The following are tributes by friends and colleagues of Bertram (Bert) P. Karon, Ph.D., in memory of his courageous and noble dedication to improving the lives of those labeled and stigmatized with mental illness diagnoses.
Al Galves, Ph.D.
What are the negative emotions?
Anger
Jealousy
Fear
Guilt
Sadness
Anxiety
Others?
Why do we think they are negative?
They aren’t comfortable.
It’s interesting to wonder about why these important feelings are uncomfortable. Perhaps it is because we need to be motivated to do something about the concerns that are causing them.
They are associated with behavior that is dangerous.
It’s important to make a distinction between the emotion and behaviors that are associated with the emotion. All emotions are valid, OK and potentially useful. But the behavior that results from emotions can be either helpful or dangerous and hurtful.
They can make us sick.
When these emotions are stuffed and repressed, they go inside, put a strain on the body, impair the immune system and cause sickness.
What evidence is there that these emotions are useful?
Evolution or Creation
Whether you believe in evolution or creation, there is evidence that the “negative” emotions are beneficial and useful. If you believe in evolution, you understand that the human organism has been evolving over the past 30 million years. Any faculty or state of being that wasn’t useful and didn’t have survival value would have been wiped out long ago by the process of natural selection. If you believe in creationism, why would God have given us a faculty or state of being that wasn’t somehow useful?
Research
Antonio Damasio
In his book Descarte’s Error, Antonio Damasio describes his study of people who, due to lesions on their amygdalas, were unable to experience emotions. He found that such persons were unable to make good use of their reasoning abilities. Unable to feel bad, they couldn’t learn from mistakes. For example, they would see a stock they owned going down in value but wouldn’t feel bad about it so wouldn’t sell it.
James Pennebaker
People who write about the most traumatic experiences of their lives have better immune system functioning and are healthier than people who write about impersonal topics.
Method Actors
The immune systems of actors function better while they are experiencing emotions and it doesn’t make any difference if the emotions are “positive” or “negative”.
Medical students
Medical students included in the “Bland-No emotions” group were 16 times more likely to contract cancer than those in the “Acting out” group.
Joseph Ledoux
Signals that are received through the eyes, ears, nose and skin pass through the amygdala (the part of the brain which processes emotions) before they go to the neo-cortex (the part of the brain which processes thinking, problem solving and analyzing), evidence that the human organism is “designed” to enable the emotional processing and reasoning faculties to work together.
How are these “negative” emotions useful?
Five basic ways in which they are useful:
They tell us what’s important, what we care about, what we like, what we don’t like, what we are afraid of, what we want to get rid of.
They help us get clear about our values.
They help us make decisions.
They give us energy and motivation.
They help us understand other people and, therefore, to behave in better ways.
Following are some examples:
Anger: Anger tells us what we don’t like, what we want to get rid of, what is threatening us, what we want to overcome.
Jealousy: Jealousy tells us what we want and don’t have or what we have and don’t want to lose.
Fear: Fear tells us what we want to avoid, what we want to be careful about, what can hurt us, what we must protect ourselves against.
Sadness: Sadness tells us what is precious to us and what we want to nurture and protect in our lives.
Anxiety: Anxiety gives us the energy, the mental acuity and the stamina to do things that we want to do but which are going to be difficult and scary.
Guilt: Guilt tells us what we think is wrong, keeps us from doing things we think are wrong and enables us to make amends to persons we have wronged. It enables us to act in accordance with our moral code.
What do we have to do in order to use them?
1. Experience them.
We experience them in our bodies. We first get in touch with them through bodily sensations. What we have to do is let them in, sit with them, wait with them, let them work in us. Many of us have been told that these emotions are bad, that they can’t be trusted, that they only lead to no good. So, as soon as we begin to feel them, we find a way to avoid them. We get busy, we act out, we take drugs and alcohol, we escape. If we only would let them work in us for five minutes or so, we could take the first step to turning them into positives.
2. Find out what they are telling you. What is behind them? What are they about? What is the message?
This is easier said than done. It may take some time to get the message from the emotion. One thing that will help is to find a quiet place in which to sit. Sit in a comfortable position. Tell yourself that you are open to receiving whatever the message is. Take some time to relax, let the tension out of your body and allow yourself to receive whatever messages come up from inside of yourself.
Here are some other rules of thumb that may be useful in taking this step.
• Anything which gets in the way of you loving the way you want to love and working - expressing yourself and using your abilities - the way you want to work is going to cause one of these “negative” emotions.
• Welcome whatever thoughts come up. Even if they don’t make sense or seem to be coming out of left field, they may be the start of a useful insight. If they seem weird, ask them what they are doing there and what they have to tell you. Be open to answers.
• It is not necessary to push yourself hard at this point. It works better to relax and allow things to come to you – all by themselves – without you making it happen.
3. Take some action based on what you have learned or decide not to take action.
This may be the hard part. Since these emotions are usually about something which is bothering you or is in your way, something you want to get rid of or you want to confront, it may take some courage to take action. And since action will often involve confronting other people you will have to learn how to confront without making them defensive.
Here are some rules of thumb for taking action.
• If you are confronting another person, use the rules of assertiveness.
Describe what is going on for you, what you are noticing, how you are feeling using “I” instead of “You”.
Tell the person that you are having a problem with what is going on, that you don’t know what the solution is and that you’d like her or him to join with you in finding a solution.
Take responsibility for your feelings, your thoughts and your desires.
Say what you want – calmly and directly.
Don’t take responsibility for the other person’s feelings.
• If you are afraid, ask yourself what you are afraid of. When you get the answer, see if it is a fear that you can walk with, that you can manage without letting it stop you.
• Ask yourself what is the worst thing that can happen and see if you could live with that or somehow mitigate it.
• Be aware of the ways in which you habitually stop yourself from taking action. We often stop ourselves by saying things like:
"I don’t want to be petty."
"I’m afraid if I say something or do something, things will get worse."
"It’s not that important."
"I’ll just let things ride and see what happens."
"Who am I to think I should get what I want?"
"If I do what I want to do, they’re going to think I’m mean and nasty and not a nice person."
Check these thoughts out to see if they really make sense and if you want to let them stop you or not.
What if I don’t want to take action?
After experiencing the emotion and getting its message, you may decide not to take any action. If so, you need to find some way of discharging the energy that is in the emotion. Examples of how some people use this energy effectively is exercise, sports, creative activity, talking to friends, writing, playing music, and helping other people. Any activity which uses energy and is not harmful to self or others will work.
So what is the bottom line?
These so-called “negative” emotions are valid, beneficial and potentially useful. They tell you what is important to you and what you need to do in order to live more the way you want to live. If you want to use them, take the following steps:
1. Experience them. Let them in and let them work on you.
2. Learn from them. What are they telling you?
3. Take action based on them. If you decide not to take action, find a way of using the energy in them that is helpful to you and/or others.
