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A psychiatrist criticises the psychiatric publishing industry

Notes on a critique of biological psychiatry by Dr. Niall McLaren

Introduction: Throughout the world today, the dominant approach to mental disorder is what is known as the biological model. This says simply that all forms of mental disorder are, at base, physical disorders of the brain. It does not identify mental disorder – that is determined by the individual society – but it claims to be able to explain all cases of mental disorder as a matter of disturbed brain function. As such, it is an example of what is called physical reductionism, the philosophical system that says that all complex matters can be explained in terms of the subsystems that make them up. In biology, reductionism says that the complex behavior of a large organism can only be understood in terms of understanding the cells that make up the organism. In turn, the functions of a cell can be reduced to matters of biochemistry. Therefore, the correct approach to mental behavior is to analyze it in terms of the cells of the brain, known as neurons. Since, it is claimed, disturbed behavior is always and only due to disturbances of neuronal function, treatment of mental disorder will consist of interventions at the chemical level, meaning using drugs and occasionally physical treatment such as ECT, magnetic stimulation or even brain surgery. Modern psychiatry does not consider there may be other explanations of mental disorder.

 There are, however, many people in the world who are not happy with this idea. It is possible to object to the biological model in psychiatry on a number of grounds:

1. The first and most obvious objection is to deny that mental disorder exists. This is most commonly identified with the Hungarian-born American psychiatrist, Thomas Szasz. Over some sixty years, he has taken a rigid and uncompromising line that there is no such thing as mental disorder, that it is an artificial construct which is of no value to the individuals, even if it helps society (by getting rid of nuisances) and enriches the various mental health professions. However, denial is very much a product of the twentieth century.

2. The oldest objection would be the ancient view that mental disorder has religious significance. People who act strangely are not sick in any accepted sense of the word but are undergoing some sort of supernatural experience which should either be allowed to take its course or should be treated within a strictly religious framework. Disturbed people may be seen as victims of possession by evil spirits, so that treatment would therefore consist of exorcism by qualified practitioners. They may be seen as victims of evil magic of some sort, which can only be countered by correctional incantations and so on. Finally, the experience itself may be seen as a beneficial experience or spiritual journey for the individual, who is encouraged and assisted in the passage for the knowledge the experience may yield. If the altered state continues, the person may even be granted a special status in the society as a person (shaman) who can communicate with or intervene on behalf of supernatural powers in ways that are not open to ordinary members of the community.

In modern Western society, there are only one or two minor groups taking an extreme religious view. Others include the less-defined but still large group of people who see dissatisfaction or unhappiness as a matter of imbalance between the individual and some sort of cosmic ideal, or what are often called New-Age practitioners, even if there is nothing new about it. On the other hand, orthodox Abrahamic religions do not normally encourage religious objections to biological psychiatric treatment, but tend to support it. This is possibly because they see the soul as the direct product of the divinity, meaning that if anything goes wrong in mental life, it cannot be a fault within the soul itself as that would mean the divinity had created a faulty soul. They have no problem with the idea that, if anything disturbs mental life, it must be in the body, because bodies are very faulty. By this means, they can allow people who claim to be the son of god to be treated humanely because otherwise, they would have to be punished.

3. It is possible to object to biological psychiatry on what are called esthetic or moral grounds, the notion that it isn’t fair or decent to lock people in secure buildings and force them to take unpleasant drugs against their will. Essentially, this is a human-centered approach which does not appeal to a divine authority or any force stronger than the question: “How would you feel if this were done to you or your wife/son/mother?” It says that humans are not just cattle but have feelings which have to be taken into account and not crushed underfoot for bureaucratic convenience. The moment words like decent, reasonable, considerate or humane are used, then they are appealing to our esthetic sense of what ought to be done to humans just because they are creatures with feelings. It is, of course, very difficult for these people to argue against the idea that cattle can be treated like cattle just because they aren’t humans, and most of them would not try. Fairness and decency, they would say, are universals which cannot be applied arbitrarily. 

