Another psychiatrist breaks ranks to expose the myths, corruption and pseudoscience, undergirding psychiatry.
Psychiatrist Sam Lieblich’s critique, not unlike my own contribution published earlier this year, features a litany of inconvenient truths.
Here are a selection of highlights from the article.
Mental Health is broken; it has been broken by psychiatrists who are not scientists but who have scientific pretensions; patients who are desperate, who for reasons of expediency may prefer not to confront the truth of their symptoms, and who have no-one more trustworthy to turn to; and corrupt businesses that have snake oil to sell.
Psychiatrists do not treat illnesses.
[P]sychiatry makes a false equivalence of the brain and the person, psychiatry pathologises some of the normal problems of human life, psychiatrists enforce highly constrained norms of thought and behaviour, and psychiatrists don’t value patients’ autonomy. There is still however a lot of confusion about the status of the things that psychiatrists treat. These are by no means illnesses, and the medications doctors use to treat them are by no reasonable measure effective. (emphasis added)
The article goes on to dismiss the notion of a ‘chemical imbalance’; a myth that has been exposed innumerable times.
[A] ‘chemical imbalance’ has never been substantiated for any of the things that have been called a ‘mental illness’, and…the prescription of medications for psychiatric problems is always tendentious. The abundance of scientific support for these claims is only equalled by the total absence of their accommodation in the practice of psychiatry and the lay discourse about mental health. Although science does not really support the use of many psychopharmaceuticals in the ways they are represented to be supported, and although there is no acceptable measure by which most of the things treated by psychiatrists qualify as illnesses, the cultural position of the medical profession and their medicines is such that even a scientific refutation of a medical claim appears unscientific. This position of the doctor as super-scientific is perpetuated and co-opted by pharma for profit, and by the state for the purposes of social control.
How has psychiatry gotten away with this con for so long? Follow the money.
[T]here has been a determined marketing campaign – to the effect that all despair is an illness – by the pharmaceutical industry which has insinuated itself into the state and into academia so thoroughly that to find a research project or piece of regulation untouched by their money is almost impossible. To illustrate the point:
University departments are funded by pharma money.
Researchers are funded by pharma money. Local research stars like Patrick McGorry and Ian Hickey between them have taken money from every major pharma company.
Politicians are funded by pharma money. In 2020 Pfizer donated about 60:40 Democrat/Republican, which is standard for most of the pharma industry.
The publishers of medical guidelines are funded by pharma money. The UK National Institutes of Clinical Excellence which publishes the NICE guidelines, had panels with 8 of 12 members paid by pharma.
The writers of psychopharmacology textbooks are funded by pharma money. Stephen Stahl, whose book is the main anglophone psychopharmacology textbook, takes up to USD 3.6 million per year from pharma. Copies of his book are given to students for free by drug reps.
Government regulatory panels are stocked with experts funded by pharma money. For instance Professor David Nutt former president of the European College of Neuropsychopharmacology who was on the British Committee on Safety of Medicines inquiry into ‘anti-depressant’ safety despite the fact he and three others on that committee also worked for GlaxoSmithKline who make one of the most commonly prescribed ‘anti-depressants’.
So-called mental health advocacy organisations act as de facto pharma advertisers who ‘hide behind smokescreen public relations slogans of medical awareness campaigns, while slyly growing drug markets by over-medicalizing everyday experiences such as sadness, anxiety, and shyness’. It’s enough to mention Jeff Kennett who when in power defunded psychiatric services, degraded public housing, closed schools, derided the homeless, and once out of office founded Beyond Blue the mental health advocacy organisation that wants to remind you that ‘good mental health is good for business’.
Finally and crucially there is the community of patients-turned-consumers who have been exposed to so much explicit and implicit advertising by pharma that they tend to hold their products in high regard even if they are suspicious of pharma corporations themselves.
Here, Lieblich explains why psychiatric drugs should not be viewed as curative medicines.
Central to pharma advertising is the idea that the causes of so-called mental illnesses are locatable in the body; yet no identifiable pattern in the brain or blood of sufferers has ever been identified. There are nevertheless some weakly useful medicines for a number of the problems we describe as mental. It is clear that lithium does something for mania, it is clear that chemicals that lower the amount of dopamine activity in certain areas of the brain do something for the problems that bring the schizophrenic into contact with the psychiatrist. However what exactly is ‘happening’ when these drugs ‘do something’ is complex, tendentious, dependent on ‘the interpretive flexibility of personal experience’, not analogous to what happens when an antibiotic cures pneumonia by eradicating the germ that’s causing it, and not justified by the notion that they are reversing some deficiency in the body ‘like a vitamin’. The term ‘anti-depressant’ is only a marketing term; there is nothing else that could possibly tie together the disparate range of chemicals that have come to be known by this term except that they are all marketed together as supposed cures for the same supposed problem. These drugs have never been shown to be treating any particular thing in the brain that can be consistently linked to the disorder we say a patient has, and often enough the side-effects of the drugs are worse than the disease itself. (emphasis added)
Tell consumers the truth about ‘antidepressants’, then let them decide if they are worth taking.
[A]ll manner of things might cheer a person up, or reverse their ill fortune, but only some of them should be marked with the stamp of medical authority to be prescribed by doctors, and I do not believe that ‘anti-depressants’ are one of these things. There is no convincing science that supports their use, and just because there exist anecdotes of their success here and there doesn’t mean that they qualify as medicines…. The so-called ‘anti-depressants’ should be re-classified as either poisons or research chemicals, and then people may do what they will with them, without believing them to be supported by medical science. (emphasis added)
More on the corruption endemic to psychiatry:
According to their own guidelines the DSM-V task force members were allowed to earn up to $10,000 per annum in honoraria from the pharmaceutical industry and to keep up to $50,000 worth of shares in pharmaceutical companies. It’s clear however that committee members receive perks worth many thousands of dollars that they do not declare, and they also funnel pharma funds towards the institutions and laboratories they head rather than receiving them personally so as to avoid having to declare. Drug companies groom and fund lab heads who in turn support pharma on the task forces. In all instances it is in pharma’s interests to degrade reliability, because that means more patients are diagnosed and treated. It’s also worth mentioning that the DSM manuals are bestsellers; the DSM-IV made the APA USD 5 million per year during its run, and the DSM-5 made more than USD 20 million in its first printing. The DSM story is exemplary of the way a confluence of academic and financial interests can come together to make good money.
Lieblich ends by suggesting that ‘There is an emancipatory and compassionate potential within psychiatry’ and that it is to be found in ‘listening to patients, and in providing patients with the opportunity, not much afforded them elsewhere, to listen to themselves.’
This is a nice sentiment. But it is not one that undergirds psychiatry. As I have argued elsewhere, the problems that Lieblich bemoans are the defining characteristics of psychiatry. We already have people capable of ‘listening to patients’ (although, ideally, without calling them that—‘client’ is my preferred term); among them are counselors, psychotherapists, and social workers.
Note: Footnotes included by Lieblich were removed from the above excerpts. See the original article for the full reference list.
