Anyone familiar with Niall McLaren, MD?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Jock

Outstanding!

I've pulled their little fig leaf of respectability off them but it hasn't won me many friends.

Above from your blog if there is one thing the psychiatry hates it is dissent from with in its own ranks. May the wind be at your back.


I know that most men, including those at ease with problems of the greatest complexity, can seldom accept the simplest and most obvious truth if it would oblige them to admit the falsity of conclusions which they have proudly taught to others, and which they have woven, thread by thread, into the fabrics of their lives

Meanwhile, life for the mentally ill just goes on

Spot on!

Members don't see this ad.
 
Last edited:
Hi there-
I wanted to address your criticism that modern psychiatrists are misguided in using the 'chemical imbalance' model to explain depression to their patients.

I'm quite sure this is no longer true..... I must stress that nobody in psychiatry is discounting environmental stress in any psychiatry disorders as they do indeed induce neuroplasticity and direct physical CNS changes. Hence cognitive changes.

http://www.wliw.org/productions/local/healthy-minds/neurogenesis-108/171/
We must be living in different worlds. Where I live, there is a ceaseless barrage of material designed to support the notion that mental disorder is just a special form of brain disorder. My case is that this is not just factually incorrect but logically impossible.
Yes, I do use the expression 'chemical imbalance' as a shorthand for "all those notions that the full complexity of mental disorder can be directly reduced to a matter of brain disorder according to the principles of ontological reductionism as used in the rest of medicine and that the principles of disease as clearly understood in reductionist medicine apply directly to psychiatry with no loss of explanatory power." You see now why I use the shorter expression.
I am aware of the various chemical, physiological, pathological, genetic, epigenetic and other changes which, from time to time, are touted as yet another breakthrough in the causation of mental disorder and my case is that, individually and collectively, they are fundamentally and irredeemably wrong in their nature. Mental disorder, I have argued at very great length, is a matter of primary psychological distortions. Mental disorder is not and can not be a case of secondary disturbances of neurophysiology.
I have argued that, the depressed brain is not a sick brain in any meaningful sense of the word 'sick.' Can I make my position any clearer? The brain in depression is a healthy brain generating unpleasant mental states, but that's what brains do. I can be angry, or sad, or frightened, or confused, or driven to repetitive behavior, or obsessed with philosophy and religion to the point of failing to function, and there is no a priori reason why my brain should be in a pathological state. It is the mental state that is disturbed. I can use my computer to generate gobbledegook and it is still a perfectly healthy computer.
I have outlined in considerable detail a molecular resolution of the mind-body problem which takes into account the various changes in brain function in mental disorder. Nobody who has heard that presentation has faulted it.
Also, remember I've been hearing this Brave New World stuff for 41 years. We're no closer to a chemical understanding of the mind that we were when I had my first lecture in psychiatry as a medical student in 1969. How long can we live on promises?
I'm planning my next trip to the US for late Sept-early Oct. If you want to hear it, let me know where you are and we may be able to meet.
Meanwhile, listen to this for a fairly provocative interview:
http://www.blogtalkradio.com/ajmaha...iatry-and-biology--is-it-science-dr-niall-mcl
 
Mental disorder is not and can not be a case of secondary disturbances of neurophysiology.
I have argued that, the depressed brain is not a sick brain in any meaningful sense of the word 'sick.'

Hmm,

What about depression as a result of hypothyroidism, Vit B deficiency, or traumatic brain injury?

The brain in depression is a healthy brain generating unpleasant mental states, but that's what brains do.

Setting depression that may be the result of a general medical condition aside, chronic depression leads to a decreased level of brain derived neurotrophic factor, which in turn leads to atrophy of the hippocampus.

Depression also increases the rate of cortisol release, that in turn also causes damage to the hippocampus. That's just the tip of the iceberg. It does a heck of a lot more things that have been validated in studies including setting off the inflammatory pathways in the body, disrupting REM patterns, etc.

I'd call that more than simply an "unpleasant" experience. Would you call a brain with an atrophying hippocampus healthy?

We're no closer to a chemical understanding of the mind that we were when I had my first lecture in psychiatry as a medical student in 1969. How long can we live on promises?

I disagree. I do highly respect some of your criticisms of psychiatry. Ours, as any field, requires that people challenge the paradigm if we're going to push ahead. The statement however that we're no closer, when taking into consideration several of the advances made in the field in the past few decades IMHO is not true. Just one example, Eric Kandel's achievements in the field of neuroscience have advanced our field.
 
Last edited:
Members don't see this ad :)
Above from your blog if there is one thing the psychiatry hates it is dissent from with in its own ranks. May the wind be at your back.

Can you identify what justifies this statement?

What is this "psychiatry" that you speak of that appears to elicit the emotion of "hate" when there is dissention? It appears you've personified the entire field of psychiatry on an emotional level.

Since psychiatry is field, not a person that experiences hate, how about you name specific people that may fit in the category you mention, and with evidence? Wouldn't that be more productive?
 
My case is that this is not just factually incorrect but logically impossible.

I am aware of the various chemical, physiological, pathological, genetic, epigenetic and other changes which, from time to time, are touted as yet another breakthrough in the causation of mental disorder and my case is that, individually and collectively, they are fundamentally and irredeemably wrong in their nature.

Mental disorder is not and can not be a case of secondary disturbances of neurophysiology.

It is indeed a matter of fundamentals.

In one corner you have numerous empirical studies and findings via peer review process throughout the world, which are supported by a Nobel laurete winner. On the other corner is a small group of individuals who make their case via years of anectodotal evidence, personalized logic and intuition. Most of these individuals have no experience at academic institutions let alone having conducted observational studies.

Galileo was well published but he also built a telescope and charted the stars. Columbus obtained a few boats and sailed the oceans to prove that the world was not flat. They were proven right because they did more than just talk the talk.
 
Whooper

First I take what I believe is your general point. Yes, even though internet fora are not academic journals the discourse often leaves a lot to be desired. Dip your toe in hear to see how it should be done

http://forums.philosophyforums.com/threads/debates-forum-parameters-7968.html

(clearly I jest, I am only interested in other peoples ideas and how they relate to my own. I'm not prothletiseing, I don't have fixed ideas anyway, just a general disposition.)
How ever this is just a forum and Niall's blogg, from which I have picked a quotation is just a blogg.

To the specifics:

Ibid - Above from your blog if there is one thing the psychiatry hates it is dissent from with in its own ranks. May the wind be at your back.

Whooper - Can you identify what justifies this statement?
*

Yes, look no further than Nialls own blogg.

Hi, my name is Jock McLaren and I am a psychiatrist in Darwin, in Australia's last frontier, the Northern Territory. Because I live and work so far from the bright lights of civilisation, I need something to keep me busy at night. Many years ago, I wanted to know what was the proper, scientific form of psychotherapy, so this eventually led me to the philosophy of science.*It soon led me to realise that psychiatry has no rational basis, meaning it isn't a science. Unfortunately, this doesn't endear me to my colleagues, because other psychiatrists like the idea of being seen as part of the scientific medical establishment. It's much better than being seen as a "trick cyclist." I've pulled their little fig leaf of respectability off them but it hasn't won me many friends.

So that is exhibit one. "Their" in the sentence I reproduced, I think clearly refers to the "psychiatrists…who would see themselves…as part of the scientific establishment". You would have to read the blogg and decide if the person Niall names are to be considered worthy representatives of the psychiatric establishment. They seem so to me.

Implicit in my post is an acknowledgement that psychiatry is a broad church. It's not me that needs convincing of it rather look to other poster who seem blissfully unaware that there are fundamental and substantive differences with equally impressive intellectual traditions that stand behind them.

Having dealt with that ,the notion of hate, and you have been a bit cheeky here if I may say so, you can easily hate an idea for perfectly logical reasons and it does not need to imply an emotional response. Not towards the idea or towards the person. Saying I am being unproductive by pointing out a personal belief and imputing that that is somehow emotional could reasonably be construed as an attempt to devalue my point rather than address it specifically.

The fact is that I have done exactly what you suggest in other posts.

The work of Joanna Moncrieff Consultant Psychiatrist and lecturer at University College London is in my opinion impeccable and respectable science. You could say she walks the walk. Some of her work here on Pub Med.*

http://www.ncbi.nlm.nih.gov/pubmed?t...JOANNA[au]

And here below she responds to critical analysis of her work with out throwing her toys around. (If you do have a look clicking read all rapid responses helps)

http://www.bmj.com/cgi/content/extract/331/7509/155

I submit the idea that they "hate" her ideas. Attempted discussion of her work, on this forum has led, foolishly, to her being called a scientologist, and rather ironically a hail of "emoticons" that would make a teenage girl who has just been jilted proud.

