Forum:Psychiatry is a pseudoscience

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I have recently and reluctantly come to the conclusion that psychiatry is a particularly pernicious pseudoscience. As defined by wikipedia pseudoscience is 'a claim, belief, or practice which is presented as scientific, but does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status.[1] Pseudoscience is often characterized by the use of vague, exaggerated or unprovable claims, an over-reliance on confirmation rather than rigorous attempts at refutation, a lack of openness to evaluation by other experts, and a general absence of systematic processes to rationally develop theories.'

My arguments are based on pseudoscience being correctly defined here - http://en.wikipedia.org/wiki/Pseudoscience

1. I will start with 'absence of progress'. Hippocrates stated that an imbalance in humors caused melancholia. Modern psychiatry claims that mental illness is caused by a chemical imbalance in the brain. There is no scientific evidence that shows this is a fact.

2. Use of vague, exaggerated or untestable claims. This is rife within psychiatry.

3. Over-reliance on confirmation rather than refutation. A detailed reading of published research shows this tendency. See Pubmed.

4. Personalization of issues. i.e Tight social groups and authoritarian personality, suppression of dissent, and groupthink can enhance the adoption of beliefs that have no rational basis. In attempting to confirm their beliefs, the group tends to identify their critics as enemies.

5. Use of misleading language - Creating scientific-sounding terms to add weight to claims. Dementia Praecox or Schizophrenia?

This is just a starting point. The problem as I see it is that psychiatry is viewed by the majority of society as a benefit to their own circumstances and it becomes very difficult to dislodge this kind of thinking. For example, those in authority can question any dissent. Those persons defined as 'deviant' to the accepted norms can be 'scapegoated' and stigmatised. Psychiatry can be used by certain groups.. such as the family to get rid of 'difficult' members. Institutions, such as schools, care homes for children and old people can 'manage' 'misbehaviour'. Individuals can readily excuse their own behaviour and bad decisions on a 'disease'. ('I cannot help it!) There is much money to be made from propagating this idea, from Pharma corporations to individuals who can claim extra welfare benefits.

In saying this, I do not underestimate the suffering of those who are defined as having a 'mental illness'.

I would like to add that I think that the scientific method, a la Karl Popper, is humanities best attempt to overcome the shortcomings of our evolution. I am an atheist and do not subscribe to any religious belief. (Although I am fond of the Tao Te Ching (Arthur Waley).

I am happy to be shown to be totally wrong in my views. (I am used to this and thank those that point out my errors). I also think that this issue is very important to society.

Anyone willing to debate? --Dirk Steele (talk) 03:01, 6 September 2012 (UTC)

Take an Intro to Psych course. You clearly have no idea what you're talking about as literally everything you just said can be refuted there by people far more qualified and patient then probably anyone here.--Logic and Empricism (talk) 21:01, 6 September 2012 (UTC)

Number 1 - proved wrong by the efficacy of drugs such as antidepressants. If mental illness is not caused by biochemical causes, why do antidepressants work at all? I'm not even starting on other evidence such as substantial differences in fMRI scan results between healthy and depressed people.

Number 2 - you need to be more specific. There were some dubious claims made in psychiatry in the past, such as the whole thing about lobotomy, but that was a long time ago.

Number 3 - might be true, but a few flimsy papers doesn't make psychiatry a pseudoscience.

Number 4 - very generic, you can say this about any field of science.

Number 5 - one of those is an old term. The human brain is incredibly complex, you can't expect a few simple words to capture everything that can go wrong with it. --Tweenk (talk) 00:43, 7 September 2012 (UTC)

Thanks Tweenk for taking the time. I will respond in due course to your points. Unfortunately, I was stupid enough to miss out on my opening paragraph which I hope will support my position. So... to expound further.

Psychiatry is in a unique position as a medical speciality. Unlike science based medicine, Psychiatry has failed to find one single biological marker with which to identify a mental illness. See the Diagnostic and Statistical Manual of Mental Disorders as produced by the APA here http://www.dsm5.org/Pages/Default.aspx. This is a massive failure, despite 100 years of extensive research. Psychiatry is also unique in not having a defined pathology or etiology for any disorder. It also has no cures. Not one for the 300+ recognised 'illnesses'. This is no surprise because the 'mind' is not considered within science to be a physical object and therefore the very concept of 'mental' health, or 'diseases' of the mind is not scientifically valid. I am therefore beginning to wonder if the whole basis behind psychiatry is fundamentally flawed. --Dirk Steele (talk) 11:20, 7 September 2012 (UTC)

1. There is much debate within psychiatry regarding the efficacy of antidepressants. Although I could cite the scientific research, I.e Irving Kirsch, a starting point for this position can be found here. http://whyevolutionistrue.wordpress.com/2011/06/25/is-medical-psychatry-a-scam/ Despite much speculation and extensive research, substantial differences revealed to fMRI scans have not stood up to scientific scrutiny. Indeed, there has been many discussions on what fMRI scan actually show. See the blog http://neuroskeptic.blogspot.co.uk/ for more information. Also results from pharma research has often been 'manipulated'. Read this examination of how GSK, in conjunction with psychiatry, has managed to alter conclusions. (Study 329 - http://1boringoldman.com/index.php/2012/09/06/the-lesson-of-study-329-were-only-as-sick-as-our-secrets/). I realise there is a lot of reading here so I doubt any on rationalwiki with only a passing interest will bother to take the time. Are there any psychiatrists on board here? Dirk Steele (talk) 11:48, 7 September 2012 (UTC)