Thomas Scheff, Professor Emeritus, University of California, Santa Barbara, Department of Sociology
Many years ago (1894), the noted philosopher John Dewey published a theory of emotions that today might seem peculiar, at least at first glance. He proposed that each emotion is a bodily process like breathing, only painful if obstructed. Dewey’s articles were ignored because, oddly, he provided no examples: he didn’t describe the patterns of obstruction that cause grief, anger, fear or shame to be painful.
Much later Bull (1951) partially responded to Dewey’s theory. She provided one example: grief is painful only if there is too little crying. No attention has been given to these writings; little evidence has been offered to support them. This note describes a small bit of evidence that might be relevant: my own personal experience of catharsis of obstructed emotions (Scheff 1979, 2007).
Some 50 years ago (I am nearing 90), I had a personal experience of removing obstructions of grief, anger, shame and fear. It occurred when I enrolled in a small informal class called Re-evaluation Counseling (1965). Although not mentioned in the class or it’s supportive writings, it seems to be based on the Dewey-Bull theory. After the first class, I cried every day for almost a year. Since at the age of 40 I hadn’t cried since childhood, I was quite surprised and gratified. The crying seemed to remove or at least decrease a substantial amount of pain and doubt.
Similarly, instead of bearing anger for much of a day and night, I saw that my little screams produced a flash of heat in my whole body that ended the anger. After a few minutes. I was no longer angry. A great relief, since in those days I was often angry.
A prolonged burst of happy laughter seemed to remove shame or embarrassment completely.
Unlike the other three emotions, fear was infrequent. But a few moments of intense sweating and shaking removed fear the few times that it occurred.
There is a complication which I can only mention in passing in this brief note: not all crying, shouting, shaking and laughter removes obstructions of emotions. For example, one can cry for many, many hours without removing the obstructions. I would guess that most of the crying, laughter and shouting that we see is like this. To remove obstructions, these actions must be under control, even though the person who is crying, laughing and/or shouting may not know that they have control. But in my experience, there have been moments when I needed to attend to business other than my emotions. To my surprise, I could stop and start the cathartic process at will. I have called this feature “aesthetic distance” because it resembles that emotional reactions of audiences in the theatre (Scheff 1979).
Most people in modern societies seem to have little interest in emotions. They take their beliefs about them for granted. In actuality all emotion terms, especially in English, are undefined and highly ambiguous. For example, most of the emotion research in psychology is not about emotions themselves, but about facial expression of emotions. Facial expressions are visible, without dealing with the problem of emotions, which are partly internal. In this way, they think they are studying emotions, but they only deal with a very small aspect.
Since the public and most of the researchers seem to be certain that the four emotions dealt with in this note are inherently painful, it will be difficult to convince them that they are not. According to this theory, we need not only to think differently about emotions, but research them directly, and also stop hiding them from self and from others so one can experience each emotion directly.
Bull, Nina. 1951. The Attitude Theory of Emotion. New York: Nervous and Mental Disease Monographs.
Dewey, John. 1894. The Theory of Emotion. Psychological Review. 1; 6 (553-568) and 2; 1 (13-32).
Jackins, Harvey. 1965. The Human Side of Human Beings. Seattle: Rational Island.
Scheff, Thomas. 1979. Catharsis in Healing, Ritual and Drama, Berkeley: U. of Calif. Press.
Scheff, Thomas. 2007. Easy Rider, pp 194-195. Lincoln, Nebraska: iUniverse Press.
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:
I do not believe in mental illness. ... Psychiatric drugs and electroshock inflict real injury in the name of treating fictive maladies. ... My opinions are based on my years of experience with patients and review of records from all over the country as an expert witness in electroshock malpractice cases.2
In 2011, Steve Balt, M.D., a psychiatrist at the UCLA-Kern Medical Center in Bakersfield, California, acknowledged “some argue convincingly that mental illness is itself a false concept," citing an article by psychiatry professor Thomas Szasz.3 Dr. Szasz published his book The Myth of Mental Illness in 1961, which now in 2019 is 58 years ago. If mental illness is a myth, why do people still believe in mental illness?
One reason is the effects of repetition over time. The more often one hears a myth stated, the harder it is to bring oneself to use one's own powers of perception and reason to examine and question it. Almost everything we read in newspapers and magazines, and almost everything we see on television or hear on radio, and much of what we read on the Internet, discusses “mental illness” as if it were as real and valid a concept as heart disease or cancer. We tend to believe what those around us believe, and eventually “most of our stored misinformation is virtually [metaphorically] cast in concrete.”4
Another reason the myth of mental illness and other widespread myths persist is the risk to anyone who questions what almost everyone believes. Dare one be the first to declare the emperor has no clothes? People who clearly understand the mythical nature of a widespread belief risk the disapproval of others, or worse, if they speak the truth about these myths. Historians have said those questioning the concept of witchcraft in the 1690s when the Salem, Massachusetts witch trials took place risked being accused of being witches themselves. According to Peter Charles Hoffer, research professor of history at the University of Georgia, in his book The Salem Witchcraft Trials—A Legal History:
In the 1600s, popular or “vernacular” belief in witches was repeated in the writings of the most learned men. ... In the late sixteenth century, many educated men assumed that there was a spirit (invisible) world, and that the Devil and His witches could move freely through it. ... Everyone believed in witches ... no lawyers stepped forward during the [witch] trials to help the accused”, but if they had, the people making such accusations “would probably have accused the lawyers of witchcraft before long.”5
Just as lawyers speaking on behalf of defendants in the Salem, Massachusetts witchcraft trials of the 1690s would have been in danger of being accused of witchcraft themselves, as a lawyer representing or speaking in defense of people accused of mental illness today, a reaction I sometimes get is people accusing me of being crazy. As psychiatry professor Thomas Szasz says in his book Suicide Prohibition—The Shame of Medicine, “The individual who assumes the task of setting such dislocations aright runs the risk of being destroyed in the process.”6
A related reason for the persistence of the concept of mental illness is support by supposed experts—psychiatrists and psychologists—who make money and acquire professional prestige with the use of the concept. Their status as experts would be lost and their incomes would drop dramatically if the falseness of the concept of mental illness were widely and generally acknowledged. As Judi Chamberlin wrote in her book about psychiatry, “Leaving the determination of whether mental illness exists strictly to the psychiatrists is like leaving the determination of the validity of astrology in the hands of professional astrologers.”7 Support for a myth from those perceived as experts, even if they actually are not experts, makes a myth harder to question.
