A psychiatrist made a series of tweets in response to my article, 12 Essential Facts About Psychiatry. He said that the article ‘shows a deep ignorance’ of the overarching subject matter, but went on to demonstrate his own ignorance in subsequent tweets.
Here is a brief response.
1. ‘You only have to think what function do diagnoses like “migraine” & “low back pain” serve in medicine.’
Doctors don’t claim a migraine or back pain is a disease.
2. ‘It doesn’t mean that biological factors aren’t of explanatory relevance.’
The article doesn’t claim biological factors aren’t relevant to how people feel and behave. Technically, biology plays a role in everything. Acknowledging this explains nothing, though. It just serves to distract from the contents of the article.
3. ‘The contribution of genetic factors varies from disorder to disorder’.
Note how the existence of discrete psychiatric ‘disorders’ is just assumed. Re-read Fact 1.
4. ‘Antidepressants are not placebo’
This isn’t a rebuttal. Also, placebos can be said to have ‘therapeutic value’.
5. ‘idiosyncratic opinion’
According to Dr Peter R. Breggin, the FDA broke its own rules in order to approve Prozac. In other words, if the FDA had upheld its own rules, Prozac would not have been approved. Prozac should not have been approved based on the FDA’s own rules. Not an opinion. Fact.
6. ‘over-prescribed’
This implies ‘antidepressants’ constitute medicine. Review Fact 4.
7. ‘Why don’t we discuss the larger market and systemic forces which have made psychotherapy so hard to access?’
Sure—let’s also discuss what psychiatrist Daniel Carlat1 admitted in his 2010 book:
Doing psychotherapy doesn’t pay well enough. I can see three or four patients per hour if I focus on medications (such psychiatrists are called “psychopharmacologists”), but only one patient in that time period if I do therapy. The income differential is a powerful incentive to drop therapy from our repertoire of skills, and psychiatrists have generally followed the money.
8. Of course, Schaefer and colleagues’2 findings don’t actually mean that the majority of the population will develop a psychiatric ‘disease’ at some point in their lives; they simply mean that most people will receive a psychiatric label based on psychiatry’s arbitrary set of criteria.
9. ‘Psychiatric diagnosis does not equal “biogenetic explanations”.’
Of course it does. The belief that these diagnoses represent valid medical illnesses is the only thing propping up psychiatry’s house of cards. Without this belief, psychiatry’s claim to being a valid medical sub-field evaporates, along with any remaining confidence in its legitimacy.
10. ‘There are many different reasons for why that is the case. Complex discussion.’
That’s it? Repeating the word ‘complex’ (used five times in this series of tweets) doesn’t invalidate any of the article’s points.
11. No citation given.
12. ‘It doesn’t mean that UN is calling to abolish psychiatric diagnoses and psychiatric interventions.’
False. In the report’s3 conclusion, it says we should ‘abandon the predominant medical model that seeks to cure individuals by targeting “disorders”.’4
Footnotes
- Carlat, D. (2010). Unhinged: The trouble with psychiatry – A doctor’s revelations about a profession in crisis. New York: Free Press.
- Schaefer, J. D., Caspi, A., Belksy, D. W., Harrington, H., Houts, R., Horwood, L. J., . . . Moffitt, T. E. (2017). Enduring mental health: prevalence and prediction. Journal of Abnormal Psychology, 126(2), 212-224. doi:10.1037/abn0000232
- UN General Assembly. (2017). Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. United Nations Human Rights Council. Retrieved from http://www.ohchr.org/EN/Issues/Health/Pages/SRRightHealthIndex.aspx
- UN General Assembly, 2017, p. 19.