2. Given that there are no biological markers to determine any mental illness, then there can be no method of falsification. See http://ilearn.totton.ac.uk/pluginfile.php/36993/mod_page/content/3/Rosenhan%20paper.pdf . Within science based medicine one cannot claim or pretend to have cancer, or an infectious disease without being found out. I ,for example, could easily pretend to have bi-polar or schizophrenia and there would be no psychiatrist able to disprove my claim. Furthermore, certain mental conditions as defined within the DSM such as Multiple Personality Disorder, now renamed http://en.wikipedia.org/wiki/Dissociative_identity_disorder, where an individual can have up to 10 completely autonomous independent personalities, (as popularised by the film Psycho) to be ludicrous woo. Dubious procedures such as Psychosurgery and of course ECT are still performed within psychiatry although the precise nature of the lobotomy has not been performed since the 1960s. Deep Brain Stimulation is now the physical experimental procedure prefered. Dirk Steele (talk) 12:25, 7 September 2012 (UTC)

3. A single search for say Schizophrenia on PubMed produces thousand of papers that attempt to prove that this illness is caused by a biochemical or genetic malfunction. All papers have failed to be replicated and thus have not been accepted by the psychiatric institutions such as the APA or NIMH.There are very few voices or papers that attempt to disprove this belief/idealogy such as can be found here http://jayjoseph.net/publications . According to Popper, this is a sign of a pseudoscience. Dirk Steele (talk) 12:45, 7 September 2012 (UTC)

4. Agreed this is a weak point. It is based on my own anecdotal experience that has resulted in accusations of being a 'denialist' or even a scientologist and other such insults. This is rife on skeptical forums such as JREF where any attempt to discuss controversial topics is met with a groupthink rejection and ridicule without attempts to examine the evidence. I do understand that debating with creationists and homeopaths and other quacks can result in such exasperation as to invoke these type of responses. Dirk Steele (talk) 12:45, 7 September 2012 (UTC)

5. Psychiatry seems to be rife with changing of names to obscure lack of progress. Changing terms from greek to latin such as what happened to schizophrenia is just one example. Child minimal brain damage becomes ADHD. Terms such as hysteria and neurosis can disappear. Multiple Personality Disorder becomes DID, and Aspergers has now disappeared from the DSM5. I find this peculiar to psychiatry, as opposed to science based medicine, and is a sign of a pseudoscience. Dirk Steele (talk) 12:51, 7 September 2012 (UTC)

If we look at geology we find that plate tectonics gives us an overarching view. If we look at biology we have the theory of evolution. Cosmology has relativity. Physics has quantum mechanics. What is the grand theory of Psychiatry?--Weirdstuff (talk) 12:57, 7 September 2012 (UTC)

Not sure there is one. 100 years ago there were 3 mental illnesses, as identified by Kraeplin - schizophrenia, bipolar disorder, and endogenous depression. Today as defined in the DSM5 there are over 300. Not one has an accepted biological marker used in clinical diagnosis. Not one has a cure. That is the progress of psychiatry. Does no-one consider this very very weird? Any explanation would be most welcome. Dirk Steele (talk) 21:46, 7 September 2012 (UTC)

I agree with you. It's just a lot of discoveries some of which work. Although the fact that some of the medical one work takes it out of pure pseudo-science I think. I guess it's more of an art.--Weirdstuff (talk) 07:03, 8 September 2012 (UTC)

I also find it strange that the US (population 300 million) accounts for 95% of the prescriptions for Ritalan. The rest of the world (5.7 billion approx) accounts for 5%. If we then evaluate other cultures, such as China and Asia, we find that major mental illnesses are defined as defined here http://en.wikipedia.org/wiki/Chinese_Classification_of_Mental_Disorders .

   Koro or Genital retraction syndrome: excessive fear of the genitals (and also breasts in women) shrinking or drawing back in to the body.
   Zou huo ru mo (走火入魔) or qigong deviation (氣功偏差): perception of uncontrolled flow of qi in the body.
   Mental disorders due to superstition or witchcraft.
   Travelling psychosis
   ego-dystonic homosexuality.

Can anyone explain this rationally or scientifically? Anyone make an attempt even? Dirk Steele (talk) 00:42, 8 September 2012 (UTC)

http://www.newstatesman.com/culture/books/2012/09/your-brain-pseudoscience Neat article. Dirk Steele (talk) 10:17, 13 September 2012 (UTC)

Or how about the bad science of the 'chemical imbalance' myth and the drugs used to 'treat' it. http://www.badscience.net/2008/01/washing-the-numbers-selling-the-model/ --Dirk Steele (talk) 13:08, 13 September 2012 (UTC)

http://www.uic.edu/htbin/cgiwrap/bin/ojs/index.php/bsi/article/viewFile/1874/1913 Of course no person here wants to debate anything apart from the obvious. You only see what you believe. Dirk Steele (talk) 19:15, 13 September 2012 (UTC)