The inexplicit nature of the concept of mental illness also contributes to the perpetuation of this myth. Consider another myth: Can it really be proved evil spirits do not exist, and that they do not possess people? Even as perceived by those who believe in it, the concept of mental illness is as amorphous and difficult to pin down in specific terms as the idea of evil spirit possession. Some, like Millen Brand in an article in 1970 in The Journal of Contemporary Psychotherapy titled “Is Mental Illness a Myth?” argue against the notion that “because ‘mental illness’ isn't a medical or physical illness, it doesn't exist at all.”8 Psychologist Vernon W. Grant, Ph.D., in his book This Is Mental Illness, says this:
There is, again, a certain tendency in popular thinking to suppose that mental illness includes something more than the symptoms. Thus a person is said to be doing or saying certain things because is mentally ill. The illness, supposedly, causes him to act and speak as he does. ... It would be misleading, however, to say that the abnormal ways of feeling and perceiving are caused by “mental illness.” These ways of feeling and perceiving are the illness. Too often the term suggests a mysterious something behind the unusual behavior.9
Other mental health professionals argue there is a mysterious something behind, or causing, the person's behavior, or so-called symptoms, and that this mysterious something is a still undiscovered “chemical imbalance” in the brain or some other brain abnormality. They argue mental illness is, by definition, a disease of the brain, even if current science can find nothing wrong with the brains of supposedly mentally ill people. Mental health professionals can't agree among themselves about whether mental illness is physical or non-physical. Being a vague concept makes the concept of mental illness more difficult to disprove and reject than it would be if it were clearly defined.
Also helping to perpetuate the myth of mental illness is the desire of some people to avoid personal responsibility for their actions and their lives. These are the people who telephone or write to me hoping I will, as a lawyer, help them prove that because of their supposed mental illness they are not responsible for something they did. These also are the people who go to a mental health professional and in effect say “Doctor, make me happy”: It is much easier to swallow supposedly antidepressant pills than get a better education or a better job, or a better marriage or intimate relationship, or be cured of a serious health problem like cancer. People who neglect or mistreat their children sometimes rely on the concept of mental illness to relieve them of responsibility for how their children turn out as adolescents or adults. What have they done wrong? In many cases, the answer is plenty. But they prefer to believe a disease (mental illness) that “could happen to anyone” intervened and that “It's no one's fault.”
Another reason is our discomfort with ignorance. When we don't understand the real reasons for something, we often create myths to give us an illusion of understanding. Believing a myth is more comfortable than acknowledging ignorance. For example, ancient man did not understand the why behind rain and therefore created the myth of the Rain God. As man gained a knowledge of meteorology and hence a true knowledge of the why behind rain, the Rain God was no longer needed, and the Rain God idea was discarded. Earlier in human history, being baffled by the thinking and behavior of some people, people theorized the existence of evil spirits or demons and created the myth of demon possession, the belief that people behaved strangely or wrongly because they were possessed by evil spirits. In the words of A. John Rush, M.D., “Deranged behaviors were typically considered curses from the gods by the Ancients... During the Dark Ages, Western civilization returned to beliefs in possession and supernatural forces as explanations for psychiatric disorders.”10 Today we attribute thinking or behavior we dislike and don't understand to mental illness. However, mental illness is just as much a myth as curses by gods or possession by evil spirits. Often we just don't know why people think or act as they do. Rather than acknowledge our ignorance, which makes us uncomfortable, we create myths such as evil spirits or mental illnesses to provide an explanation.
Why aren't all crimes considered mental illnesses or the result of mental illness? Some people do say “all criminals are sick.” However, for those of us who don't agree with this viewpoint, the difference between crime and mental illness typically is this: When we feel we understand the motives behind the disapproved behavior, we make the behavior a statutory offense. When we do not understand the motives behind disapproved behavior, we cover up our ignorance of these motives by creating a myth—the myth of mental illness—and say mental illness caused the behavior — and punish the supposedly mentally ill person with involuntary “hospitalization” or an involuntary outpatient commitment order, and forced psychiatric “therapy” such as “involuntary medication”, or involuntary guardianship of his person and property. The myth of mental illness deludes us into believing we understand the reasons for disliked behavior that we in fact do not understand.
Another reason for continued belief in mental illness is drug company advertising designed to convince everyone mental illness is biologically caused. Marcia Angell, M.D., former editor-in-chief of the New England Journal of Medicine, in her book The Truth About Drug Companies—How They Deceive Us and What To Do About It approvingly quotes bioethicist Carl Elliott saying “The way to sell drugs is to sell psychiatric illness.”11 Psychiatrist Colin A. Ross, M.D., makes a similar comment in his autobiographical book The Great Psychiatry Scam—One Shrink's Personal Journey: “Whatever makes mental illness be biological sells drugs.”12 In Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, psychiatrist Allen Frances says —
Psychotropic drugs are now among the very top best sellers for the drug companies. Their stock prices would be cut by more than half were it not for the antipsychotics, antidepressants, stimulants, antianxiety agents, sleeping pills, and pain meds. ... At the very top of the Pharma hit parade are the antipsychotics at a resounding $18 billion a year.13
Do you think drug company executives and advertising departments will tell the depressing truth about their products if widespread awareness of the truth would cause their company stock to be worth less than half what it is now? It is more likely they are determined to maintain the myth that mental illness is biological and to hide the harm done by psychiatric drugs so they can continue to earn huge profits from selling them. Advertising mental illness as biological when it is not to sell more psychiatric “medications” is unethical, but as Dr. Angell warns us in The Truth About Drug Companies, “Drug companies are in business to sell drugs. Period.”14 And drug companies have huge advertising budgets.
REFERENCES
1 Judi Chamberlin, Own Our Own: Patient-Controlled Alternatives to the Mental Health System(National Empowerment Center 1977), p. 8
2 John Friedberg, M.D., https://ectjustice.org/neurologist-john-m-friedberg-on-ect, https://web.archive.org, archive date: February 19, 2017, accessed August 5, 2019
3 Steve Balt, M.D., “Is the Criticism of DSM-5 Misguided?”, psychiatrictimes.com, December 22, 2011
4 I borrow this phrase from Donald G. Smith, How to Cure Yourself of Positive Thinking, E. A. Seemann Publishing, Inc., Miami, 1976, p. 73.
5 Peter Charles Hoffer, The Salem Witchcraft Trials—A Legal History(University Press of Kansas 1997), pp. 4, 78, 87, 89, 90
6 Thomas Szasz, M.D., Suicide Prohibition—The Shame of Medicine(Syracuse University Press 2011), p. 105
7 Judi Chamberlin, Own Our Own(note 1, above), p. 9
8 Millen Brand, “Is Mental Illness a Myth?”, The Journal of Contemporary Psychotherapy, Summer 1970, Vol. 3, p. 13
9 Vernon W. Grant, Ph.D., This Is Mental Illness(Beacon Press 1963), p. 4, italics in original
10 A. John Rush, M.D., “Diagnosis of Affective Disorders” in Depression Basic Mechanisms, Diagnosis, and Treatment(Guilford Press 1986), p. 2
11 Marcia Angell, M.D., The Truth About Drug Companies—How They Deceive Us and What To Do About It(Random House 2005), p. 88
12 Colin A. Ross, M.D., The Great Psychiatry Scam—One Shrink's Personal Journey(Manitou Communications, Inc. 2008), p. xv
13 Allen Frances, M.D., Saving Normal—An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life(HarperCollins 2013), p. 104
14 Marcia Angell, M.D., The Truth About Drug Companies—How They Deceive Us and What To Do About It(Random House 2005), p. 250
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:
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.
