used-car-salesman-psychiatry

A Faux Test for a Faux Disease Promoted by Real Psychiatrists

*Originally posted on Mad in America

“Influential psychiatrists last week called on the NHS to make a faux schizophrenia test available to patients and their families. The condition has never been demonstrated to be genetic, but it’s proving inconvenient to claim otherwise.” — Mental Health Today, March 25, 2019

The stereotype of a used car salesman depicts a person trying to get a naïve person of little means to purchase a heap of garbage through manipulative, dishonest, aggressive, and brash tactics. Everyone knows they’re being taken advantage of, but it becomes an accepted means to an end in a culture built on values of greed and consumerism. Used car salesmen, hated and reviled as they are, get away with their behaviors because they hold enormous power and wear tacky suits that exude authority.

What if people in an ostensibly trusted position were to don the metaphoric used car salesman coat?

On March 22, 2019, Professors Kam Bhui, David Curtis, and trainee Katherine Adlington published an article in the British Journal of Psychiatry, one of the most well-respected authorities on mental health policy and research, advocating the use of theoretical methods and policies based on findings that might one day emerge in order to convince patients and families to comply and agree with their perceived theories and best practices. In other words, they are promoting practices that would amount to lying in order to manipulate people to buy into what they, as psychiatrists, have to sell.

What is most astounding about the actions of these particular psychiatrists is the utter and complete lack of pretense. “We are so certain of our power and righteousness that we are going to tell you to your face that we are lying, and yet, we will still get our way.” In the same vein as the archetypal used car salesman, they dare the public to challenge their powerful hold on people in a less privileged position by not even pretending to be honest.

This brings to mind the storied fable of teaching a man to fish:

Give a man a fish, and you feed him for a day. Teach a man to fish, and you feed a man for a lifetime.

Tell a man that he is genetically incapable of feeding himself fish, and you get a lifetime of dependency to help pay for your lake house on a lake full of fish.

History of lies

The entirety of psychiatry’s history is built upon manipulation of evidence, assertion of truths that are anything but, and efforts to claim and hold onto power and control. Probably the most familiar campaign of lies is that pertaining to the “chemical imbalance theory.”

The theory of chemical imbalances is based on claims that experiences such as depression, anxiety, and even psychosis are a result of an imbalance of neurotransmitters in the brain. Conveniently, this theory first developed in the rigorous research labs of the Pfizer marketing department.

The idea that “antidepressants” had a specific effect on the brain, leading to identifiable and predictable improvements in mood and behavior, was certainly convenient to pharmaceutical companies. It didn’t matter that no one’s brain chemicals ever got tested for their level of balance, and that no standard base for what a balanced brain is existed.

This marketing campaign also provided a steady stream of consumers, willing or not, for psychiatrists. It supported their theories that emotional problems were the result of dysfunction in the brain, and legitimized their profession as a whole.

The problem, of course, is that the chemical imbalance theory isn’t true. That hasn’t stopped professionals from perpetuating the idea anyways.

In an article written by Philip Hickey for MIA in 2014, several eminent psychiatrists are quoted promoting theories of chemical imbalances, brain disease, and the curative nature of psychiatric drugs as fact, despite the lack of evidence for such claims. These “little white lies” were justified by Ronald Pies, MD* as acceptable practices.

While this decades-long manipulation has been increasingly rebuked as the public becomes more informed, it certainly is not the first (and clearly not the last) example of psychiatry’s attempt at social control through dishonest and aggressive tactics.

Emil Kraepelin may be considered the father of the medical model of emotional distress. He popularized the term “dementia praecox” in the early 20th century, as a description of what was being experienced by the mostly poor, minority individuals he was seeing in hospital.

His theory was that these individuals were suffering from an incurable brain disease, aka early dementia, that was genetic and biological in nature. Although he acknowledged at the time that it was not possible to delineate those with this brain disorder from those suffering from “hysteria,” and that no physical pathology could be identified, he nonetheless insisted on the truth of his conceptualization.

This assumption has lived on through the category of “schizophrenia,” despite the known racial biases inherent in this diagnosis, the lack of any specific biomarkers, and the ongoing difficulties of delineating this category from trauma and mood disorders.