I am not perfect and when I have been accused of being offensive I have apologised. I can't do more than that.

Thank you for the question. Drilling down a bit further one of the "criticisms" of some sections of the psychiatric profession, is that they attempt to engender a notion of cohesiveness in the profession that is not really true. This has the effect of promoting a notion of otherlyness (not a real word, I know) in the people they would seek to help. I have observed this over the years and I suggest it begins at the start of medical school and never really ends unless the student/Dr. wills it or I would say matures. I present no evidence, it is merely a personal observation.

Again, thank you and good day. Your reflections are always enlightening.
 
Last edited:
Galileo was well published but he also built a telescope and charted the stars. Columbus obtained a few boats and sailed the oceans to prove that the world was not flat. They were proven right because they did more than just talk the talk.


Snafer

Instructive. Galileo was indeed proved right. It is also worth pointing out that the church didn’t deny he was right they just threatened to excommunicate him if he kept talking about his ideas.

Columbus again proved himself right, going against the conventional wisdom of the time. Another good lesson.

Alchemists wrote the first periodic table while they searched for a way to turn any metal into gold. A bitter pill but I don't hold it against them. I bet they got really cross when challenged though.

Like all good stories it is the way you tell them that counts.
 
The work of Joanna Moncrieff Consultant Psychiatrist and lecturer at University College London is in my opinion impeccable and respectable science. You could say she walks the walk. Some of her work here on Pub Med.*

.

Not sure where the 'science or work' is here. A quick review shows a handful of hypercritical editorial or meta analysis type papers attacking SSRI, neuroleptics, research methologies etc.. The biostats she uses to 'analyze' seem a bit odd.

Seems like a lot of rhetoric to me.
 
Instructive. Galileo was indeed proved right. It is also worth pointing out that the church didn’t deny he was right they just threatened to excommunicate him if he kept talking about his ideas.

Columbus again proved himself right, going against the conventional wisdom of the time. Another good lesson.

Alchemists wrote the first periodic table while they searched for a way to turn any metal into gold. A bitter pill but I don't hold it against them. I bet they got really cross when challenged though.

Like all good stories it is the way you tell them that counts.

Not sure if you understood my points here. I will be happy to clarify further if you IM me.
 
What I really don't understand is the trend towards unproductive bifurcations in this discussion. Of course not all of mental illness is the result of immutable genetic code. Of course psychology plays a large role in mental illness. I don't really think there are many mental health professional who would disagree with this.
But it is also impossible to deny that biology also plays a huge role in any of these disorders. The high rates of heritability for many psychiatric conditions, especially the more serious ones like bipolar and schizophrenia, showcases this. If I have a twin with schizophrenia, in general I have about a 50% chance of developing the disorder myself. That seems like a pretty good argument for the role of biological AND psychological/environmental factors (After all, it's only a 50% chance) in mental illness. It just seems ridiculous to propose that it's either psychology or biology. I feel like this shouldn't be a controversial position.
 
Ibid, fair response.

Wow, my opinion of Dr. Mclaren changes with each new post. I do think several of his criticisms are worth serious consideration. I can't, however, accept that a trained psychiatrist believes that depression is a healthy brain that merely gives off some unpleasant thoughts. There's plenty, plenty, plenty of data, not theory, that shows this is not true.

I don't believe in throwing out the baby with the bathwater. I will try to take some of the doctor's points that I believe are valid seriously. I do think, however, that if he's having trouble with people accepting his ideas, with statements that depression is a simply a healthy brain giving off unpleasant thoughts is one of the reasons why.
 
Members don't see this ad :)
What I really don't understand is the trend towards unproductive bifurcations in this discussion. Of course not all of mental illness is the result of immutable genetic code. Of course psychology plays a large role in mental illness. I don't really think there are many mental health professional who would disagree with this.
But it is also impossible to deny that biology also plays a huge role in any of these disorders. The high rates of heritability for many psychiatric conditions, especially the more serious ones like bipolar and schizophrenia, showcases this. If I have a twin with schizophrenia, in general I have about a 50% chance of developing the disorder myself. That seems like a pretty good argument for the role of biological AND psychological/environmental factors (After all, it's only a 50% chance) in mental illness. It just seems ridiculous to propose that it's either psychology or biology. I feel like this shouldn't be a controversial position.

First off, it's a matter of degrees. How much is nature and how much nurture.

Second, the heritability of schizophrenia in twins (based on research) is not as strong of an evidence as you are suggesting. If you look at adopted twins who were raised in very different environments and discover a similar biological makeup, what have you proven? It only becomes important if you situate the "mental" illness in the biological makeup. To say that both react to the world in somewhat similar manner does not mean they're mentally ill. So what I'm saying is that it depends on how define mental illness and where you look for causation.
 
First off, it's a matter of degrees. How much is nature and how much nurture.

Second, the heritability of schizophrenia in twins (based on research) is not as strong of an evidence as you are suggesting. If you look at adopted twins who were raised in very different environments and discover a similar biological makeup, what have you proven? It only becomes important if you situate the "mental" illness in the biological makeup. To say that both react to the world in somewhat similar manner does not mean they're mentally ill. So what I'm saying is that it depends on how define mental illness and where you look for causation.

That it's a matter of degrees I'm certainly not disputing. The nature versus nurture dispute has been solved really, with both taking the prize (to different degrees for different traits of course). In that it seems like we agree.

I'm rather confused about your next point though. If I look at adopted twins raised in separate households, and over the whole population the concordance rate is ~50%, then I think you have a very strong case for the influence of biology/genetics on mental illness. Now believe me, I understand that most DSM-IV diagnoses can be vague and heterogeneous, but that's a whole other debate. Leaving even that aside, if I prove that they "both react to the world in the same way), I have simply proven that genetics play a role in (abnormal) behavior, and therefore what we call mental illness. But again, not quite sure if I got your point.

My memory of this subset of the literature is a little foggy, so it's possible I'm just missing what you're saying because of that. There are plenty of people on this thread with much more knowledge in this area than I. If so, my apologies. However, all that I'm arguing is that seeing psychiatric disorders as either solely biological or psychological in nature is foolish. Anyone who claims that either biological psychiatry or psychodynamics hold the sole answer for any disorder is certainly missing a valuable part of the whole picture.
 
Last edited:
Ibid, fair response.

Wow, my opinion of Dr. Mclaren changes with each new post. I do think several of his criticisms are worth serious consideration. I can't, however, accept that a trained psychiatrist believes that depression is a healthy brain that merely gives off some unpleasant thoughts. There's plenty, plenty, plenty of data, not theory, that shows this is not true.

I don't believe in throwing out the baby with the bathwater. I will try to take some of the doctor's points that I believe are valid seriously. I do think, however, that if he's having trouble with people accepting his ideas, with statements that depression is a simply a healthy brain giving off unpleasant thoughts is one of the reasons why.

My position is clearly stated: Mental disorder is primarily a matter of psychological states and secondarily a matter of everything else. Biologically determined depressive states are definitely uncommon and are easily distinguished from the great bulk of people exhibiting pathological sadness. Grief itself is psychologically determined but must have some biological substrate, just as all emotions do. Anxiety we accept as wholly psychological in origin. Chronic anxiety leads to depression, there is nothing contradictory in that claim.
I do not have a problem with the idea that prolonged states of intense emotion have some measurable effect on the brain but they are not primary, they are secondary. Also, most if not all would self-rectify if and when the abnormal emotional state returned to normal. The question to answer is not: What is the state of the brain at the end of years of terror or misery? but this: What started it? If we treat the end result but leave the causative factors intact, then the problem will start all over again as soon as the treatment stops. This is almost certainly why people are now saying that depression is a chronic disorder. Anything is a chronic disorder if you leave the etiological factors in place.
The question I ask psychiatrists is: "What is the name of the scientific model of mental disorder that you use in your daily practice, teaching and research? Give me the name and three seminal references so that I can check its logical status." I cannot get an answer. In Canada, they say "the biopsychosocial model," but that does not exist, Engel never finished it. In USA, they say biological psychiatry, but where is it written? Point me to the definitive statement which sets out the theory of biological psychiatry as a series of testable propositions. All a mystery to me.
Somebody mentioned a Nobel prize-winner as supporting the biological approach. Please, not Eric Kandel. Biological reductionism doesn't work. Why is everybody so edgy about the notion that mental disorder is psychologically determined? Of all people in the world who have an interest in matters mental, only psychiatrists are still holding tightly to their biological reductionism.
To go back to the quote at the top, "depression is a healthy brain that merely gives off some unpleasant thoughts" Do you find anything contradictory in the idea that depression is a reaction to prolonged, intensely painful perceptions? I don't. I accept that it has a biological substrate but all emotions do, that is why they are deemed output states and not primary. I saw a 44yo fireman today who has lost his career after an accident. Because he values physical prowess so highly (OK, he's a bit narcissistic), the effect has shattered him. He started drinking, his wife left him. Now he has sunk into a severe depressive state. Why does that have to be seen as a primary brain disturbance, as distinct from a valid reaction to life events?
He has been told he has a chemical imbalance of the brain by a professor of psychiatry. That statement pushed him to suicidal despair. Being told there is nothing wrong with his brain has (initially) given him some hope that he may have a life. We'll see. But you can't put men like that on huge doses of drugs, they just curl up and die.
Anyway, if somebody could just let me know the name of the model of mental disorder you were taught, I'd be very interested to hear it. In all my time in psychiatry, I've never come across it and nobody in this country can tell me.
 