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
3 ChildStats.gov: https://www.childstats.gov/AMERICASCHILDREN/tables/pop1.asp
4 CDC: https://www.cdc.gov/childrensmentalhealth/data.html
5 American Academy of Child & Adolescent Psychiatry (AACAP) https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychiatric-Medication-For-Children-And-Adolescents-Part-I-How-Medications-Are-Used-021.aspx
6 The New Inequality for Toddlers: Less Income; More Ritalin. https://parenting.blogs.nytimes.com/2014/05/16/the-new-inequality-for-toddlers-less-income-more-ritalin/?action=click&module=RelatedCoverage&pgtype=Article®ion=Footer
7 Psychiatric Drugs For Babies? More Kids Aged 2 And Under Getting Prescribed Antipsychotics: https://www.medicaldaily.com/psychiatric-drugs-babies-more-kids-aged-2-and-under-getting-prescribed-antipsychotics-365236
9 Some of his colleagues referrered to the effect as “non-permanent, pharmacological lobotomy." https://en.wikipedia.org/wiki/Antipsychotic#History
10 Pierre Deniker Foundation – for research and prevention of mental illness. https://www.fondationpierredeniker.org/what-is-it
12 For a thorough review of thorazine advertisements see: http://www.bonkersinstitute.org/medshow/thorazine.html
14 See a review of The Creation of Psychopharmacology@https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1279263/
17Behind the Thorazine Shuffle, the Criminalization of Mental Illness. https://jjie.org/2012/03/16/behind-thorazine-shuffle-criminalization-of-mental-illness/
Gail Tasch, M.D.
I was able to get a medical license in Florida, one of the more difficult states to get a license due to its history of medical fraud and abuse. In order to maintain a license in the state one has to take a “Medical Errors” continuing medical education course at licensure and every two years afterwards. I read the course and took the easy test and fulfilled the requirement. The course always begins with citing the 1999 study that stated that over 100,000 people die yearly from medical errors. I remember when this study came out and it made news headlines.
For the next license renewal 2 years later, I received the medical booklet for the course and the writer of the course said that now 200,000 people a year die from medical errors. Now this information isn’t coming from some "granola eating people" (that’s how the medical world refers to natural health practitioners) or some other offshoot group from Portland spreading “misinformation.” These courses are mainstream medical education. I was stunned by the doubling of the statistic and even wore the booklets out carrying them around and showing them to people. I brought the course booklets to dinner parties to show to other professionals and friends to see if they shared my outrage (none did).
So at the NEXT license renewal, lo and behold, the course in the booklet reported that “now it is closer to 400,000 people that die each year from medical errors.” Why is no one seriously looking at this statistic? My psychologist friend is fond of telling me “there are no doctor police!” In medical school we are told that each doctor kills an average of 6 people during their practice. Looks like we are crushing it.
There has been some comparison of the healthcare system’s safety record to the airline industry. Hospitals made an effort to copy the airline industry’s stellar safety record with more team decision making and “time outs” in the operating room to ensure surgery took place on the correct side of the body, one of the most common surgical errors.
The number of fatalities in the aviation industry has fallen from approximately 450 to 250 per year. This stands in comparison to the healthcare system where there is an estimated hundreds of thousands of preventable medical deaths each year. This amounts to the equivalent of about three fatal airline crashes per day. The renowned airline pilot, Chesley Sullenberger noted if such a level of fatalities was to happen in aviation, airlines would stop flying, airports would close, and there would be congressional hearings and a presidential commission. No one would be allowed to fly until the problems have been solved.
Sully has been passionate about safety for many years and serves on the editorial board of the Journal of Patient Safety and he is a member of the Greenlight Group, a team of experts supporting a number of global healthcare research and development initiatives. He noted that in healthcare mistakes affect just one person at a time. Mistakes are buried, failures are buried. Sully has referred to an era in aviation where pilots acted like gods with a small "g" and Cowboys with a capital "C". He said sadly some of this culture would still appear to remain in parts of healthcare. He believes patient safely should be a priority at all levels in the healthcare system, from the emergency rooms to the board rooms.
Unfortunately, there is less and less transparency regarding medical errors. The USA TODAY newspaper reported that “The federal government this month quietly stopped publicly reporting when hospitals leave foreign objects in patients' bodies or make a host of other life-threatening mistakes.”
People are likely to die in other ways from our healthcare system. Dr. Gary Null published a very well researched white paper Death by Medicine. In the paper, Dr Null reports that over 700,000 people die each year due to the healthcare system making healthcare treatment the number one cause of death in this country. It is very easy to me to think about friends and family members who died from the treatment they received. My wonderful sister-in-law died from the chemotherapy she received, not the lung cancer that plagued her.
Peter C. Gotzsche wrote an article for the British Medical Journal called “Does long-term use of psychiatric drugs cause more harm than good?” Dr. Gotzsche concludes that psychiatric drugs are responsible for the deaths of more than a half a million people age 65 and older each year in the Western world. He feels the benefits of psychiatric drugs are minimal. He believes that psychiatric prescription drugs are the third leading cause of death after heart disease and cancer. He believes that psychiatric drugs alone are the third major killer, mainly because antidepressants kill many elderly people through falls.
We are told as psychiatrists in our training that when prescribing atypical antipsychotic medications, we take 15-25 years off one’s life. These drugs cause weight gain, diabetes, chronic disease, and early deaths.
According to an article in the Journal of the World Psychiatric Association, antipsychotics, and to a lesser degree antidepressants and mood stabilizers, are associated with an increased risk for several physical diseases, including obesity, dyslipidemia, diabetes mellitus, thyroid disorders, hyponatremia; cardiovascular, respiratory tract, gastrointestinal, hematological, musculoskeletal and renal diseases, as well as movement and seizure disorders. Higher dosages, polypharmacy, and treatment of vulnerable (e.g., old or young) individuals are associated with greater absolute (elderly) and relative (youth) risk for most of these physical problems.
The rationale is that they work so well that the tradeoff is justified. There is an attitude that because someone has mental health symptoms they don’t deserve the respect a “normal” person does. The psychiatric profession goes to great lengths to keep the current paradigm in place.
How would one best avoid these medical errors and adverse effects from medical treatment? First of all, many of our illnesses are preventable. Eighty to ninety percent of visits to doctors and hospitals are for conditions that are preventable. For instance, 50% of people over 50 years of age suffer from hypertension, a mainly lifestyle related problem.
For the health care system in general, patient safety should be an integral part of medical training. Sully would say, “Safety should be a part and parcel of everything we do. Every decision that is made, whether it is administrative, budgetary, or otherwise should take safety implications into account because there is such an important business case for doing so.” Unfortunately there is a great lack of accountability in our medical system.
I personally do not go to mainstream doctors, I went to midwives when I was having children, I don’t even have health insurance, but I do have an inexpensive catastrophic policy. I do not get mammograms or flu shots.