One issue I am trying to get to grips with is the way in which 'morality' is metaphorically and inextricably linked with 'health' within human thought. So, as George Lakoff points out in, http://www.wwcd.org/issues/Lakoff.html#MORALPATH , 'immoral' acts are linked with disease. This is the 'myth' that Szasz refers to - an idea that underpins society that may not be scientifically valid but is accepted as a truth which is not allowed to even be discussed without being accused of heresy or 'denialism'. But I appear to be talking to myself on this board.. a sure sign of mental illness. --Dirk Steele (talk) 23:40, 18 September 2012 (UTC)

Oh dear. I suppose I came here to see what debate I could encourage. I have found a bunch of sheeple. Dirk Steele (talk) 23:21, 20 September 2012 (UTC)

http://www.youtube.com/watch?v=ihooFXrGBM0

Dr Szasz was right. You are all tossers. Dirk Steele (talk) 15:06, 23 September 2012 (UTC)

Goodbye, then. And not a single fuck was given that day. ^pathetic 15:08, 23 September 2012 (UTC)

I always feel that, as soon as someone uses the term 'sheeple' they have lost the argument. It's a sort of Godwin. Of course, what it means is that the speaker - along with a small number of like minded folk - are the only ones who have seen The Truth(tm) and that everybody else is ignorant and deluded. Oh to be the only sensible one in such a world of fools! Innocent Bystander (talk) 22:51, 23 September 2012 (UTC)

A litmus test to see if someone is something is to see how much they claim not to be, and vice versa. ^bomination 11:44, 24 September 2012 (UTC)

And I think all those who love to mention Godwin have also lost the argument. "The fool doth think he is wise, but the wise man knows himself to be a fool.” --Dirk Steele (talk) 11:22, 24 September 2012 (UTC)

A poll to determine what is and is not a science? How quaint. http://www.youtube.com/watch?v=6gaQb7GzZFQ --Dirk Steele (talk) 11:30, 24 September 2012 (UTC)

Poll

Is Psychiatry a pseudoscience?

Yes	251	Vote
No	80	Vote
Don't know	11	Vote
Don't care	4	Vote

No of course not. Homeopathy? Intelligent design? You all run (rightly) to dismiss.! 40,000 lobotomies and homosexuality = disease? You all run to disclaim. Like a 'true' scientist you work to the tune you want. Dirk Steele (talk) 22:27, 23 September 2012 (UTC)

I would submit to you that psychiatry, like all sciences were at one point, is still a science under development. I, for one, do have serious questions about various parts of psychiatry (for example: the idea that drug therapy trumps traditional talk therapy in most circumstances). Mind you, modern psychiatry date only as far back as Freud and, as we all know, most of his ideas were completely ass-backwards. So it psychiatry a pseudoscience? Not necessarily (though any science can become a pseudoscience with the right amount of nonsense; see quantum woo). But is there much room for improvement and more research in order to establish it? Absolutely. Reckless Noise Symphony (talk) 11:39, 24 September 2012 (UTC)

So by your logic - creationism is still a science under development. Well back in the old days, Hippocrates talked about the disease of the 'mind' called melancholia. He thought it was caused by an imbalance of the humors. Today we think it is caused by a chemical imbalance. (There are no biological markers or clinical tests for any of the 300+ mental illnesses as defined in the DSM. Not one. Why? ) One may say that 'modern' psychiatry began the day before yesterday and so it is a science 'under development'. To me you can say the same about homeopathy. It is a new science which given time will produce results. What bollocks thou speaketh of. But of course all Americans (population 300 million) suffer from the disease ADHD. 95% of prescriptions for speed are shoved down their throats. The rest of the world.. (6 billion and rising) do not seem to have this plague. How come? All 'Underdiagnosed' says the company who sells the Methylphenidate. Have fun... http://www.bonkersinstitute.org/simpleadhd.html. Dirk Steele (talk) 12:01, 24 September 2012 (UTC)

Boy, there's so much bullshit in this post, I don't even know where to start. No biological markets for mental illnesses, claiming that psychiatry hasn't produced any results, spotlight fallacy for ADHD, and even a hint of conspiracy theory. I guess I should start with the obvious one: regarding your argumentum ad populum, what makes you think that the U.S. isn't doing it right and the other countries aren't doing it wrong? Your task is twofold; one, you have to provide a cite that ADHD and similar diagnoses are false or over-represented and secondly you need to show that it's an ineffective treatment. If you can't do that then there's no point in having this discussion. Dr. Swordopolis (talk) 13:18, 24 September 2012 (UTC)

http://www.youtube.com/watch?v=yuCwVnzSjWA Allen J. Frances on the overdiagnosis of mental illness and ineffective treatments. Obviously this major psychiatrist is biased though. --Dirk Steele (talk) 14:49, 9 October 2012 (UTC)

Ok. Name one biological marker for any one mental illness used in a clinical diagnosis. As for ADHD let me quote the DSM.

http://en.wikipedia.org/wiki/Alzheimer%27s_disease_biomarkers. Why was this so hard for you to search for? Dr. Swordopolis (talk) 15:40, 24 September 2012 (UTC)

