They are merely checklists of "symptoms." In this sense, the DSM has the same false positive danger as does any other screening instrument. Using it to diagnose "mental illness" results in an overabundance of people wrongly branded with mental illness diagnoses. Yet, those people become a fertile market for the mental health industry.

¹https://www.cdc.gov/media/releases/2016/p0331-children-autism.html.

²https://www.npr.org/sections/health-shots/2018/02/26/588334959/pediatrians-call-for-universal-depression-screening-for-teens.

³https://www.nami.org/Learn-More/Mental-Health-Public-Policy/Mental-Health-Screening.

⁴https://academic.oup.com/jpepsy/article/41/10/1081/2951811.

⁵https://www.cdc.gov/childrensmentalhealth/data.html.

⁶https://www.census.gov/quickfacts/fact/table/US/AGE295216#viewtop.