Our medical system provides the most expensive care, not what is in the patient’s best interest. When one does require care, one has to search out like minded practitioners. Unfortunately we do not have good mental health treatment but societies such as ISEPP and Mad in America are doing great work to reach people in need of help so that one can receive the very best care.
Wakefield, M. (2000). To err is human: An Institute of Medicine report. Professional Psychology: Research and Practice, 31(3), 243-244.
USA Today August 6, 2014.
Death by Medicine. March 2004. Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD.
Committee on Quality of Health Care in American. To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press; 1999.
Makary MA, Daniel M. Medical error: the third leading cause of death in the U.S. BMJ. 2016;353:i2139.
Does long term use of psychiatric drugs cause more harm than good? BMJ. 2015; 350. doi: https://doi.org/10.1136/bmj.h2435 (Published 12 May 2015).
JRSM Open. 2016 Jan; 7(1): 2054270415616548. Published online 2015 Dec 2. doi: 10.1177/2054270415616548 Aviation and healthcare: a comparative review with implications for patient safety Narinder Kapur,Anam Parand,Tayana Soukup, Tom Reader, and Nick Sevdalis.
World Psychiatry. 2015 Jun; 14(2): 119–136. Published online: doi: 10.1002/wps.20204. Effects of antipsychotics, antidepressants and mood stabilizers on risk for physical diseases in people with schizophrenia, depression and bipolar disorder. Christoph U Correll, Johan Detraux, Jan De Lepeleire, and Marc De Hert.
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
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”.
Wayne Ramsay, J.D.
In the Introduction to his book Rethinking Depression (New World Library 2012, p. 3, italics his) California-licensed family therapist Eric Maisel, Ph.D., says this:
One of the goals of this book is to help you remove the word depression from your vocabulary and, as a result, from your life. If depression were an actual disease, illness, or disorder you wouldn't be able to rid yourself of it just by removing it from your vocabulary. But since it isn't a disease, illness, or disorder, you can dispense with it right this second. What I would love for you to say is "I can't be depressed because there is no disease of depression!
Similarly, in her book A Straight Talking Introduction to Psychiatric Drugs (PCCS Books, Ross-on-Wye 2009, p. 65), Joanna Moncrieff, M.B.B.S., M.Sc., MFRCPsych, M.D., Senior Lecturer in Mental Health Sciences at the University College, London, says this:
...it is important to say here that the term "depression" as currently used is misleading. ... there is no scientific evidence to support the idea that there are particular features of the brain that give rise to the particular feeling of depression.
Unhappiness or "depression" alleged to be the result of biological abnormality is called "biological" or "endogenous" or "clinical" depression. In her book The Broken Brain: The Biological Revolution in Psychiatry, University of Iowa psychiatry professor Nancy Andreasen, M.D., Ph.D., says: "The older term endogenous implies that the depression 'grows from within' or is biologically caused, with the implication that unfortunate and painful events such as losing a job or lover cannot be considered contributing causes." (Harper & Row 1984, p. 203).
Similarly, in 1984 in the Chicago Tribune newspaper columnist Joan Beck alleged: "...depressive disorders are basically biochemical and not caused by events or environmental circumstances or personal relationships" (July 30, 1984, Sec. 1, p. 16). A July 2013 Readers Digest article (pp. 132-133) says "For the past 50 years, the conventional wisdom among many psychiatrists was that depression was caused by a brain-chemical imbalance such as low levels of the feel-good hormone serotonin."
The concept of biological or endogenous depression is important to psychiatry for two reasons. First, it is the most common supposed mental illness. As Victor I. Reus, M.D., wrote in 1988: "The history of the diagnosis and treatment of melancholia could serve as a history of psychiatry itself" (appearing in: H. H. Goldman, editor, Review of General Psychiatry, 2nd Edition, Appleton & Lange 1988, p. 332). Second, all of psychiatry's biological "treatments" for depression—whether it is drugs, electroshock, or psychosurgery—are based on the idea that the unhappiness we call depression can be caused by a biological malfunction in the brain rather than life experience. The erroneous belief in biological causation justifies the otherwise unjustifiable use of biological therapies, primarily "antidepressant" drugs and electroconvulsive "therapy" (see Psychiatry's Electroconvulsive Shock Treatment—A Crime Against Humanity). The biological therapies for this nonexistent "disease" of depression and other so-called mental illnesses also in theory justify the existence of psychiatry as a medical specialty distinguishable from psychology, social work, and counseling.
Many professional and lay people today think depression can be caused by a"chemical imbalance" in the brain even though no chemical imbalance theories of depression have been verified. As psychiatry professor Thomas S. Szasz, M.D., said in 2006, "There is no evidence for a chemical imbalance causing mental illness, but that does not impair the doctrine's scientific standing or popularity" ("Mental Illness as a Brain Disease: A Brief History Lesson"). Psychiatry professor Nancy Andreasen discusses some of the chemical imbalance theories of depression in her book The Broken Brain.
One of the theories she describes is the belief that "depression" (what I think should be called simply unhappiness or severe unhappiness) is the result of neuroendocrine abnormalities indicated by excessive cortisol in the blood. The test for this is called the dexamethasone suppression test or DST. The theory behind this test and the claims of its usefulness were found to be mistaken, however, because, in Dr. Andreasen's words, "so many patients with well defined depressive illness have normal DSTs" (pp. 180 182). An article in the July 1984 Harvard Medical School Health Letter reached a similar conclusion. The article, titled "Diagnosing Depression: How Good is the 'DST'?", reported that "For every three office patients with an abnormal DST, only one is likely to have true depression. ... [And] a large fraction of people who are depressed by other criteria will still have normal results on the DST" (p. 5). Similarly, in an article in the November 1983 Archives of Internal Medicine three physicians concluded that "Data from studies currently available do not support the use of the dexamethasone ST [Suppression Test]" (Martin F. Shapiro, M.D., et al., "Biases in the Laboratory Diagnosis of Depression in Medical Practice", Vol. 143, p. 2085). In her 1993 book If It Runs In Your Family: Depression, Connie S. Chan, Ph.D., acknowledges that "There is still no valid biological test for depression" (Bantam Books, p. 106). Despite its having been discredited, some biologically oriented psychiatrists are (apparently) so eager for biological explanations for people's unhappiness or "depression" that they continue to use the DST anyway. For example, in his book The Good News About Depression, published in 1986, psychiatrist Mark S. Gold, M.D., says he continues to use the DST. In that book Dr. Gold claims the DST is "highly touted as the diagnostic test for biologic depression" (Bantam, p. 155, emphasis in original).