You ignore the part of the article that states "Currently, there are many biomarkers for diagnosis of Alzheimer's disease. However, most of them do not provide consistent data results." However, I do accept that Alzheimer's is a neurological disease. But I do not think it is a mental illness. The problem with psychiatry is, as Szasz says, that if all mental illnesses are shown to be neurological brain disorders - i.e neurosyphilis, epilepsy, and the speculation that schizophrenia may be caused by a cat toxoplasma parasite!, then the condition will be removed from psychiatry to another medical speciality. Where does that leave psychiatry as a medical discipline? --Dirk Steele (talk) 00:11, 29 September 2012 (UTC)

'Often runs about or climbs in situations where it is inappropriate.' Inappropriate for whom? Name one scientific statement used to diagnose ADHD from the DSM. The treatment methylphenidate does not produce improvements in outcomes. (See Robert Whitaker Anatomy of an Epidemic).This is social control of (mis)behaviour not science. Does psychiatry have one defined etiology for a mental illness. It does not even have a definition of what the mind is. Ok if you think that the US is doing 'it' right then cite your scientific reference. Otherwise you are talking rhetorical rubbish. Dirk Steele (talk) 13:32, 24 September 2012 (UTC)

Considering the massive scope that psychiatry covers, you're clearly munching on straw for a lot of this. Your problem seems to be centred around medicalisation, which is only one particular sociological factor to do with mental illness. This doesn't translate into "psychiatry is a pseudoscience" at all. ^gnostic 14:30, 24 September 2012 (UTC)

Oh dear. "Your problem seems to be centred around medicalisation, which is only one particular sociological factor to do with mental illness." Name other illnesses or diseases that are not to do with medicalisation. --Dirk Steele (talk) 00:31, 29 September 2012 (UTC)

'Name one scientific statement?' What a laughably broad question. Does the word 'abductive' mean anything to you? Also, your assertion that methylphenidate does not produce improvements in outcomes is, if not already heavily disputed, is like your 'no disease biomarkers' so hasty that I'm || shy of saying that you're flat-out lying. You want to play cite poker? Here you go: http://www.ncbi.nlm.nih.gov/pubmed?term=methylphenidate Dr. Swordopolis (talk) 15:40, 24 September 2012 (UTC)

Yes I will play cite poker with you. So I look at the research. The papers all disagree. They cannot all be right. But they can all be wrong. Which ones do you choose that are correct? --Dirk Steele (talk) 00:25, 29 September 2012 (UTC)

Methylphenidate produces an improvement in attention (but not hyperactivity) in all people. The children who are forced fed it do not improve their acedemic performance. I can cite the research. But their behaviour is managed better by school institutions. Bully for them. --Dirk Steele (talk) 00:31, 29 September 2012 (UTC)

Ok I define psychiatry as being a branch of medicine that deals with 'mental' disease. Yes my problem is centred on this definition that I consider in error that defines social deviance as a medical issue, including the approved treatments. In my view psychiatry is as much a science as homeopathy. What is your definition of psychiatry? Dirk Steele (talk) 14:42, 24 September 2012 (UTC)

It's the same definition, which is actually very broad, but what you're almost exclusively focusing on is medication. Your problems with it are highly specific and relate to the medicalisation of mental illness and social deviance, which are very specific. If you look at any issue of the DSM, there's an increasing trend towards not counting "social deviance" as a problem unless it actually causes a problem. Asexuality and adhedonia, for instance, are no longer psychiatric problems unless they cause problems for the sufferer. Fetishism no longer counts as a mental illness unless it's expressed though dangerous behaviour. Hence why you seem to be chewing on a straw man based upon part of psychiatric treatment that are continually evolving - in most cases through observational methods - and then comparing it to homeopathy. Which is not even wrong. ^pathetic 14:50, 24 September 2012 (UTC)

"Fetishism no longer counts as a mental illness unless it's expressed though dangerous behaviour." Do you know how stupid that sounds? Mountain climbing no longer counts as a mental 'illness' unless it's expressed through dangerous behaviour. So an activity just becomes a medical disease? http://www.dsm5.org/proposedrevision/Pages/proposedrevision.aspx?rid=16 --Dirk Steele (talk) 23:59, 29 September 2012 (UTC)

'psychiatric treatment that are continually evolving' ? How has it changed since the days of Kraepelin? Apart from the fact that there is now 300 mental diseases instead of the 3 he defined. A sign of a pseudoscience is the lack of progress. Where is your evidence that psychiatry has evolved at all? The field trials for the DSM5 (over 10 years in the making) have been a complete failure. http://1boringoldman.com/index.php/2012/09/24/take-notic/

'unless they cause problems for the sufferer.' Yes tell that to the children who are given the 'diagnosis' of ADHD. Or tell to the kids in foster homes who are now drugged up to the eyeballs with anti-psychotics. Same for old folks in the care homes. Anywhere where institutions exist the 'authority' has now to be in control of individual behaviour by the (mis)use of psychotropic drugs. Dirk Steele (talk) 15:22, 24 September 2012 (UTC)

Psychiatry, like medicine, is an applied science. The fact that medicine or some particular treatment can be misapplied or misdirected due to political, societal or other reasons in a particular place in a particular time doesn't mean that medicine is a pseudoscience. Science was wrong before, and being wrong is a part of science.

By necessity, cognitive science, including psychiatry, treats the mind as a black box. As science advances, the box shrinks and changes shape, but until someone invents a "mind probe", psychiatry will remain a "pseudoscience" according to your criteria.