Evidence based

I take your general point and agree you need the whole picture but on this point…

If I look at adopted twins raised in separate households, and over the whole population the concordance rate is ~50%,

50% even if you accept the bulk of the studies is not the number they suggest. It is in the 9 -16% range as people who have gone back over the data have demonstrated.

50% has just become part of folklore. That aside and why it keeps appearing in text books is another matter.

All these studies you allude to are confounded not just by the poor analysis of their own statistics but methodological flaws. Not addressing the environmental equivalence assumption being the main one. Back fitting of data (diagnosis) seems to have been a problem, not dealing with time of placement issues, non blinded diagnoses and zygosity are others.

If some one posited that most of these studies were junk or that the other interpretation of them is that they really do more to support an environmental etiology rather than anything else I would probably agree.
 
Evidence based

I take your general point and agree you need the whole picture but on this point…

If I look at adopted twins raised in separate households, and over the whole population the concordance rate is ~50%,

50% even if you accept the bulk of the studies is not the number they suggest. It is in the 9 -16% range as people who have gone back over the data have demonstrated.

50% has just become part of folklore. That aside and why it keeps appearing in text books is another matter.

All these studies you allude to are confounded not just by the poor analysis of their own statistics but methodological flaws. Not addressing the environmental equivalence assumption being the main one. Back fitting of data (diagnosis) seems to have been a problem, not dealing with time of placement issues, non blinded diagnoses and zygosity are others.

If some one posited that most of these studies were junk or that the other interpretation of them is that they really do more to support an environmental etiology rather than anything else I would probably agree.

I would genuinely like to see any of the literature supporting this. I have not seen anything in this range (9-16%), but would be very very interested to see any journal articles that posit that.

That being said:
http://www.ncbi.nlm.nih.gov/pubmed/10025441
(Twin concordance rates of ~40%)
http://www.ncbi.nlm.nih.gov/pubmed/10813799
(Twin concordance rates of 30-40%)
http://www.ncbi.nlm.nih.gov/pubmed/1853734
(48% concordance rate)

Etc etc. So you're right, it's not exactly 50%. Believe me, I'm onboard for the environmental contributions to psychosis. I'm just also oboard with biological contributions as well.
 
Very, very dualist. That would cause a problem with the materialist-monist bent of... all medicine and science.

Whether or not dualism is right (again, the standard functionalist view does seem more likely), it's essentially scientifically likely to be unprovable. It seems odd to challenge psychiatry practice on whether it is really a science-based practice, and at the same time having a main criticism be based on dualist theory.

You would be right, that if dualists are right, some of the psychiatric models would be invalid. But considering that functionalist models are held more commonly among philosophers of mind than dualist ones (nevermind other non-dualist theories such as reductive materialism), it would seem to be a poor starting point to challenge a whole practical applied field of science based on what is generally considered an unsettled question in philosophy. Cart before the horse and all that.

Again, your arguments do sound theoretically interesting, but it really seems that they would be at best laying groundwork to build an eventual practical critique after creating a body of work that shows how to apply your theories (with strong experimental evidence) as an alternative to current psychiatric practice. You seem to be missing steps, but I'd be interested to see if you follow them. I still find it likely that a functionalist view will ultimately win out in terms of practical utility.

The whole misunderstood persecution thing doesn't help your arguments, and it sort of makes it harder to take you seriously as a philosopher though.
 
Dr. Mclaren.

You lost me, but this time it's not something on the order of perhaps I don't understand you.

Mental disorder is primarily a matter of psychological states and secondarily a matter of everything else.

No, several psychiatric disorders are a chicken and egg situation. No one is sure in many respects if the disorder is the product of environment, or if it's physiology (genetic predisposition among other biological factors) or a mixture of both.

Anxiety we accept as wholly psychological in origin. Chronic anxiety leads to depression, there is nothing contradictory in that claim.

No. It could be due to physiology as well. Pheochromocytoma, stimulants among several other things can cause anxiety.

I do not have a problem with the idea that prolonged states of intense emotion have some measurable effect on the brain but they are not primary, they are secondary.

Of course this is true in some cases. This is not 100% known to be true in all cases. Some people become depressed when there is nothing clearly point-able as a cause of depression in a clinical sense.

The problem I'm seeing here is that you're reducing depression to a specific phenomenon that it does not perfectly fit into, then making a conclusion that only works if your assumption would have been correct.

I do agree with the following statement, given if it is assumed the depression is as you state not truly physiological in it's primary causation....

If we treat the end result but leave the causative factors intact, then the problem will start all over again as soon as the treatment stops.

In fact, I see this problem all too often. If we give an antidepressant to a person who is depressed, as a result of chronic and difficult stressors, and those problems are still there, well it's just as you state.

But, this is not all the cases. I have several patients who have been chronically depressed and/or suicidal when they could not point to any specific problems that one would typically associate with driving someone to that extreme.

And even in the cases that appeared to be a result of environment, antidepressant treatment does give benefits worth their while. Restoration of brain derived neurotrophic factor, protection of the hippocampus against atrophy, improvement in concentration, memory, reduction of suicidal ideation, calming of the inflammatory pathways, restoration of REM patterns, among several other factors are all improvements that are worth it. Yes, the stressors are still there, but at least the person can deal with those stressors on a better level.

Please, not Eric Kandel.

Why not? Kandel's work was monumental, well done, and did advance our understanding of the brain past the example you brought--when you were last in medical in the 1960s.

I saw a 44yo fireman today who has lost his career after an accident. Because he values physical prowess so highly (OK, he's a bit narcissistic), the effect has shattered him. He started drinking, his wife left him. Now he has sunk into a severe depressive state. Why does that have to be seen as a primary brain disturbance, as distinct from a valid reaction to life events?
He has been told he has a chemical imbalance of the brain by a professor of psychiatry. That statement pushed him to suicidal despair.

I very much agree with you that several cases are should not be reduced to biological reductionism. However, some cases can be very much improved with just medication, though not all. In the above case, it certainly seems the psychosocial factors are very important.

But you can't put men like that on huge doses of drugs, they just curl up and die.

Well, I'm not treating him, but medications could help. I certainly agree that one should not simply just give him a pill and then let it be. I would think a case like this requires much more than that. An antidepressant, however, could be part of the process, along with several other things.

Anyway, if somebody could just let me know the name of the model of mental disorder you were taught, I'd be very interested to hear it. In all my time in psychiatry, I've never come across it and nobody in this country can tell me.

The model I use in the one in the DSM, and the one in Kaplan and Sadock.

I actually salute your approach. IMHO too many doctors throw a pill at the problem, don't treat the patient as a whole person, and use as you call it "biological reductionism" in everything.

But I do disagree with how you categorize depression and anxiety. I've seen too many people be depressed, yet cannot point to specific stressors, or even don't want to do anything about their stressors because they can't, or choose not to do so.

As for anxiety, even if it's very much the product of environment, giving antidepressant therapy, to at least stabilize the condition faster, in addition to psychotherapy IMHO is a good thing in many cases. I've always educated patients with several anxiety disorders that once their anxiety is stabilized, and after several months of stability, that we could see if they could cope on less medication, and possibly none at all, I leave it up to the patient.
 
Last edited:
Evidence Based

Apologies for the late reply. It took me a while to find what I was looking for and I wanted to read them through before pasting.

The first link is a salutary lesson for the wiki generation. The second link is where I took from memory my figure which should have been as high as 21%. Table 2 on page 78.