4. People can object to biological psychiatry on the rational basis that any claim about mental disorder being a chemical imbalance of the brain is not a scientific statement because it ignores the notion that humans are creatures with a private but crucial mental life. The psychological model says that mental disorder is a feeling state induced by intrapsychic disturbances in the mind, not chemical disturbances in the brain, and chemistry is therefore only of marginal significance in psychiatric disorders. These days, the analogy that is used is that most problems with computers are not in the hardware but are in the software. Therefore, they would say, the correct form of treatment is not to suppress mental symptoms with drugs because they are important pointers to the actual intrapsychic problems to be rectified, and treatment can only be done via psychological means, essentially talking and learning. Talking and learning are not effective if the distressed person is heavily sedated.

5. More recently, people have been taking objection to the usual methods of biological psychiatry, meaning involuntary institutional psychiatry, on the basis that it breaches the individual’s human rights. This doesn’t say anything about how the mental disorder arises but says that, in a given legal framework, certain activities are illegal and cannot be carried out without the patient’s informed consent. This doesn’t actually prohibit biological psychiatry but places major restrictions on it and forces it to adhere to a particular standard of treatment. The same standard will also apply to psychological or religious treatment, so that disordered people cannot be forced to participate in, say, rebirthing rituals or exorcisms if they don’t like them.

6. Finally, and most recent of all, there are rational-logical objections to biological psychiatry. This is my particular field and it attacks the central notions of biological psychiatry, i.e. that mental disorder can be reduced to a special case of brain disorder. This is not popular among orthodox psychiatrists because one of their strongest arguments has always been: “Ah yes, but we have the science. We have the actual facts about mental disorder and not just silly sentimentalists.” By a lengthy process of analysis of all the claims on which biological psychiatry can logically be based, I have concluded that, in fact, they don’t have the science. I have shown that the central claims of biological psychiatry are false, that it doesn’t make any sense at all when it is examined closely and that it is pure ideology, in the bad sense of the word. My case is based in the philosophy of science, meaning that I use only the same standards of science as are used in all other fields of investigation, and biological psychiatry fails the lot. It is rational in the sense that it takes the predetermined rules of what constitutes a science and applies them uniformly with no favoritism. It is logical in the sense that it dismantles the superstructure of biological psychiatry (all the claims about this drug being better than that, or this group of patients doing better than that, and so on) and looks only at the fundamental claims of the actual model of mental disorder. Of course, it finds that there isn’t one.

Biological psychiatry, which wanted so much to be part of orthodox clinical medicine, is the only medical specialty that doesn’t have a formal, articulated model of pathology (in this case, mental disorder) to guide its daily practice, its teaching and its research. The vast output of the huge academic-pharmaceutical-bureaucratic industry dedicated to finding and treating “chemical imbalances of the brain” is a gigantic exercise in pseudo-science. It is no longer irrational to challenge the scientific basis of modern psychiatry.

Conclusion: Objections to biological psychiatry are valid. This is partly because anybody is allowed to object to any part of western science, because criticism is an essential part of the scientific tradition. If there is no institutionalized criticism, then there can be no scientific progress. It is valid partly because no one group can monopolize the thought processes of a civilization (diversity breeds progress) and also because modern western science makes no claims about mental life qua sentience. Western materialist science cannot handle mentality, so it tries to get it out of the equation.

Any person who sees a psychiatrist is entitled to ask this question: “What is the name of the model of mental disorder you use to guide your daily practice, your teaching and your research? Please give me three seminal references where it is set out as a series of axiomatic propositions which can be tested against the canons of science and which have direct predictive value.” All you will ever get is a frustrated stare, followed by a quick exit.

© Dr. Niall McLaren for biopsychiatry.ca – All rights reserved.

Dr. Niall McLaren is a psychiatrist who lives and works in Australia. He is the author the following books:

 

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Psychiatry – Making a Killing

Source: Truthfultv on YouTube.com


Join my email list and you will be able to join me in free conference calls and ask me your questions about BPD and recovery or for loved ones ways to cope as a loved one or questions about staying or leaving and much more. I will also be having some free conference calls for subscribers to my newsletter on the general topic of mental illness and how you can really empower yourself if you've been diagnosed with a mental illness in ways that can create positive healthy change in your life.