Do you think that physics and chemistry were a pseudosciences before the confirmation of the atomic theory? Do you think that biology was not a science before Darwin? Do you think that astronomy was a pseudoscience before the Big Bang theory?--ZooGuard (talk) 15:55, 24 September 2012 (UTC)

I do not think medicine is a pseudoscience. I think psychiatry, like homeopathy, is, and as such should be exposed as a quack CAM theory. Dirk Steele (talk) 17:03, 24 September 2012 (UTC)

So you are either conceding that you think that physics, chemistry, biology and astronomy were pseudosciences before their "central dogmas" were developed, or you are evading the questions. In both cases, Point scored!

"CAM" stands for "complementary and alternative medicine", with "complementary" and "alternative" being "to mainstream medicine". Mainstream psychiatry doesn't claim to be any of those, so your use doesn't make any sense except as a really lame slur.

Psychiatry is a branch of medicine. The term denotes both a field of study and a host of practices and treatments, each with some (attempt at) theoretical backing. Your analogy with homeopathy fails, as homeopathy is defined around a type of treatment ("tool"), not around a field of problems ("target"). (Example of the same distinction is "chemoterapy" as a "tool" and "oncology" as a field of problems - the various types of cancer.) Various psychiatric practices, treatments or theories can be determined to be wrong, useless and/or pseudoscientific, but writing off the whole discipline requires a bit more than that.--ZooGuard (talk) 18:05, 24 September 2012 (UTC)

Psychiatry is the belief that 'disapproved' behaviour is caused by a disease of the mind. It has no scientific credibility. The mind is not even a thing that can be examined. If you do not think that the comparison with homeopathy is apt, then how about astrology? And no, I do not think physics, etc, were pseudosciences and thus I did not think it even worth making a comment. Before quantum mechanics was discovered, physics was still a science. The basic idea that underpins psychiatry is woo. It will always be woo. Dirk Steele (talk) 18:40, 24 September 2012 (UTC)

No, psychiatry is the observation that some people have problems and an attempt to help them. And your argument is a pile of semantic wankery.

"The mind is not even a thing that can be examined." So, cognitive science, including psychology, is also woo?

As for things that "can't be examined", please see wp:black box, Mr. Idolator.--ZooGuard (talk) 19:25, 24 September 2012 (UTC)

Well to quote RationalWiki 'Almost anything might be referred to as a black box' Not very helpful eh? I happen to be an avid reader of cognitive science, from George Lakoff, David Chalmers, Alva Noe et all. I am not sure that their ideas can be seen as a true science. Not if my understanding of Popper is correct. But I am talking about Psychiatry (medical science?)here not cognitive psychology. Very different. You must define the mind then to be able to state that it can be diseased. Dirk Steele (talk) 19:41, 24 September 2012 (UTC)

It was a link to Wikipedia, and you are either willingly obtuse, or really dumb. My point was that you can study something without understanding its inner workings or even what it is.--ZooGuard (talk) 20:28, 24 September 2012 (UTC)

'No, psychiatry is the observation that some people have problems and an attempt to help them.' Which is my goal also. But you must be sure of what the problem actually is before you can help. Some people have problems with being bald. Some people have problems with being ugly. So does that make them psychiatric diseases? The history of psychiatry does not show this. 40,000 lobotomies? Homosexuality is a disease? ECT? Insulin coma? Thorazine and Risperdal?? Dirk Steele (talk) 19:52, 24 September 2012 (UTC)

Have you looked at the history of medicine? At the time homeopathy was established, mainstream medicine was worse. And various aspects of it continued to suck well into the 20th century. Unethical experimentation on humans, treatments not based on evidence, Big Pharma fucking up with things like thalidomide...

As for the "nutcase" part, I'm not the one who seems to have a fear of psychiatrists. :p Neither am I the one who rants and raves about the death of his idol.--ZooGuard (talk) 20:24, 24 September 2012 (UTC)

Yes and my other 'idols' are Nicolaus Copernicus and Charles Darwin. Like Szasz, they stood up to the religious persecution of their 'heretical' beliefs. Who are your idols? --Dirk Steele (talk) 00:35, 29 September 2012 (UTC)

Dirk Steele (talk) 00:35, 29 September 2012 (UTC)

No question the recently published DSM V evoked charges of quackery and pseudoscience. The complaints seem to be Big Pharma encourages diagnosis of new diseases so it can invent a pill, like FSD, ADD, PTSD, Bi-Polar disorder, wp:Oniomania, etc. In the case of Female Sexual Dysfunction it appears the pill was invented first, then the psychiatrists had to be convinced to go along with the marketing plan. nobs^{Corporations are people, too} 20:09, 24 September 2012 (UTC)

To quote the comments of your DSM link: "You’ll notice that the ones who are raising the fuss in this story are a psychologist and a psychiatrist." Sounds like science-in-progress to me.--ZooGuard (talk) 20:24, 24 September 2012 (UTC)

I do not care what they may call themselves. Science is a method. You are a tool. Dirk Steele (talk) 20:37, 24 September 2012 (UTC)

You've had enough time to learn proper MediaWiki indentation. Did Szasz object to counting colons, too?--ZooGuard (talk) 21:04, 24 September 2012 (UTC)

Oh a good argument from you for once. Have you had a colonoscopy lately? --Dirk Steele (talk) 21:18, 24 September 2012 (UTC)

Here's the criticisms of the DSM; "evolution of the DSM has been driven by socio-political and economic reasons, rather than continuous research guided by scientific scrutiny." nobs^{Corporations are people, too} 20:46, 24 September 2012 (UTC)

Sidebar: Wow. Is that the Richard Dawkins, Ken DeMyer's noted nemesis, who posted in a comment in the experimentation-online.co.uk link above? nobs^{Corporations are people, too} 20:51, 24 September 2012 (UTC)

Really unlikely. The comment feature allows you to type any name.