Joseph, J. (2000). Inaccuracy and Bias in Textbooks Reporting Psychiatric Research: The Case of the Schizophrenia Adoption Studies. Politics and the Life Sciences, 19, 89-99

http://jayjoseph.net/yahoo_site_adm...ticle_Pol_and_the_Life_Sciences.163190937.pdf


Joseph, J., & Leo, J. (2006). Genetic Relatedness and the Lifetime Risk for Being Diagnosed with Schizophrenia: Gottesman's Figure 10 Reconsidered. Journal of Mind and Behavior, 27, 73-89.

http://jayjoseph.net/yahoo_site_admin/assets/docs/Joseph_Leo_2006_Article.159111451.pdf
 
Hi and thank you for taking the time to read my comments and think about them. I can't deal with each point you make, many if not most of them are addressed in my publications.
It is important not to change the topic mid-stream, I am talking about the causation of mental disorder, not the treatment. My case is that human mental function cannot be reduced to matters of brain chemistry either in health or mental disorder. This puts me directly opposite the mainstream, including people such as Eric Kandel, who claim that all human mental life can be explained in biological terms. Not so. Interestingly, not one of them will attempt to justify the claim, which therefore becomes ideological. I am not aware of a serious philosopher in the world who supports biological reductionism these days. In philosophy, it is soooo 50s. What does that prove? It proves we should be careful before accepting it.
However, you are making a couple of fundamental mistakes. Arguing from phaeos to all anxiety is one of the informal fallacies of classic logic, known as Converse Accident. In English, that means 'hasty generalization,' taking a single, unusual case and concluding that it leads to general truths about all similar cases. In formal terms, if one A is B, that does not prove that all As are B. Tell me something about phaeos that is true for all anxiety?
Same goes for depression. 99% of the depression I see (and I see about 400 individual patients a year) is not biologically determined. Sure, quite a few of them have injuries (that's just the nature of my practice) but their depressed mood is a psychological reaction to the injury. I do use antidepressants but very little compared to the national average (we have all those figures available from the national prescribing service) I do not use 'mood stabilizers,' rarely admit people to hospital and never use ECT. Yet my patients are at least as disturbed as any you will see in a major hospital setting anywhere in the world. Are you interested in learning how to do that? You may be, but I can tell you, your professors aren't. They are angered by those figures, deny that they can be true. yet the figures are all there, we have very good statistics in this country.
Eric Kandel has not PROVEN that mind can be reduced to brain. Granted, he is convinced it can happen but conviction is not good enough. We want proof, and he adamantly refuses to attempt to offer it. In fact, I don't think he has to. He is now very old, he has established his name, so let one of the bright young things coming along do it: Prove that all mental disorder can, as a matter of logic, be reduced to a matter of brain pathology. Meantime, have a look at my criticisms of his version of biological reductionism, chap 1 of my second book.
What else have you said? Oh yes, you have patients who don't seem to be able to point to a cause of their disorder. Well, we all have them. Haven't you heard of unconscious causation? The idea has been around a long time. Unconscious (= less than full awareness) causation is consistent with a cognitive model of mental disorder. The therapist's role is to bring those ideas to full awareness, where they can be dealt with. But that doesn't prove their disorders are biological, it just says that mental disorder is fairly complicated and should be left to people with proper training.

DSM is not a model. It is a nosology. If you have a look at the introduction, it says they deliberately tried to be atheoretical (not so, as the example of PTSD shows). Their categorical approach only makes sense in a biological context; a psychological model of mental disorder says that all parameters are dimensional, not categorical, see my crit. in Chap 7 of book I.
Last time I looked at Kaplan and Sadock, there was no model of mental disorder, i.e. a set of testable hypotheses which explain the phenomena of mental disorder in terms removed from the field of observation. Freud's model was a model of mental disorder, it just happened to be wrong. Biological reductionism is a model of mental disorder, my case is that it is also wrong.

The second error I see in this thread goes to the heart of my complaints against the psychiatric establishment. Where are the young people who are doing their scientific duty in criticizing the prevailing models? Criticism is the engine of scientific progress; where in your medical training were you taught to criticize your professors? We certainly weren't, we had to step aside when they walked past. Yet they seem to believe they have mental disorder on a short rope, it's only a matter of time before it all falls into the out tray, cured. I heard that from psychoanalysts, all those years ago, then they were dumped. Then the behaviorists had their day, we all had to learn Skinner and Eysenck and Wolpe and all the others, then they fell by the wayside. Psychiatry rushed to embrace biological reductionism as the CAUSE of all mental disorder, but the case was never argued. When it is examined, as so many people have done, it is found wanting. So, Dr Whopper, as a young scientist, your job is to criticize what your professors are saying, not to swallow it in one gulp. Question them, demand they prove their case. You won't be liked, but science is not a popularity contest.

The important thing is for young psychiatrists to show that they have absorbed the scientific ethos, to take whatever they are taught and attempt to pull it to bits. Simply parroting what the professors say may be good for passing exams but that wasn't what Galileo a place in the history books. It is clear that Dr Whopper thinks about his work; that is so much better than the legions of psychiatrists who just memorize DSM, prescribe huge doses of drugs and rush off to golf. Just for the record, I started off wanting to be a psychoanalyst; a few months in psychiatry proved to me that neither they nor the mainstream biological psychiatrists could answer my questions about the causation of mental disorder. That led me to the philosophy of mind, then to philosophy of science, and thence to a radical view. It is my duty to put my views forward in a coherent manner, the duty of the profession to analyse them and criticise them. That's how science progresses.
 
Jay Joseph is a top thinker. Look at:
"The Gene Illusion: genetic research in psychiatry and psychology under the microscope."
ISBN 087586 344 2.
"The Missing Gene: psychiatry, heredity and the fruitless search for genes."
ISBN 087586 410 4.
Also Alvin Pam wrote a powerful crit of genetic research in schizophrenia many years ago, probably 1992 or so, published as a supplement in Acta Psychiatrica Scandinavia.
In the same vein, has anybody NOT read:
Horwitz and Wakefield, The loss of Sadness: how psychiatry transformed normal sorrow into depressive disorder? This should be compulsory reading in any training course.
 
Red Beard, it's very good to hear that you're interested in Dr McLaren's work. I'm a 4th year medical student and I plan on going into psychiatry. I randomly found this author a couple years ago and been following him since. His insights are groundbreaking and his understanding of philosophy profound.

Hmm . . . I read your long post, Cstruble, and skimmed your articles, but frankly I don't see the big deal. I don't see a huge conflict between Niall's ideas and psychiatry and psychology as I know it; I don't see why he or you think these ideas are a profound attack. I have a psychology degree and am now going into psychiatry, and what I love about both fields is the openness and the pluralism of ideas. It's strange that Niall criticizes the field both for not being open to his ideas and for not having a unified guiding principle . . . you can't be both open to new ideas and have all the answers already. It just doesn't work. I'd rather be in an open field that is in flux as new information is found, new discoveries are made, new treatments are invented. That is psychiatry as I know it.
 
Pardon me for a potentially pessimistic, jaded question, but: Cstruble, are YOU Niall? You seem to admire this one person a little overmuch.

Nah, not Niall although I know his writings extremely well. I'd need to be 35 years older and 5k books better read, haha. I started reading his work early in medical school, checked his references and found his conclusions to be objective and accurate. I have no doubt that in the future he'll be regarded as the Chomsky of psychiatry. If you read more you'll also notice that he is absolutely not anti-psychiatry in any way (he has recently written a paper criticizing Szasz's writings, this may not be published yet but look for it in the future). While he contends that we're overprescribing medications he does not advocate not using medications, just using them judiciously with the end goal of medication removal after stabilization.
I may seem zealous but more people need to take his writings seriously as the current paradigm in psychiatry leaves much to be desired (especially from an outcomes perspective). Robert Whitaker has laid out a devastating case showing the poor outcomes with meds in his recent book "Anatomy of an Epidemic." My original read was enlightening and now I'm checking Whitaker's references. So far Robert's conclusions are in line with what I've read of his references. I'd be very curious to see what other posters think of "Anatomy's..." conclusions.
 
Narcissists and their followers. :rolleyes:

Just looked at the posts here and it was interesting to see crocodile dundee's interaction with the rest of the others as well as his self promotion.

What a marooon!
 
Of the "antipsychiatrists" I've seen so far, Mclaren is the least out there. Breggin totally lost credibility and then went on the order of propagandist, IMHO, when he started writing that liberals were "delusional" and gave speeches on the order of pure political propaganda. A youtube video showing this was later removed. I wonder if it was because Breggin realized it only hurt his credibility, of which he barely had.