In The Broken Brain, Dr. Andreasen also describes what she calls "the most widely accepted theory about the cause of depression...the 'catecholamine hypothesis.'" She emphasizes that "the catecholamine hypothesis is theory rather than fact" (p. 231). She says "This hypothesis suggests that patients suffering from depression have a deficit of norepinephrine in the brain" (p. 183), norepinephrine being one of the "major catecholamine systems" in the brain (pp. 231 232). One way the catecholamine hypothesis is evaluated is by studying one of the breakdown products of norepinephrine, called MHPG, in urine. People with so called depressive illness "tended to have lower MHPG" (p. 234). The problem with this theory, according to Dr. Andreasen, is that "not all patients with depression have low MHPG" (Id). She accordingly concludes that this catecholamine hypothesis "has not yet explained the mechanism causing depression" (p. 184).
Another theory is that severe unhappiness ("depression") is caused by lowered levels or abnormal use of another brain chemical, serotonin. A panel of experts assembled by the U.S. Congress Office of Technology Assessment reported the following in 1992 (The Biology of Mental Disorders, U.S. Gov't Printing Office, pp. 82 & 84):
Prominent hypotheses concerning depression have focused on altered function of the group of neurotransmitters called monoamines (i.e., norepinephrine, epinephrine, serotonin, dopamine), particularly norepinephrine (NE) and serotonin. ... studies of the NE [norepinephrine] autoreceptor in depression have found no specific evidence of an abnormality to date. Currently, no clear evidence links abnormal serotonin receptor activity in the brain to depression. ... the data currently available do not provide consistent evidence either for altered neurotransmitter levels or for disruption of normal receptor activity.
Even if it was shown there is some biological change or abnormality "associated" with depression, the question would remain whether this is a cause or an effect of the "depression". A brain-scan study (using positron emission tomography or PET scans) found that simply asking normal people to imagine or recall a situation that would make them feel very sad resulted in significant changes in blood flow in the brain (José V. Pardo, M.D., Ph.D., et al., "Neural Correlates of Self-Induced Dysphoria", American Journal of Psychiatry, May 1993, p. 713). Other research will probably confirm it is emotions that cause biological changes in the brain rather than biological changes in the brain causing emotions.
IN ALL OF HUMAN HISTORY THERE HAS NEVER BEEN EVEN ONE CASE IN WHICH IT WAS PROVED A PERSON FELT DEPRESSED BECAUSE OF A CHEMICAL IMBALANCE IN HIS OR HER BRAIN
One of the more popular theories of biologically caused depression has been hypoglycemia, which is low blood sugar. In his book Fighting Depression, published in 1976, Harvey M. Ross, M.D., says "In my experience as an orthomolecular psychiatrist, I find that many patients who complain of depression have hypoglycemia (low blood sugar). ...Because depression is so common in those with hypoglycemia, any person who is depressed without a clear cut obvious cause for that depression should be suspected of having low blood sugar" (Larchmont Books, p. 76 & 93). But in their book Do You Have A Depressive Illness?, published in 1988, psychiatrists Donald Klein, M.D., and Paul Wender, M.D., list hypoglycemia in a section titled "Illnesses That Don't Cause Depression" (Plume, p. 61). The idea of hypoglycemia as a cause of depression was also rejected in the front page article of the November 1979 Harvard Medical School Health Letter, titled "Hypoglycemia—Fact or Fiction?"
Another theory of a physical disease causing psychological unhappiness or "depression" is hypothyroidism. In her book Can Psychotherapists Hurt You?, psychologist Judi Striano, Ph.D., includes a chapter titled "Is It Depression—Or An Underactive Thyroid?" (Professional Press 1988). Similarly, three psychiatry professors in 1988 asserted "Frank hypothyroidism has long been known to cause depression" (Alan I. Green, M.D., et al., The New Harvard Guide to Psychiatry, Harvard Univ. Press 1988, p. 135). The theory here is that the thyroid gland, which is located in the neck, normally secretes hormones which reach the brain through the bloodstream necessary for a feeling of psychological well being and that if the thyroid produces too little of these hormones, the affected person can start feeling unhappy even if no problems result from the endocrine (gland) problem other than the unhappiness. The American Medical Association Encyclopedia of Medicine lists many symptoms of hypothyroidism: "muscle weakness, cramps, a slow heart rate, dry and flaky skin, hair loss ... there may be weight gain" (Random House 1989, p. 563). The Encyclopedia does not list unhappiness or "depression" as one of the consequences of hypothyroidism. But suppose you began to experience "muscle weakness, cramps...dry and flaky skin, hair loss ... weight gain"? How would this make you feel emotionally?—depressed, probably. Just as hypothyroidism (hypo = low) is a thyroid gland that produces too little, hyperthyroidism is a thyroid glad that produces too much. Therefore, if hypothyroidism causes depression, then it seems logical to assume hyperthyroidism has the opposite effect, that is, that it makes a person happy. But this is not what happens. As psychiatrist Mark S. Gold, M.D., points out in his book The Good News About Depres-sion: "Depression occurs in hyperthyroidism, too" (p. 150). What are the consequences of hyperthyroidism?: Dr. Gold lists abundant sweating, fatigue, soft moist skin, heart palpitations, frequent bowel movements, muscular weakness, and protruding eyeballs. So both hypo- and hyper- thyroidism cause physical problems in the body. And both cause "depression". This is only logical. It is hard to feel anything but bad emotionally when your body doesn't feel well or work properly. It has never been proved hypothyroidism affects mood other than through its effect on the victim's experience of feeling physically unhealthy.
Some people think chemical imbalance related to hormonal changes must be a possible cause of "depression" because of the supposed biological causes of women's moods at different times of their menstrual cycles. I don't find that argument convincing because I've known so many women whose mood and state of mind was consistently unaffected by her menstrual cycle. Psychology professor David G. Myers, Ph.D., labels premenstrual syndrome (PMS) a myth in his book The Pursuit of Happiness (William Morrow & Co. 1992, pp. 84-85). Of course, some women experience physical discomfort due to menstruation. Feeling lousy physically is enough to put anybody in a bad mood.
Some people believe women experience undesirable mood changes for biological reasons because of menopause. However, a study by psychologists at University of Pittsburgh reported in 1990 that "Menopause usually doesn't trigger stress or depression in healthy women, and it even improves mental health for some". According to Rena Wing, one of the psychologists who did the study, "Everyone expects menopause to be a stressful event, but we didn't find any support for this myth" ("Menopausal stress may be a myth", USA Today, July 16, 1990, p. 1D).