As for your links, the second one cites the first as half its sources. Both are written by psychologists/psychoterapists. Again, people working to refine their discipline and get rid of undue influence. Science in progress.

Oh, and by all means, read Zur's biography. Your head may explode. :D --ZooGuard (talk) 21:04, 24 September 2012 (UTC)

Allen Frances

Allen Frances, on the chair of the committee that created the DSM IV now says this. http://www.cosmosmagazine.com/features/online/5773/is-crazy-new-normal. There is no science within psychiatry. As such it is worth as much as astrology (or maybe less). Dirk Steele (talk) 21:02, 24 September 2012 (UTC)

Final sentence of that article:

“There’s great advantage in treating people who really need help,” he insists. “Psychiatry’s absolutely essential and quite wonderful when it’s done well where people really need it.”

So, argument from authority and/or quote mining.--ZooGuard (talk) 21:11, 24 September 2012 (UTC)

Homeopathists claim the same thing. So who needs to be treated by a pseudoscience? Dirk Steele (talk) 21:22, 24 September 2012 (UTC)

You were trying to use Frances as an authority, but his words directly contradicted your claims. You either didn't read the article before linking to it, or decided to bluff with your cards opened. So, why did you do that? Editing under the influence or common arrogance and plain stupidity?--ZooGuard (talk) 21:27, 24 September 2012 (UTC)

They do not contradict the claims I make. Allen Frances wrote much of the DSM IV. He is now more Szaszian than Szasz. http://www.psychologytoday.com/blog/dsm5-in-distress

http://blogs.scientificamerican.com/streams-of-consciousness/2012/05/11/why-are-there-no-biological-tests-in-psychiatry/ I can cite more if you want to look more ignorant than you are. I would even provide a link to this http://www.wired.com/magazine/2010/12/ff_dsmv/ but it is now way past my bedtime. Dirk Steele (talk) 21:35, 24 September 2012 (UTC)

Most physicians have regarded psychiatry as the illegitimate stepchild of medical science since about the time Dr. Mesmer began mesmerizing people. It's only a step up from chiropractic medicine. Given the choice of treatments between wp:bloodletting -- the recommended treatment for just about any ailment by our best scientific minds of the day -- and being mesmerized, I'd probably go with being mesmerized. Thank God I don't put my faith in doctors. nobs^{Corporations are people, too} 03:11, 25 September 2012 (UTC)

Allen Frances was chair of the committee that created the DSM-IV. Diagnosis, he says, is “part of the magic,” part of the power to heal patients—and to convince them to endure the difficulties of treatment. “You know those medieval maps?” he says. “In the places where they didn’t know what was going on, they wrote ‘Dragons live here.’” He admits that he thinks that mental illnesses are not true diseases and that he help to widen the diagnosis to include far too many people who are now stigmatised with being mentally ill.

Tom Insel is the director of the National Institute for Mental Health. “We don’t talk much about this,” he said, but when it comes to mental illnesses, psychiatrists lag far behind their colleagues in other specialties. “Diagnosis is by observation, detection is late, prediction is poor. Etiology is unknown, prevention is undeveloped. Therapy is by trial-and-error. We have no cures, no vaccines. We’re not even working on vaccines. Prevalence has not decreased. Mortality has not decreased.”

These people represent current mainstream psychiatry! Those commentators here such as Zooguard, Swordopolis and others who criticise my views are therefore the ones who are actually 'anti-psychiatry'. They are out of touch with what is happening today. Psychiatry is a secular religion that has replaced deviance (from the 'moral norms of behaviour' as defined by societal authority) from being caused by the devil and demons invading individuals - with the concept of a 'disease of the mind'. What does 'mental health' actually signify? It is a myth not a scientific concept. Dirk Steele (talk) 00:11, 29 September 2012 (UTC)

The field of psychiatry, going back to Mesmer & Fruad, were essentially medical doctors with an exceptionally well "bedside manner" whom other doctors with less patience referred clients to when they were unable to help or communicate with to make a diagnosis. These doctors with good people skills could make a patient at ease, and didn't have to bloody their hands with surgery or stick fingers up their rectum. Eventually, they began inventing diseases to bill patients for, and didn't have to send the patient back to the referring doctor with a physical diagnosis. nobs^{Corporations are people, too} 00:26, 29 September 2012 (UTC)

And of course they utilised cold reading skills to justify their excellence at 'mind reading'. Ye olde magical practise as epitomised by Phineas Taylor Barnum. Dirk Steele (talk) 00:39, 29 September 2012 (UTC)