Szasz has no credibility either. If he were truly intellectually honest, he wouldn't be associated with CCHR. A true physician would not resort to the below the belt presentations and misrepresentation of data. E.g. CCHR alleges that Osama Bin Laden was converted to a terrorist by psychiatry.

Mclaren? I disagree with him but he's on the order of something where I believe he may actually believe what he says and is trying to do the right thing. Of course that's where Szasz and Breggin could've been if they just published their books showing an alternative opinion, and didn't go on the paid speaking tours and release videos showing completely out-of-line ideas and data.

IMHO, the best critics of the field are the Last Psychiatrist and Daniel Carlat. They are pointing out the problems in the field and seemingly want to improve it without trying to destroy or take away credit from the positive things the field has done.
 
IMHO, the best critics of the field are the Last Psychiatrist and Daniel Carlat. They are pointing out the problems in the field and seemingly want to improve it without trying to destroy or take away credit from the positive things the field has done.

Taking nothing away from the above I am surprised you don't rate somewhere the International Critical Psychiatry Network. Not least because they are more comprehensive.

INTERNATIONAL CRITICAL PSYCHIATRY NETWORK
The International Critical Psychiatry Network (ICPN) has been created by medical doctors as a forum (primarily for medical doctors) to discuss, critique, and publicise opinions, practices, literature, and events that support critical thinking and alternative approaches to psychiatry. Building on the work of the Critical Psychiatry Network (CPN) in Britain and motivated by a concern about the ‘global mental health' movement's approach of globalising Western models of psychiatry, the ICPN wishes to consider a greater variety of ways of thinking about psychic difference and suffering. Recognising that the current dominant models (the medical model) for thinking about psychiatric difficulties and helping sufferers are not the only ones, we hope that the ICPN can contribute toward an exchange of ideas that can promote more locally meaningful and effective practice.

http://www.criticalpsychiatry.net/

Pat Bracken and Joanna Moncrieff among others in particular being members.

Edit: add Moncrieff publications http://www.criticalpsychiatry.net/authors/joanna-moncrieff/

Maybe Jock should be in touch with Proff Jureidini?

Now there is CRITICAL PSYCHIATRY NETWORK AUSTRALIA
If you are interested in joining, please e-mail Professor Jon Jureidini at [email protected]
 
Last edited:
Thanks for the information. I might just check it out. IMHO, good psychiatry requires critical thinking. Unfortunately, I find that many practice fast-food psychiatry. E.g. the patient is depressed? Psychiatrist gives an antidepressant and the same one to everyone without truly considering if it's the best one that fit's the patients' profile, nor discussing options with the patient.

Unfortunately, I've found several doctors severely lacking in discussing alternatives to medications, psychotherapy, risks and benefits of each medication, and trying to figure out the best specific medication option for the specific patient.

I've actually found some merit in the arguments of Breggin and Szasz (even a broken clock is right twice a day), but they want to throw the baby out with the bathwater.
 
I soaked up Szasz when I first came across him but I have to say that for me the over riding thing about Szasz is the essential unkindness of his message.

What he is saying is just cruel to me. Saying someone is not responsible for an act is one thing. To say that they can not be responsible for the consequence but not the act is equally wrong. What I mean is that being able to say sorry for harm done even when not responsible for the act itself is a matter of common humanity.

(Szasz saying you must be responsible for both as I follow him)

The position of Szasz as I understand it does not allow for this or even make that particular distinction and that I can not abide.

I have probably muddled a subtle but important point but I go off him more and more all the time while accepting his contribution as an important one.
 
If Szasz was for real, he wouldn't be associated with CCHR. That organization's released plenty of videos that have released out-of-context, and even bogus claims.
 
Breggin Szasz and Nial all seem to share the inability or lack of desire to get on with anyone else. Breggin has fallen out with the group he started and has tried to reform it for instance. Nial just wants to be an outsider, if his ideas suddenly became mainstream he wouldn't know what to do with himself. He must be an individualist at all costs.

The thing that disappointed me most about this thread, when it was running, was Nials failure to answer the reasonable questions you asked. Instead he just went off on a ramble. Ironic really given that his main gripe is not being taken seriously.

Fair enough taking on the establishment and playing the outsider (I am a sucker for the underdog everytime) but Nial really should have done his homework and found out that that blog radio channel is associated with a scam (alleged) selling self help programs at an extortionate price.

Joanna can and will answer tough questions which is another reason why I really rate her. (not that my rating counts for anything)
http://www.bmj.com/content/331/7509/155/reply
 
Hmm . . . I don't see a huge conflict between Niall's ideas and psychiatry and psychology as I know it; I don't see why he or you think these ideas are a profound attack. I have a psychology degree and am now going into psychiatry, and what I love about both fields is the openness and the pluralism of ideas. It's strange that Niall criticizes the field both for not being open to his ideas and for not having a unified guiding principle . . . you can't be both open to new ideas and have all the answers already. .

You will have to tell me where you are studying so I can go there, too, because orthodox psychiatry here DOES see a huge conflict between their views and mine.
I say they are not scientific as they have no declared model of mental disorder; that the categorical approach to mental disorder is irrational (DSM5 will agree with me on that); that there is no institution of criticism of ideas; that the psychiatric publishing industry in this country at least is corrupt; that drugs are only a small part of the answer; that there is no genetic basis to mental disorder; that psychiatry as an institution is now driven by the needs of drug companies and not the needs of our patients... Shall I go on?
In fact, I do have a "unified guiding principle," it is set out in detail in my publications, this is not the place to try to repeat it but, in briefest terms, I see mental disorder as a reality, being the result of distorted cognitive states, not of biology: the brain in most mentally disturbed people is fine. Nothing wrong with it. All of these claims are established in detail in various papers and books. I spend my spare time trolling the literature for new ideas. Orthodox psychiatry has not had a new idea since 1896 (biological psychiatry: Henry Maudsley 1867l Behaviorism: Wilhelm Wundt, 1878; Psychoanalysis: Sigmund Freud, 1986).
Come on, you younger generation, where is your spirit of adventure?
 
Of the "antipsychiatrists" I've seen so far, Mclaren is the least out there. .... Breggin totally lost credibility and then went on the order of propagandist....
Szasz has no credibility either. .

Hey, man, go easy on that. I am most definitely NOT an antipsychiatrist. I believe in the reality of mental disorder. So does Peter Breggin. Thomas Szasz does not, he says very explicitly that anybody who shows features of what other people call mental disorder is putting it on. This includes soldiers, psychotics, neurotics, everybody. However, he claims he is not an antipsychiatrist, so I don't know what you would have to do or say to qualify if he is not.

I have met Peter Breggin and keep contact with him from time to time. His complaint is the over-medicalisation of mental disorder and the corrupt practices of Big Pharma and their lickspittle university boys who feed them the results they want - for a fee, of course. Yes, he can be a bit difficult at times, and he is a bit intense for most people, but you don't take on a company like Pfizer and force them to cough up hundreds of millions of dollars by being nice and waiting in queue. You have to go for the jugular. They went for his, too, but he beat them. But it hasn't profited him. He has had a tough life. All power to him.

Szasz I don't know but I may meet him in LA in October, I am of the view that his work is hopelessly out of date, that he is missing a critically important point and that hell will freeze over before he will admit it. As far as I can see, he is now totally irrelevant to the world of psychiatry. Only the chattering classes heed him, and who heeds them?
 
Dr. Mclaren,

Are you aware of Dr. Breggin's recent accusations of liberals being "delusional"? on right wing talk radio? There used to be a clip of it on youtube, but it was taken off.

Breggin has always been unconventional, but with recent anti-liberal comments were the pure stuff of misuse of mental health to purely back one's political viewpoints.

Or his comments where he tried to link the Columbine tragedy to the use of medications? His comments were thrown out of court because of his lack of credible science to back them up.

At one point I interpreted Breggin as someone I may simply disagree with, but seeing he may have some valid points. After seeing some things such as the above examples, I'm now convinced he's now trying to profit on the role of a type of antipsychiatry troll. He's also worked with Gary Null, a self-proclaimed HIV denier advocating people to question the existence of HIV. Null's own credentials are questionable.

If you think this is the type of guy deserving more power to him, then I'd say you are either misinformed, or my intrepretation of you is off. You say Breggin hasn't profited? He's sold several items based on his antipsychiatry claims, many of which are not valid.
 