Of course, the diagnostic system itself is an example of a set of theoretical assumptions being promoted as facts despite their being anything but. This system is based on a medical concept of categorizing emotional distress, originally considered “reactions” and now called “disorders,” into distinct clusters of emotions and behaviors. They are descriptive labels that have morphed into explanatory models and suggest that concrete entities exist in the brain and might one day be found.

While promoted by most mental health professionals as identifiable entities, they are only loose descriptions of behaviors that lack predictive value, are based on subjectivity, cultural values, biased observations, and general guesswork, lack any clinical usefulness, and are not warranted by scientific research.

Yet, the public continues to be inundated by the lie that “mental illness is an illness like any other” and that these “diseases” can be scientifically diagnosed and predictably treated by trained professionals. The public is being sold a rusted-out jalopy missing a transmission.

Instead of lying, why not look at the actual evidence?

Psychiatrists such as Bhui and Curtis justify their lies and manipulative tactics because they sincerely believe that they are right, and that it’s only a matter of time before they are proven so. This is the same reasoning behind terrorism, religious warfare, and the Pied Piper of Hamelin.

In this, they actively continue to ignore a much greater reality. To continue to rigidly insist that their perception is truth in the face of overwhelming evidence to the contrary is itself delusion at its finest.

Around the same time Kraepelin was promulgating his theories of dementia-raddled brains, Sigmund Freud was developing his theories of psychoanalysis. Originally, Freud observed and wrote about how so many of his patients were suffering the results of childhood trauma and abuse. He recognized how people developed defenses to cope with overwhelming and confusing experiences, and how these defenses were at the root of many of the problems with which people were presenting.

Sadly, this wasn’t so popular among the elite and powerful. Freud shifted his focus to more acceptable ideas, like accusing women of making up sexual assault or, worse, wanting it. This was perhaps best exemplified in Freud’s story of Dora, a 14-year-old girl who saw him and complained of sexual advances from an adult family friend. Rather than validate this girl’s trauma, he instead proclaimed her accusations to be projections of her own sexual fantasies and symptoms of hysteria. His reaction to her vehement disagreement was to further blame her for being disagreeable, declaring her “incurable.”

Nothing has changed.

Despite the ever-increasing evidence that childhood trauma, sexual abuse, racism, poverty, and other adversities are nearly universal in “serious mental illness,” individuals continue to be blamed, ignored, gaslit, and proclaimed sick and incurable.

For instance, 80-90% of individuals diagnosed with borderline personality disorder report overt childhood trauma. Developmental trauma is a major risk factor for diagnoses of ADHD and bipolar disorders. PTSD and psychotic disorders highly overlap, with numbing and avoidance factors being closely associated with psychotic experience. Psychosis is commonly diagnosed in economically deprived areas, minorities and immigrants, and those who’ve experienced childhood abuse and bullying, with an apparent dose-response, causal relationship.

Meanwhile, all the public hears about is faulty genes, glitchy brains, and the need for drugs, more drugs, and even more drugs.

Those who dare to question the heap of trash being fed to them get dismissed through accusations of “anosognosia” — a fancy term that basically means “you don’t agree with me, so I think you’re crazy” — or of being “antipsychiatry,” a term that gets equated with the likes of flat-earthers.

The ways in which adversity and other environmental harms get ignored in favor of the mental gymnastics necessary to promote theories of genetic inferiority are no more pronounced than in the category of schizophrenia. It was only three years ago that researchers were flooding the media with claims that the “black box” of schizophrenia and its biological origins had been discovered.

It boggles the mind that three years ago the genetic basis for schizophrenia had finally been found, and yet in 2019 psychiatrists are outwardly suggesting the need to create public policy built on overt lies because they lack evidence to actually back up their claims.

Huh.

You might want to check beneath the hood of that absurdly cheap BMW being sold to you at cost. It just may be that beneath the surface, it’s actually a 1979 Pinto with an Oldsmobile diesel engine. And, if you dare to drive it, you might find it leads you right off a cliff.

Never hesitate to question authority.

* Editor’s note: Dr. Pies has requested clarification regarding his take on the “chemical imbalance theory” and his use of the term “little white lie.” Dr. Pies offered a link to an article published in The Behavior Therapist, which he states provides a full discussion of the issue at hand. As the statement in question was referencing an article written by Philip Hickey for MIA in 2014, readers may be interested in reading Hickey’s response to Pies’ concern here.