So Szasz would question. Is the way we behave justly 'just' because of a unproven brain 'disease'? If we disobey social norms is it because of a mental disease? If we act according to social norms as defined by 'authority' are we not not crazy? Ok. I am just thinking about these concepts. You may say I am mad to do so (and question the moral fabric of the masses?). Am I mad? Dirk Steele (talk) 02:00, 29 September 2012 (UTC)

The silence here is deafening. Have you lot lost the plot? Dirk Steele (talk) 00:20, 30 September 2012 (UTC)

http://www.dsm5.org/proposedrevision/Pages/proposedrevision.aspx?rid=16

Does anyone think that this is a scientific medical illness? To be treated by an M.D? With drugs? I like the fact that this illness can only be diagnosed if one is 18 years of age or older! Like a true disease eh? What a pseudoscience! Dirk Steele (talk) 18:41, 1 October 2012 (UTC)

I really do not understand how 'rational' people cannot see the madness of psychiatry. Please can someone enlighten me. Dirk Steele (talk) 00:33, 2 October 2012 (UTC)

I don't know about the others but I'm waiting for you to realize that you basically did the wiki talk page equivalent to an insane obsessive rant and that basically everyone has been ignoring you and waiting for you to leave. Frullic (talk) 01:33, 2 October 2012 (UTC)

Ahhhhhhpwaattt! says Frullic from his arse. Just joined have you? Oct 2nd? You dogbreath thickflap. ;-) Dirk Steele (talk) 23:53, 3 October 2012 (UTC)

Oh yeh. The RationalWiki entry on mental illness denial "Nowadays anti-psychiatry is limited to a smaller, but vocal, minority within the mental health industry, the CCHR and Scientologists, and various woo-meisters, usually alties, New Agers, and other hippie types, that recycle their propaganda to hawk their own brand of quackery." is also a rant. I just followed suit. As Szasz has pointed out the term 'mental illness' is a metaphor. Lakoff and Johnson have shown the metaphor Morality is Health is prevalant. Psychiatry adopts the view immorality is a sickness or disease. This irrational myth has very serious consequences to society, and the fact that psychiatry aligned to the state is merely a totalitarian device in which to control deviance. This to me is a far more important topic than much of RationalWiki members realise. But ok rant over. Dirk Steele (talk) 12:18, 2 October 2012 (UTC)

Metaphor (cognitive science) - Immorality = disease

Thieving bastard = Kleptomania http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=72#

Selfish bastard = Antisocial personality disorder http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=16

Disobedient bastard = Oppositional Defiant Disorder http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=106

Smokin' bastard = nicotine abuse http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=459

Stoner psychonaut = druggie fiend http://www.dsm5.org/ProposedRevisions/Pages/Substance-RelatedDisorders.aspx

Sad bastard = you know what I mean.. http://www.dsm5.org/proposedrevision/pages/depressivedisorders.aspx

Please note that I think I suffer from multiple personality disorder in that I contain in my brain from up to ten seperate different personalities including a boy named Sue, (not even eleven?) and I am very very forgetful.... or to give it a fancy name Dissociative Identity Disorder http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=57

Drink! Gurls! http://www.dsm5.org/proposedrevision/Pages/SubstanceUseandAddictiveDisorders.aspx http://www.dsm5.org/proposedrevision/pages/proposedrevision.aspx?rid=415

I bet you £20 it is all garbage! http://www.dsm5.org/proposedrevision/pages/proposedrevision.aspx?rid=210

RationalWiki Ranting - see the DSM6 (under development and due to be published in 2020.)

This is a science? Ha ha! Dirk Steele (talk) 00:32, 4 October 2012 (UTC)

Just shut the hell up already, you kook. You've said your piece, no-one has listened to your fallacious arguments irrelevant to 21^st Century psychiatry, and everyone else is trying to ignore you as you spam the site with your bollocks. Time to pipe down.

Sincerely, some BoN 209.188.16.122 (talk) 12:23, 4 October 2012 (UTC)

He can't stop - he has this mental disorder that drives him to be an annoying little twat. (Annoying little twat syndrome). Randy In Boise (talk) 13:12, 4 October 2012 (UTC)

My fallacious argument? Read what the director of NIMH has to say today. http://1boringoldman.com/index.php/2012/10/06/googlizing-neuroscience/

How is 21st century psychiatry different from the 19th? Answers on a postcard please. (actually, they will fit on a postage stamp). According to the DSM we all have a mental illness now. What is yours? Easy solution though. Do not read the thread. Do not respond. Do not feed the troll. If only you had the intellect. Never mind. Dirk Steele (talk) 19:12, 6 October 2012 (UTC)

In defence of my hypothesis, aside from drawing evidence from within psychiatry, that psychiatry is a pseudoscience I would like to provide evidence from other fields.

1. Sociologists. In particular the concepts of Labeling theory http://en.wikipedia.org/wiki/Labeling_theory and Framing http://en.wikipedia.org/wiki/Framing_%28social_sciences%29

2. Evolutionary psychology - http://psychology.wikia.com/wiki/Ingroup_outgroup or http://en.wikipedia.org/wiki/In-group_favoritism and http://numerons.in/files/documents/13The-Psychology-of-Prejudice.pdf - common to all primates.