Last edited:
Breggin Szasz and Nial all seem to share the inability or lack of desire to get on with anyone else. Breggin has fallen out with the group he started and has tried to reform it for instance. Nial just wants to be an outsider, if his ideas suddenly became mainstream he wouldn't know what to do with himself. He must be an individualist at all costs.

The thing that disappointed me most about this thread, when it was running, was Nials failure to answer the reasonable questions you asked. Instead he just went off on a ramble. Ironic really given that his main gripe is not being taken seriously.

Fair enough taking on the establishment and playing the outsider (I am a sucker for the underdog everytime) but Nial really should have done his homework and found out that that blog radio channel is associated with a scam (alleged) selling self help programs at an extortionate price.

Joanna can and will answer tough questions which is another reason why I really rate her. (not that my rating counts for anything)
http://www.bmj.com/content/331/7509/155/reply

Have to answer these one by one.
1. "The reasonable man adapts himself to the world. The unreasonable man persists in trying to adapt the world to himself. All progress, therefore, depends on the unreasonable man" (GB Shaw: The Revolutionist’s Handbook)

2. I am sure that biological psychiatry will whither and die, just as psychoanalysis and behaviorism did. Trouble is, it probably won't be in my life time. Psychiatry must eventually adopt a cognitive model, people will look at mine and take some points from it and discard the rest. That's how science works.

3. You are probably right that I would not be happy in the mainstream, if by mainstream you mean having an office in a huge, steel and glass complex somewhere, spending hours each day in meetings and conference calls, jetting off to seminars to deliver the same tired old keynote address and collecting a handsome fee on the way out, writing grant submissions and sitting on committees of the great and good... You're right. I couldn't stand it. I am happier seeing poor crazy people than talking to governments. The mainstream are keen to tell the world how important it is for psychiatrists to work in remote areas or difficult fields - as long as they aren't the psychiatrists. I did. You don't get to be the world's most isolated psychiatrist by having a pathological need to talk to other psychiatrists twice a day.

4. I stopped contributing to this thread because it seemed to die soon after. I don't know about these things, thought maybe I'd breached etiquette so I shut up. I'll have a look at my "rambling," I am not known for rambling.

5. The blog radio channel "Psychewhisperer" is run by a Canadian lady in her fifties who is a "psychiatric survivor." She invited me to talk about my books, so I did. I have spoken to her twice, she strikes me as very genuine. However, it looks as though some of her material has been lifted and put on a site called "biopsychiatry," which has nothing to do with her. These things happen on the internet. She gets next to nothing from her site, last time I looked, she wasn't selling vitamins.

6. It is practically impossible for an outsider or unknown writer to get publicity from the mainstream press. If anybody asks to speak to me, I have to accept, even if I don't agree with everything they stand for, but it's important to speak to people on the "other side." That's why I went to the Australian psychiatry college conference last week, take the message into the heart of the enemy's territory. The one thing orthodox psychiatry fears is anybody with a contrary view getting publicity. You need to believe this: the playing field is not level.

7. I have spoken to CCHR and been to their museum in LA. Firstly, in this country, I am not allowed to refuse to speak to anybody in the public arena just because I don't follow their religion, or politics, or their social theories or anything. That is not just illegal, it is immoral. CCHR represents a particular point of view. I must admit I don't know anything about the church of scientology, but I speak to Catholics and Protestants and Buddhists and Muslims and agnostics and atheists and you name it, nobody seems to worry about them. I don't know what inflames Americans about scientologists, but I don't care. They are human; I talk to them. Of interest:in the CCHR museum, I found two mistakes. One was about Julius Wagner-Juaregg, and the other I forget. I told the receptionist when she asked what I thought of it. Immediately, she called one of their curators down, who went around with me and I showed him the errors. He was most grateful. Next day, they were corrected. I have spent decades trying to get orthodox psychiatry to admit, for example, that they made a mistake when they embraced the so-called biopsychosocial model. I gave another talk about it last week. I wish my colleagues would be as quick to admit error as their enemies.
 
I told the receptionist when she asked what I thought of it. Immediately, she called one of their curators down, who went around with me and I showed him the errors.

Were you also aware that CCHR proclaims that psychiatry turned Osama Bin Ladin into a terrorist, that his right hand man (an eye surgeon) was actually a psychiatrist who brainwashed him?

http://www.zimbio.com/Scientology/articles/xDuS9IyAhM5/Scientology+PSYCHIATRISTS+Blame+9+11+Attacks

Or that CCHR too used Gary Null to back their viewpoints, citing him as a "professor" without explaining that many of his viewpoints have been disproved?

From Breggin's own website
http://breggin.com/index.php?option=com_content&task=view&id=285&Itemid=121

Dr. Breggin believes that his critiques of biological psychiatry and his promotion of empathic therapy cut across political lines. Dr. Breggin has for many years worked with Gary Null, the Founder of the Progressive Radio Network, and he is happy to present his show on the network that Gary founded

As I wrote above Null, he denies the existence of HIV. I have no problem with Null's criticism of medicine on several points, but others are just pure false to the point where it's inexcusable. It's one thing to say that medicine should promote wellness more. It's another thing to deny the existence of an disease that has been proven many times over to exist such as HIV.

http://www.actupny.com/index.php?op...enialist-return&catid=1:latest-news&Itemid=50

I understand if you're not familiar with CCHR, but to say Breggin's had a "tough life" as if it's some type of excuse, nope, I think now you lost me. That doesn't excuse someone going on political radio, start psychoanalyzing people with opposing viewpoints, then call them "spoiled" and for doing so.

The Psychology of Progressive Tyranny and Immorality
Peter R. Breggin, M.D.
http://www.mindfreedom.org/as/act/inter/icspp/breggin-savage-progressives

"Live Like an American!" Radio Report No. 35 on the Savage Nation
October 14, 2009

Audio available on www.breggin.com
This report may be circulated provided the author and the source are identified.
Not an exact transcript.

What do all of the following have in common? Presidential apologies to mass murderers, bowing before tyrants, undermining the CIA and America's missile shield, forcing Israel to defend itself and us from nuclear war, pushing budget-busting programs that will turn our children into fiscal chattel, destroying the best healthcare system in the world, subjugating industries to imperial whim and bailout, celebrating a day of infamy with a day of national service, and telling school children to serve their president , and no outcry over recent riots in the streets of Pittsburgh? Other than signaling the collapse of American values, what do all these disasters have in common? And what do they have in common as well with enslaving 13-year-old girls into prostitution (the ACORN tapes) and exonerating the rape of a thirteen-year old girl (liberal defenders of Roman Polanski)? So what do all these things have in common?

The underlying personal psychology that motivates progressivism explains this broad spectrum of irresponsible conduct. Having failed to manage their personal lives in a satisfying manner, progressives try to control their inner emotional pain by managing the world—whether or not the world wants it. When the world won't conform to their expectations, progressives lapse into endless harping criticisms of others and self-justifications about their good intentions. When talk fails, many turn violent.

Obama talks so much, even when it hurts his ratings, because it's all about making himself feel better. And as his frustration grows, Obama turns increasingly to force—pushing coercive legislative programs without regard for the views of American citizens or our Founding values.

Why do progressives continue to pursue endless programs that never succeed, from Roosevelt's New Deal to the War on Poverty and beyond? Why do those who inherit wealth so often become leftists who want to give away the wealth of other rich people? Progressives care more about their good intentions than their bad effects. They assuage their own personal helplessness and guilt by flaunting and even imposing their good intentions on others.

Malicious envy is embedded in this dark psychology that drives progressive theory and practice. Why else would people of seemingly normal intelligence praise Fidel or his latest clones, and imagine that these monsters have been good for their people? Feelings of guilt and helplessness breed envy toward those who succeed in life. Nothing offends a progressive more than someone who has succeeded where he has not. That's why progressives would rather level society than let some people stand out. Meanwhile, they pride themselves in doing good things for the poor merely because they have ruined the rich.

Their psychology also explains why progressives worship their leaders but hate their country. Because of their underlying helplessness, progressives eagerly worship charismatic leaders. They want to adore and to serve a "father" who coddles and protects them, and promises them heaven on Earth without risk and hard work. Because conservatives instead call for responsibility, progressives especially hate and resent them, the way a spoiled or overwhelmed child fears and resents responsibility.

Resentment of responsibility also fuels Ameriphobia. They hate our society because its ideals put a premium on responsibility, independence, and the defense of freedom. They hate Israel not only because it's America's ally but also because it vigorously takes responsibility for itself and its own freedom.