It is also widely believed that women go through a period of depression for biological reasons after giving birth to a child. It's called postpartum depression. In his book The Making of a Psychiatrist, Dr. David Viscott quotes Dr. George Maslow, a physician doing an obstetrical residency, making the following remark: "Come on, Viscott, do you really believe in postpartum depression? I've seen maybe two in the last three years. I think it's a lot of shit you guys [you psychiatrists] imagined to drum up business" (Pocket Books, 1972, p. 88). A woman who had given birth to eight (8) children, which in my opinion qualifies her as an expert on the subject of postpartum depression, told me what she called "postpartum blues" are real, but she attributed postpartum blues to psychological rather than physiological causes. "I don't know about the physiological causes", she said, but "so much of it is psychological." She said "You feel awful about your looks", because in our society a woman is "supposed" to be thin, and for at least a short time after giving birth a woman usually isn't. She also said after childbirth a woman feels considerable "physical exhaustion". Childbirth also is the beginning of new or increased parental obligations, which if we are honest we must admit are quite burdensome. The arrival of new or additional parental obligations and the realization of the negative ways new or additional parenthood obligations will affect a woman's (or man's) life is an obvious non-biological explanation for postpartum depression. It may not be until the actual birth of the child that parents realize how parenthood changes their lives for the worse, but a letter from a female friend of mine who at the time was only three months pregnant with her first child illustrates that depression associated with childbirth may come long before the postpartum period: She said she was frequently breaking down in tears because she thought with a child her life would never the same and that she would be a "prisoner" and wouldn't have time to do what she wanted in life. A reason these psychological causes are often not candidly acknowledged and postpartum (or pre-partum) blues instead attributed to unproven biological causes is our reluctance to admit the downside of parenthood.
Another theory of biologically caused depression is based on stroke damage in the left front region of the brain. What makes it seem possible this might be neurologically caused rather than being a reaction to the situation a person finds himself in because of having had a stroke is stroke damage in the right front of the brain allegedly causing "undue cheerfulness." However, a careful reading of books and articles about neurology for the most part doesn't support the allegation of undue cheerfulness from right front brain damage. Instead, what most neurological literature indicates sometimes results from right front stroke-related brain damage is anosognosia, usually described as lack of concern or inability to know their own problems, not happiness or cheerfulness (e.g., neurology professor Oliver Sacks in The Man Who Mistook His Wife for a Hat and Other Clinical Tales, Harper & Row 1985, p. 5).
Perhaps the most often heard argument is that antidepressant drugs wouldn't work if the cause of depression was not biological. But antidepressant drugs don't work. As psychiatrist Peter Breggin, M.D., says in his book Talking Back to Prozac (St. Martin's Press 1994, p. 200), "there's no evidence that antidepressants are especially effective". Or as British psychiatrist Joanna Moncrieff writes in her book The Myth of the Chemical Cure—A Critique of Psychiatric Drug Treatment (Revised Edition, Palgrave Macmillan 2009, pp. 144 & 152):
...contrary to current opinion, antidepressants are not superior to placebo even in the most severe forms of depression. ... The idea that antidepressants have a specific action on a biological process is still cited as the main justification for the idea that depression is caused by a biochemical abnormality. ... However, the evidence reviewed above suggests that antidepressant drugs do not exert a specific effect in depression.
Psychologist Irving Kirsch, Ph.D., wrote an entire book bebunking the assertion that so-called antidepressants have antidepressant effects: The Emperor's New Drugs—Exploding the Antidepressant Myth (Basic Books 2010). In The Antidepressant Fact Book (Perseus 2001, p. 14) psychiatrist Peter Breggin, M.D., says "The term 'antidepressant' should always be thought of with quotation marks around it because there is little or no reason to believe that these drugs target depression or depressed feelings." There is even evidence that so-called antidepressants make people feel more depressed: According to Dr. Moncrieff, "Evidence suggests that for people without mental health problems, antidepressant drugs are unpleasant to take and make them feel worse. The evidence reviewed in the previous chapter suggests that we have no reason to believe that they elevate mood in patients either" (The Myth of the Chemical Cure, p. 171). Antidepressants are, in other words, a health care scam. Their only possible beneficial effect is placebo effect. This has not prevented drug companies from making billions of dollars selling supposedly antidepressant "medications," however. As California-licensed family therapist Eric Maisel, Ph.D., asks in his book Rethinking Depression (p. 240), "Has the 'mental disorder of depression' been fabricated by the mental health industry to turn human unhappiness and the consequences of human unhappiness into a cash cow? ... You will have to decide if all this mental health labeling is a marvel of medical progress or a variation on the age-old penchant for selling snake oil." Even if so-called antidepressants did help (aside from placebo effect), that wouldn't prove a biological cause of "depression" any more than would feeling better from using marijuana or cocaine or drinking liquor.
"ANTIDEPRESSANTS" ARE A HEALTH CARE SCAM
A careful reading of the books and articles by psychiatrists and psychologists alleging biological causes of the severe unhappiness we call depression usually reveals purely psychological causes that explain it adequately, even when the author believes he has given a good example of biologically caused depression. For example, in Holiday of Darkness: A Psychologist's Personal Journey Out of His Depression (John Wiley & Sons 1982), an autobiographical book by York University psychology professor Norman S. Endler, Ph.D., he alleges his unhappiness or so-called depression "was biochemically induced" (p. xiv). He says "my affective disorder was primarily biochemical and physiological" (p. 162). But from his own words it's obvious his depression was due primarily to unreturned love when a woman he got emotionally involved with, Ann, decided to "wind down" her relationship with him (pp. 2-5) and when he suffered a career setback (loss of a research grant) at about the same time (p. 23). Despite his claims of biochemical causation, nowhere does he cite any medical or biological tests showing he had any kind of biological, bio¬chemical, or neurological abnormalities. He can't, because no valid biological test exists that tests for the presence of any so-called mental illness, including allegedly biologically caused unhappiness (or "depression").
Similarly, in The Broken Brain, psychiatry professor Nancy Andreasen gives the example of Bill, a pediatrician, whose recurrent depression she thinks illustrates that "People who suffer from mental illness suffer from a sick or broken brain [emphasis Andreasen's], not from weak will, laziness, bad character, or bad upbringing" (p. 8). But she seems to overlook the fact that Bill's allegedly biologically caused recurrent depressions occurred when his father died, when he was not permitted to graduate from medical school on schedule, when his first wife was diagnosed with cancer and died, when his second wife was unfaithful to him, when he was arrested for public intoxication during an argument with her and this was reported in the local newspaper, and when his license to practice medicine was suspended because of stigma from psychiatric "treatment" he received (pp. 2-7).
One of the reasons for theorizing about biological causes of severe unhappiness or "depression" is sometimes people are unhappy for reasons that aren't apparent, even to them. The reason this happens is what psychoanalysts call the unconscious:
Freud's investigations shocked the Western world ... Comparing the mind to an iceberg, largely submerged and invisible, he told us that the greater part of the mind is irrational and unconscious, with only the tip of the preconscious and conscious showing above the surface. He main¬tained that the larger, unconscious part—much of it sexual—is more important in guiding our lives than the rational part, even though we deceive ourselves into believing it is the other way around. [Ladas, et al., The G Spot And Other Recent Discoveries About Human Sexuality, Holt, Rinehart & Winston 1982, pp. 6 7]
In An Elementary Textbook of Psychoanalysis, Charles Brenner, M.D., says "the majority of mental functioning goes on without consciousness... We believe today that...mental operations which are decisive in determining the behavior of the individual...even complex and decisive ones—may be quite unconscious" (Int'l Univ. Press 1955, p. 24). A news magazine article in 1990 reported that "Scientists studying normal rather than impaired subjects are also finding evidence that the mind is composed of specialized processors that operate below the conscious level. ...Freud appears to have been correct about the existence of a vast unconscious realm" (U.S. News & World Report, Octo¬ber 22, 1990, pp. 60-63). An article in the June 2011 Psychology Today magazine tells us "Neuroscience has also confirmed another fundamental tenet of psychoanalytic theory—the idea that our motivations are largely unconscious ... 'Neuroscience tells us unambiguously that consciousness really is just the tip of the iceberg'" (Molly Knight Raskin, "The Idea That Wouldn't Die", p. 75 at 83). People's unhappiness or so-called depression being caused by life experience is not always obvious, because the relevant mental processes and memories are often hidden in the unconscious parts of their minds.
