I think several psychiatrists should read Breggin, only because he brings up some salient questions that aren't often asked in our profession that need to be answered.
However, as a whole I question some of his ideas & publications which may possibly be self serving.
For example he has brought up several arguments which attack any field of medicine, but he selectively chooses psychiatry.
E.g. he argues that studies where psyche meds are found superior vs placebo in RCT, double blinded placebo controlled studies should not be considered valid because these meds have side effects, while placebos do not. Therefore, if a person feels the side effects--the person in the study will realize they have the real medication, and thus will believe it will work, thus the real medication is a placebo.
OK--doesn't that apply to all meds? Psychiatric or not? Someone on Nexium feels some type of side effect from it and will think its the real med in a study? OK Breggin, why selectively only attack psychiatric meds?
Also factor in that some placebos could cause side effects depending on what the placebo is made of, and with several psychotropics, side effects may be the minority, not the majority of them.
That's just one example. Several of his arguments have the same problems.
But just like this guy, who raked in millions....
http://www.amazon.com/Natural-Cures...=sr_1_3?ie=UTF8&s=books&qid=1242007959&sr=1-3
There's a market for people who want to make anti-medical statements.
I have read Toxic Psychiatry, and I do agree with Breggin on several points--
1-Not all patients with a mental illness need medication. Several disorders such as depression & anxiety (which are the top 2 in prevalence) do not need medications if on the weaker spectrum, and the patient does not want them.
2-psychotherapy definitely has its place and unfortunately because of market forces, this aspect is being used less & less.
3-several doctors (not just psychiatrists) throw pills at the patient without educating them adequately on what can be done to treat their illness other than medication.
Which is one of the reasons why I do think several of Breggin's points should be addressed in a psychiatric residency program. However Breggin has become IMHO something of a Kevorkian with his cause. Kevorkian's own wierdness & grandstanding have made euthanasia more of a freak topic vs a serious topic for debate in the US. In Europe, its taken more seriously.
If I do not prescribe drugs for my patients, will I be looked down upon for not being a good psychiatrist? And am I going to be required to foster the philosophy that most mental problems in the patients, including depression, anxiety, and other psychological issues, are, as a fact, bio-chemical?
IMHO you will be an even better psychiatrist if you do not prescribe medicaitons for every single person who wants one. That being said, there are several psychiatric disorders where meds really are needed--Schizophrenia, Bipolar I, Major Depressive DO with psychotic features.
There are some institutions that highly focus on psychiatrists only fulfilling a prescribing role because of the market forces I mentioned. In that case, if you do not feel the person needs medication, you can refer them to the right people for psychotherapy alone.
Several of Breggin's criticisms of psychiatry are because of specific bad psychiatrists. He may cite an example where someone was misdiagnosed. There are bad doctors in every specialty. He however cognitively distorts the cases of bad psychiatrists to attack the entire field. In that case, maybe because of one bad politician, the concept of representative government should be dismantled, or because of 1 bad cop, all legal enforcement is bad etc.
However, it was very polemic and also very poorly researched. He heavily footnoted in the book to give the appearance of speaking with sound evidence, but when I looked up many of the sources they didn't fit what he was talking about. He really twisted the research to fit his agenda and it really made me question HIS motives.
Which is why I wonder if he is self serving in his interests. He appears occasionally on Fox's the O'Rielly Factor which I'm sure paid him quite a sum of money (someone correct me if I'm wrong), he's publishing books and making money off of them, he's on the lecture circuit etc.
I think if this guy was for real, he wouldn't have picked a polemic tone, and his sources would've been real. It seems though to me that since several of his arguments are weak (alongside with the ones that actually are worthy of consideration) he's trying to fill up space to get another publication out for profit, and chooses the polemic tone because it'll increase sales of his book, as well as his public persona.