Earlier I mentioned Acorn and Roman Polanski. When you emotionally reject personal responsibility, that's what you'll find at the bottom of your political barrel—Acorn reps encouraging sex trade with thirteen year olds, progressives apologizing for Roman Polanski's rape of a thirteen year old, and liberals condoning the violent riots in Pittsburgh.

Progressives claim the mantle of idealism. It is natural for adolescents to handle their own feelings of helplessness and dependence by trying to fix the world. Feeling guilt about being taken care of, of course they want everyone to be taken care of. Being dependent on their own parents, it's natural for them to imagine a Big Daddy in the Sky called government who will take care of everybody else. And since their schools denigrate capitalism and freedom, of course they have no idea about our nation's founding values and the miraculous progress produced by the free market. This kind of progressive idealism is forgivable in adolescents, but not in grown adults who use political power to impose their own unresolved, unrelenting adolescent fantasies and ignorance on other people.

Ultimately, freedom and responsibility are twin daggers in the heart of progressive psychology.

Our Founders left us a profound political and personal legacy. They made it possible for us to live by the principles of freedom, responsibility, gratitude, and love, including a passionate devotion to the rights of the individual, to the nation, and to God. The Founders gave us the basis of a sound psychology and philosophy of life, and it's wholly incompatible with progressivism.

This is Dr. Peter Breggin hoping you will read my brand new book titled "Wow, I'm an American—How to Live Like Our Heroic Founders." Pre-publication copies of "Wow, I'm an American!" are available on my website www.Breggin.com where you can also listen to all my Savage nation reports and download the transcripts.

- end -
 
Last edited:
Wow... Im sorry I missed this.

What's happening here is an argument between the Philosophers of Science, and the Scientists themselves.

Philosopher - an atom doesnt exist. there is no tiny particle with a positively charged doohickey surrounded by some negatively charged thingamajigs spinning around them in opposite directions, and becoming more numerous as the orbits extend further from the core... thereby balancing the spin and the tension between the two. An atom is simply a mathematical model explaining why a certain element behaves the way that it does, from a large heap of it, to the smallest amount where it still retains the same characteristics - i.e an atom. This mathematical model works every time, and can be used to theoretically construct a molecule or a reaction, which will prove in experimentation to occur precisely as predicted. However, an "atom" itself is not an object (like a billiard ball) - it's a mathematical concept.

Scientist - Atoms exist! I work with atoms every day in the lab.

I haven't read any of Dr. McLaren's books (yet), but I tend to agree. All the models for mental health and illness (Freud, Jung...) have been shown to apply to a handful of patients at best - making them stories rather than models. The BPS model -by encompassing everything - says nothing. The DSM is a listing of diagnostic criteria, not a model. Even if we borrow models and theories from Psychology, we still fall short. Theres the psychosexual model, theres models from evolutionary psych, models based on avoidance of pain, models based on pleasure, models based on power. Theres no unified model of the mind... and no model at all about mental illness (except perhaps the one by McLaren)

Psychiatry doesnt enjoy the same scientific rigor and reductionalist logic as the rest of medicine. Nearly every psych disorder has a multifactorial (read - unknown) etiology, and half of the drugs have an unknown mechanism of action. Those that do have a more clear MOI don't have a putative cause-effect relationship. Other fields of medicine do have models which hold up to the philosophy of science. If you remove an appendix, you'll cure appendicitis every time. If you give a bronchodilator, you'll dilate the bronchus and decrease pulmonary pressures. If you have depression.... what exactly is your talk therapy doing to the patients mind? We'll get to meds later, but whatever the therapy is doing for the patient, it isnt "bringing pathology back to physiology", because we dont know how a healthy mind is structured in the first place.

How often have we seen an unclear or incorrect Psych Dx which has been managed so far on the wrong Rx? How does an anti-epileptic stabilize the mood? Fact is - throwing pills at patients does work to some degree. (what annoys the IM guys about Psych? Rx therapy in psych - chose a drug, titrate to adverse effect, change the drug, repeat)

The biological component is far too small in Psych illness for the biological model to be effective. Any psychiatrist knows that the correct answer is "meds and therapy" but that's missing the point. Point is, the med component is so low from a theoretical standpoint, that the same medical model does fall through with psych illness. Pheo or Hypothyroid causes disordered mood, but to say that this is an example of the PBS model of psych illness is a logical faux pas.... those are medical diseases with psych Sx. The treatment for those isnt neuroleptics + therapy. Remember though, McLaren talks about mental illness, not treatment.

Why? As another thread on this forum inappropriately suggests - Psych meds snow the patients ability to think or feel ANYTHING, let alone extreme sadness, elation, suicidal thoughts, or delusions. Is there anything wrong with that? No, not really... We take a lady who has social phobia, snow her a little bit, and help her find out why shes phobic, and gradually get her out of the house. One might say its like physical therapy under local anesthesia for an ankle sprain. But we need to recognize it for what it is... and I think much of psychiatry ignores that.

I'm NOT saying that psych meds are horrible, and we're just sedating patients. I'm saying, that we'll need to agree to disagree, because from a philosophical standpoint psychiatry is unscientific. That doesn't mean we can't do good work in it.
 
Last edited:
1. "The reasonable man adapts himself to the world. The unreasonable man persists in trying to adapt the world to himself. All progress, therefore, depends on the unreasonable man" (GB Shaw: The Revolutionist's Handbook)
Nice quotation. Cf. Bureaucracies eat hero innovators for lunch every day. Edward De Bono. The tallest poppy will be cut down and so on.

2. I am sure that biological psychiatry will whither and die, just as psychoanalysis and behaviorism did. Trouble is, it probably won't be in my life time. Psychiatry must eventually adopt a cognitive model, people will look at mine and take some points from it and discard the rest. That's how science works.
I think I understand you but I do think that "biological psychiatry" has become a rather tired phrase that because of its association with anti-psychiatry is beyond resurrection as a useful term. It just invites an argument rather than meaningful debate.

3. You are probably right that I would not be happy in the mainstream, if by mainstream you mean having an office in a huge, steel and glass complex somewhere, spending hours each day in meetings and conference calls, jetting off to seminars to deliver the same tired old keynote address and collecting a handsome fee on the way out, writing grant submissions and sitting on committees of the great and good... You're right. I couldn't stand it. I am happier seeing poor crazy people than talking to governments.
It rather begs the question "What is mainstream?". One could argue that this forum is part of the mainstream. I would say so and there is nothing to stop you posting here. Are blogs mainstream media? Some of them have huge readerships and prestigious commentators.
The other point I would make is that just because someone works in a corporate environment does not mean that they must submit to "the system". Of course one will have an easier life if one does but plenty of people don't. Many many people chose to challenge the system by working inside it. That I would put it to you is just as hard and perhaps harder than working outside the tent.
I would go further and say that if one wants to effect real lasting change it is inside the system that one should find oneself. As the Islamic saying goes "If the mountain will not come to Mohamed then Mohamed must go to the mountain." Of course it's not for everyone.

4. I stopped contributing to this thread because it seemed to die soon after. I don't know about these things, thought maybe I'd breached etiquette so I shut up. I'll have a look at my "rambling," I am not known for rambling.
It was impolite of me to say ramble but I was making the point that you didn't take the opportunity to answer Whoppers questions one by one and I don't really understand why.
Obviously that's your prerogative but I for one was hoping you would. It seems to me that there is plenty of debate going on. Here in particular and elsewhere on the internet.
I don't mean to be rude but not to use an outlet like this when others are denied one then it is a bit like the saying "I don't want to be a member of any club that would stoop so low as to have me as a member."

5. The blog radio channel "Psychewhisperer" is run by a Canadian lady in her fifties who is a "psychiatric survivor." She invited me to talk about my books, so I did. I have spoken to her twice, she strikes me as very genuine. However, it looks as though some of her material has been lifted and put on a site called "biopsychiatry," which has nothing to do with her. These things happen on the internet. She gets next to nothing from her site, last time I looked, she wasn't selling vitamins.
The trouble is one cannot have it both ways. The internet is fraught with charlatans because anyone and everyone can make a blog, post on a forum or create a plausible looking website. On the other hand traditional media like journals are trusted precisely because they have barriers to entry and are trusted for that reason.