DEPRESSED? IT'S NOT YOUR BRAIN. IT'S YOUR LIFE
This critical aspect of human psychology was missed or overlooked in an otherwise excellent book, The Loss of Sadness—How Psychiatry Transformed Normal Sorrow Into Depressive Disorder (Oxford University Press 2007) by Allan V. Horwitz, Ph.D., Professor of Sociology and Dean of Social and Behavioral Sciences at Rutgers University, and Jerome C. Wakefield, Ph.D., D.S.W., Professor of Social Work at New York University. Drs. Horwitz and Wakefield effectively debunk the American Psychiatric Association's concept of depression as a disorder except when there is no obvious cause in terms of life experience. They erroneously assume experiences in life and the thinking that cause sadness will always be obvious and easy to identify and that when no such cause can be readily identified, deeply felt or prolonged sorrow may indeed be a true biological or psychological "disorder" even though they, like all who support the idea of endogenous or biological depression, are unable to identify the supposed non-experiential, biological causes and simply assume such causes must exist.
I believe unhappiness or so-called depression is always the result of life experience. There is no convincing evidence unhappiness or "depression" is ever biologically caused. The brain is part of our biology, but there is no evidence severe unhappiness or "depression" is sometimes biologically caused any more than bad TV programs are sometimes electronically caused. "[T]he question is not how to get cured, but how to live" (Joseph Conrad, quoted by Thomas Szasz, The Myth of Psychotherapy, Syracuse Univ. Press 1988, title page). "When mental health professionals point to spurious genetic and biochemical causes," of depression and recommend drugs rather than learning better ways of living, "they encourage psychological helplessness and discourage personal and social growth" of the sort needed to really avoid unhappiness or "depression" and live a meaningful and happy life (Peter Breggin, M.D., "Talking Back to Prozac" Psychology Today magazine, July/Aug 1994, p. 72).
Eric Maisel, Ph.D.Psychotherapy is not quite a dying profession. But it is certainly a limping profession. Statistics indicate that over the past two decades fewer and fewer clients have gone in for "the talking cure." What's going on?
The typical reasons given for this decline are the following four. First, the pill-popping mental disorder paradigm has made meds more attractive than talk. Second, life coaching has grabbed a significant bit of psychotherapists’ clientele. Third, psychotherapists have done a poor job of branding themselves (compounded by legal restrictions against certain kinds of promising). And fourth, there is some basic passé quality to the whole enterprise, with its long-ago early-nineteenth century flavor.
On top of these, there are other reasons, too, reasons that were always there. For one, it was never really clear what a psychotherapist was supposed to be an expert “at.” Interpreting a dream? Diagnosing a mental disorder? Being a paid listener? Picking a single thing (like a client’s cognitions) as the most important thing or even the only thing to look at? Making wise suggestions? Never making any suggestions? What exactly was this sort of talk supposed to accomplish or even be “about”?
Further, psychotherapy was only attractive to a certain sort of person: basically, to an educated, psychologically-minded person who was willing to talk and willing to reveal. The client had to buy into the basic idea, that sitting, chatting with someone, and telling him or her about what was bothersome was something that made sense to do and was worth doing once a week for fifty minutes (for three hours, really, if you included the commute and the waiting time). So, right from the beginning, there was always a limited pool of prospective clients.
What's more, the staggering range of psychotherapist types, personalities, styles, and basic competences made landing on a therapist who might really serve you quite a crapshoot. Here was a person you were supposed to trust and open up to: and you might get someone wet behind the ears, or trapped on a single note (“And how did that make you feel?”), or not very wise, or icy cold, or downright cruel.
This same variety and eclecticism that made every psychotherapist his or her own gunslinger, one using unsubstantiated Freudian language, another still poring over dreams, a third looking only at cognitions, a fourth rebranding psychological conflicts as spiritual crises, and so on, meant that it was rather hard to believe that there was actually any there there. Didn’t it rather seem like each psychotherapist was just making it up?
Of course, psychotherapy always had one thing going for it: talking to another person can help. That person need not have been a psychotherapist—it could be your brother, aunt, pastor, or best friend—but by and large psychotherapists were good at listening, empathizing, reflecting back, and so on, qualities in short supply among people not paid to exhibit them. That was always what psychotherapy had going for it. But it also had all the negatives I just described; and so, the chickens were really bound to come home to roost.
So, what might now save psychotherapy? Shifting its feet. Rather than promoting itself as expert talk of one sort—expert at “diagnosing and treating mental disorders” or expert at “reducing mental and emotional distress” or expert at “solving problems of living,” it could—and really ought to—promote itself as the best investigative tool around, one that uses the scientific method (by floating hypotheses and checking them out) rather than pretending to be a pseudo-medical enterprise or a medical sub-specialty (which it is not).
If psychotherapy shifted in the direction of promoting itself as the premier investigative tool for understanding emotional health and problems in living, and lived up to that promotion, that would change its footing, putting it on much more solid ground. It would also help therapists better know what they were actually doing in session, in addition to listening: they would be investigating. A great body of knowledge around what constituted smart investigating could grow, all therapists could be trained in something really useful and actionable (ways of investigating), and, insofar as human nature is amenable to being investigated, finally some smart investigating could commence.
I’m calling this reframed, redefined and rebranded version of psychotherapy multi-lens therapy, to put the emphasis on where it ought to have been put all along: not on diagnosing, not on problem-solving, not even on relating (which is a good and lovely thing), but on investigating. A multi-lens therapist would be trained to look at human affairs through twenty-five specific lenses (among them the lenses of original personality, formed personality, trauma, development, family, circumstance, social connection, and life purpose and meaning) rather than reducing the enterprise to the reductionist tactic of “treating the symptoms of mental disorders.” A multi-lens therapist would be trained to accept the largeness of human reality and, as a result, would work more deeply, more powerfully—and more truthfully—with clients.
The enterprise of helping another person through talking is worth saving. It always has been worthwhile and it will always continue to be worthwhile for one person to unburden himself or herself to another person, for one person to seek advice from another person, for one person to use another person as a sensible sounding board. For psychotherapy to distinguish itself from all that, for it to represent a real body of knowledge, and for it to be useful in its own right, it needs to grow and change. It needs to become the home of smart investigating and the place where you come when something human needs figuring out. It is not that yet—but it could become that.