Same Old Story, New Wrapping Paper

Psychiatry has really geared up to resell itself to the public. This recent reselling involves designing a lot of research projects to support a few basic theoretical presumptions. This reselling is called a revolution, only it’s about as far away from any real revolution as you can possibly get. The reason for this reselling is merely to further discredit and taint any and all criticism of the status quo, the orthodoxy, with the suggestion of heresy.

Indicative of this reselling campaign is Thomas Insel, director of the National Institute of Mental Health, issuing a call for “mental illnesses” to be treated as “brain diseases”. We understand why, for insurance purposes, a patient would have “mental illness” treated like a physical disease, but beyond that, the burden of proof should rest on the evidense of research. Making psychiatry mindless has the effect of making it brainless as well.

A recent article in The Economist reflects this reselling venture with all of its pseudo-scientific pretensions. That article is entitled, pretensiously enough, Psychiatric Diagnosis: Thesis, Antithesis, Synthesis.

The aim is to help doctors offer patients the most appropriate treatment. But an important by-product will be that researchers working on the psychiatric drugs of the future will be able to test them in genetically engineered animal models that more closely resemble human reality. The importance of this was underlined by Eric Nestler of the Mount Sinai Medical Centre, in New York, and Steven Hyman of Harvard University in this month’s Nature Neuroscience, when they wrote that drug development for schizophrenia, major depression, bipolar disorder and autism “is at a near standstill”.

Frankenrat is seen as a positive development for the future. Knowing how Pavlov’s dog hasn’t really worked to benefit humankind so much, and if anything such experiments have worked to the detriment of our species, I have serious doubts that Frankenrat is going to prove very beneficial either.

If this drug doesn’t work, theory runs, maybe another drug will. The problem here is that nobody is suggesting that maybe this wonder drug won’t be found. Nobody who is doing the same old same old anyway.

When the danger of medicalization is hit upon, and when doctors are admonished to do no more harm, the article suggests two DSMs, one for the researcher, the psychiatric clergy, and another for the laity, the out and out dumb ass public. Go figure. How dumb do they think people actually are?

To overcome this, there have been suggestions in the past that the DSM should be divided into two: a scientific version, for use by researchers and psychiatrists, and a pragmatic version, for everyone else. Writing in the Psychiatric Times in August, Seyyed Nassir Ghaemi of Tufts University in Boston argued that this was not the answer. It would simply lead to the “gerrymandering” of definitions based on outdated and invalid knowledge.

Actually the science is not as sound as many in the psychiatry and neuroscience departments like to think it is. There would only be a pragmatic version because some psychiatrists don’t want people to see through their deceptions, and because they would like to underestimate and devalue the intelligense of the general public. Perhaps a Dummies Guide To The DSM would to do the trick. We’ve had Dummies Guides to various serious “mental illnesses” for some time now. These Dummies Guides have helped dumb down a lot of people.

The Economist article makes a feeble attempt to end on a comforting note.

In the end, says Dr [John] Krystal, the dichotomy between the valid and the useful may turn out to be a false one. The most commonly prescribed psychiatric drugs are effective for many diagnoses, precisely because those diagnoses have underlying features in common. In his view, society’s demands are not mutually exclusive. Doctors can continue to do no harm, while researchers brace themselves for exciting, and unsettling, times to come.

We’ve got a major problem here. This is bullshit. Doctors do much harm. You’d better brace yourself. They are going to do even more harm in the times ahead.

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