6. It is practically impossible for an outsider or unknown writer to get publicity from the mainstream press. If anybody asks to speak to me, I have to accept, even if I don't agree with everything they stand for, but it's important to speak to people on the "other side." That's why I went to the Australian psychiatry college conference last week, take the message into the heart of the enemy's territory. The one thing orthodox psychiatry fears is anybody with a contrary view getting publicity. You need to believe this: the playing field is not level.
I am sure that is the right approach. If you want to get people wet there is no point in having piss outside the tent. You have to go inside the tent and then you will get people wet and have their full attention. (Apparently people make better decisions on a full bladder but I digress)
I do think that the world is changing, along with the death of deference, students and people in general are getting much better at discerning the quality of an argument rather than accepting or rejecting any particular line because of where it appears.

7. I have spoken to CCHR and been to their museum in LA.
This lecture series by Proff Wiseman is instructive. I don't think Scientologists have patient interests at heart. Some of their activities are genuinely sinister imo.
Dr. Stephen Wiseman is a Clinical Associate Professor in the Department of Psychiatry at the University of British Columbia, and Consultant Psychiatrist at St. Paul's Hospital in Vancouver, BC. For a number of years he has been researching Scientology, its inventor L. Ron Hubbard, and the organization's anti-psychiatry arm, the Citizens Commission on Human Rights
[YOUTUBE]http://www.youtube.com/watch?v=XLm_N2z60Ko[/YOUTUBE]

For amusement, I have posted this great subvertise before but you might like it.
[YOUTUBE]http://www.youtube.com/watch?v=lX0J2pGDSMY[/YOUTUBE]

I occasionally vist your blog to see if you have updated it and will continue to do so.
 
...because we dont know how a healthy mind is structured in the first place.

I agree with many of the points being made here, but I'm not sure that the biological model is totally wrong...it may just be incomplete.

It is this area that I think holds the most promise for psychiatry in the future...the mapping of both the healthy and diseased mind.

There have been numerous studies starting to come out using a variety of imaging techniques, most notably to me diffusion tensor MRI, that are beginning to show the structural alterations present in the brains of patients with diseases like BPD, MDD, and Autism.

To me, the promise this holds, both for diagnosis and treatment is exactly what is most interesting and exciting about the future of psychiatry.

I think that there is very clear evidence that there is a biological component to many psychiatric diseases. Just because we haven't perfected the model is no reason to discard it completely.
 
It is this area that I think holds the most promise for psychiatry in the future...the mapping of both the healthy and diseased mind.

The possibility remains that for some forms of distress they are the same. It could very well be that the brain is just like a perfectly working random number generator. Its just that sometimes we don't like the numbers.
 
digging this topic. and digging on mclaren and reductio.

sweet post, reductio. a fresh breeze of critical thinking.

Anyone else reading "The Rise and Fall of the BioPsychSocial Model" by Ghaemi?

Mclaren asks 'which model are we using?' And Reductio mentions again that we are model-less (not a word.).

The closest thing I've come across to a 'working model' of psychiatry (a heuristic) is McHugh's "Perspectives of Psychiatry." Seems at least to be a philosophically and clinically sound starting point.

I digress, I know.

Continue. Like I said, I'm digging it.
 
I agree with many of the points being made here, but I'm not sure that the biological model is totally wrong...it may just be incomplete.

It is this area that I think holds the most promise for psychiatry in the future...the mapping of both the healthy and diseased mind.

There have been numerous studies starting to come out using a variety of imaging techniques, most notably to me diffusion tensor MRI, that are beginning to show the structural alterations present in the brains of patients with diseases like BPD, MDD, and Autism.

To me, the promise this holds, both for diagnosis and treatment is exactly what is most interesting and exciting about the future of psychiatry.

I think that there is very clear evidence that there is a biological component to many psychiatric diseases. Just because we haven't perfected the model is no reason to discard it completely.


I think everyone agrees that there's a clear biological component to mental illness. There are the structural alterations as you mentioned, genetic polymorphisms which predispose mental illness. Theres even the "experimental" observation that we can cause Parkinsonsim by treating Schizophrenia, or that PCP can cause hallucinations. But... based on what we know, we can't alter all that much on the medical model alone. Its not a failing of the biomedical science of psychiatry - we know about serotonin, NE, and dopamine, and we can manipulate them just fine. But it doesnt help - because - the biological component to psychiatric illness is so small... and if the psychiatric illness was any more biological - (as is the case for Wilsons related psychosis, hypothyroidism related depression, or pheo related anxiety), the illness wouldn't technically be psychiatric at all.

Thats where this problem of a paradigm of mental illness comes in. For diseases which are categorically psychiatric, we need to have an understanding of how a healthy mind works, what actually goes wrong in mental illness... However, we use the Allopathic model (cf the the homeopathic, traditional osteopathic, or naturopathic models) of disease, and say - "Pt has depression - must have low serotonin in his synapse - give SSRI + therapy". Thats the Allopathic model for disease and treatment.

The suggestion is (I think) - the Allopathic model relies heavily on the biological basis of disease, whereas Psych illness has a psychological or mental basis... McLaren argues that its sometimes entirely psychological in nature. As such, Allopathy is not logically and scientifically sound as the treatment modality. But we use it anyway.... in many cases as a sort of mental "therapy under local anesthesia" at best - I say.

If biology had a larger contribution to mental illness, or if we had a better understanding of the architecture of the mind and how to manipulate it - psychiatry would be more scientific.
 
I think everyone agrees that there's a clear biological component to mental illness. There are the structural alterations as you mentioned, genetic polymorphisms which predispose mental illness. Theres even the "experimental" observation that we can cause Parkinsonsim by treating Schizophrenia, or that PCP can cause hallucinations. But... based on what we know, we can't alter all that much on the medical model alone. Its not a failing of the biomedical science of psychiatry - we know about serotonin, NE, and dopamine, and we can manipulate them just fine. But it doesnt help - because - the biological component to psychiatric illness is so small... and if the psychiatric illness was any more biological - (as is the case for Wilsons related psychosis, hypothyroidism related depression, or pheo related anxiety), the illness wouldn't technically be psychiatric at all.

Thats where this problem of a paradigm of mental illness comes in. For diseases which are categorically psychiatric, we need to have an understanding of how a healthy mind works, what actually goes wrong in mental illness... However, we use the Allopathic model (cf the the homeopathic, traditional osteopathic, or naturopathic models) of disease, and say - "Pt has depression - must have low serotonin in his synapse - give SSRI + therapy". Thats the Allopathic model for disease and treatment.

The suggestion is (I think) - the Allopathic model relies heavily on the biological basis of disease, whereas Psych illness has a psychological or mental basis... McLaren argues that its sometimes entirely psychological in nature. As such, Allopathy is not logically and scientifically sound as the treatment modality. But we use it anyway.... in many cases as a sort of mental "therapy under local anesthesia" at best - I say.

If biology had a larger contribution to mental illness, or if we had a better understanding of the architecture of the mind and how to manipulate it - psychiatry would be more scientific.


+1


Excellent posts Reductio, you speak my mind in a lot of these issues.



We can use drugs to fight some of the symptoms, but we know nothing about the neural-mental/cognitive-affective mapping of the normal-or-disordered mind. Systems/cognitive/affective/social neuroscience is/are busy investigating these things, but it is still in its infancy (i mean we still don't know exactly how vision, audition or pain happen in the brain)
 
Last edited:
We need people to criticize our field and question what we do. Due to the level of subjectivity and lack of formal objective testing, the field demands checks and balances. This is a reason why I went into forensic psychiatry because I was sick of seeing situations where doctors spot-diagnosed and treated patients and their methods were questionable.

A problem here is that many of the critics we got that have the most attention seem to be out there simply for that attention and to profiteer. When our most vocal critic is the Church of you know who, coupled with Breggin, someone who's revealed himself to be something on the order of a quack in the last few years, it doesn't fill the void of the need for a real call for concern to fix our profession.

I have no problems with someone criticizing something to make it better. I have little time or respect with someone criticizing with a hidden agenda.
 
We need people to criticize our field and question what we do. Due to the level of subjectivity and lack of formal objective testing, the field demands checks and balances. This is a reason why I went into forensic psychiatry because I was sick of seeing situations where doctors spot-diagnosed and treated patients and their methods were questionable.

A problem here is that many of the critics we got that have the most attention seem to be out there simply for that attention and to profiteer. When our most vocal critic is the Church of you know who, coupled with Breggin, someone who's revealed himself to be something on the order of a quack in the last few years, it doesn't fill the void of the need for a real call for concern to fix our profession.

I have no problems with someone criticizing something to make it better. I have little time or respect with someone criticizing with a hidden agenda.

:thumbup: :thumbup:

Whooper, you really are awesome. :love: Thanks for voicing what a lot of us are thinking.
 
Top