3. Cognitive science as expressed by Lakoff and Johnson regarding the metaphors of morality and health -http://www.wwcd.org/issues/Lakoff.html and also of known cognitive bias such as Attributional bias http://en.wikipedia.org/wiki/Attributional_bias and http://en.wikipedia.org/wiki/Attribute_substitution.

4. Szasz - and the human instinct of scapegoating http://en.wikipedia.org/wiki/Scapegoating as described in his books 'The Manufacture of Madness' and 'Ceremonial Chemistry' (regarding the war on drugs).

Now I know that understanding the above concepts may involve some intellectual effort but my understanding of this site is to expound the scientific method as the best way to uncover the 'truth' and to expose pseudoscience. Even though the myths of society are difficult to elucidate. Thoughts? --Dirk Steele (talk) 22:19, 8 October 2012 (UTC)

Regarding the mental illness ADHD, comments by Dr Peter Gray seem to me to be self evident and rational. http://www.youtube.com/watch?v=d_DJAZ-ByV0&feature=relmfu --Dirk Steele (talk) 12:21, 13 October 2012 (UTC)

Psychiatry fulfills the criteria of a religion - http://rationalwiki.org/wiki/Religion --Dirk Steele (talk) 09:41, 23 October 2012 (UTC)

Anyone taken an interest in http://en.wikipedia.org/wiki/Medicalization What do you think? Dirk Steele (talk) 23:42, 30 October 2012 (UTC)

Maybe one should peruse the meanderings of http://1boringoldman.com/. Any thoughts? Dirk Steele (talk) 04:22, 31 October 2012 (UTC)

http://www.youtube.com/watch?v=RpeHJ2wEPzk --Dirk Steele (talk) 13:52, 4 November 2012 (UTC)

http://www.youtube.com/watch?v=17xTUdIG6nQ&feature=relmfu More evidence of pseudoscience. --Dirk Steele (talk) 15:32, 4 November 2012 (UTC)

http://www.youtube.com/watch?NR=1&v=3kGG0W9s2qk&feature=endscreen http://www.youtube.com/watch?v=wjw9DC7wgvA&feature=relmfu British psychiatrists at work. Dirk Steele (talk) 16:16, 4 November 2012 (UTC)

While I personally think that psychiatry is largely crap I don't find argumentum at youtub (sic) convincing.--Weirdstuff (talk) 18:40, 4 November 2012 (UTC)

I pander to the masses here. Not that I want to and you can see from my citations above I use all information that I can to express ideas. So what media would you use to reinforce your belief structure? The problem I have is that when I state my belief.. I get a response.. normally that I am a crank. Then when I question the response.. then nothing. Silence. See my threads to understand this process in it's full beauty. Why is that? Why do you think that, apart from the initial ban and insult..., no-one responds further? Dirk Steele (talk) 02:24, 5 November 2012 (UTC)

I also do not understand the fact that certain topics such as scientology (probably only a few thousand adherents worldwide.. gets such publicity whereas 400,000 lobotomies are ignored. 10-20 million children are drugged in the USA in an attempt to change their naughty anti-authority behaviour! In the name of quackery. Pseudoscience. Phrenology. Astrology. I really cannot understand this attitude but then again I am only a european and not a mighty all-knowing American! Over 90% of the total amount of methylphenidate is prescribed in the USA. If one does not question why this is a fact then skepticism and the scientific method is lost in the aether. Dirk Steele http://www.youtube.com/watch?v=iQIVPonHhx8&feature=related is entertainment. (talk) 02:57, 5 November 2012 (UTC)

Maybe books are ok to cite then? http://books.google.co.uk/books?hl=en&lr=&id=hpOcRRum3XEC&oi=fnd&pg=PR11&dq=szasz+myth+of+mental+illness+paper&ots=sCUJYMwtuw&sig=IW5nziDBPevsPjLZXSkUO5UxmJ4#v=onepage&q=szasz%20myth%20of%20mental%20illness%20paper&f=false Dirk Steele (talk) 21:55, 8 November 2012 (UTC)

http://www.telegraph.co.uk/news/uknews/crime/9663701/Labour-MP-Margaret-Moran-claimed-53000-in-false-expenses.html The 57-year-old created bogus invoices for more than £5,000 of building work that was never done, claimed for telephones that did not exist, and “kitted out” homes she was not entitled to claim for. Following The Daily Telegraph’s investigation into MPs’ expenses in 2009, Mrs Moran’s expense claims were investigated by police, resulting in 15 charges of false accounting and six charges of forgery. The former MP for Luton South, who stood down at the 2010 election, is being tried in her absence at Southwark Crown Court in London after psychiatrists declared her unfit to plead because of the state of her mental health. Psychiatry is a pseudoscience. Dirk Steele (talk) 22:15, 8 November 2012 (UTC)

From Someone in the Know

From someone who used to work as a psychologist and is now in their second last year of medical school.

(1) Psychology/psychiatry presents a dilemma compared to more traditional disciplines (chemistry, medicine, physics) in that it is harder (but not impossible) to obtain objective evidence. Let's see a comparison with heart disease. In heart disease, we can cut open an artery to find atherosclerosis, and can visualise the valves of the heart. The brain is made up of neurons with microscopic processes and is many, many times more complex than any other organ in the body. With the advent of new imagining techniques, we are beginning to understand how it works, but we are still very far from appreciating every pathway. This indicates the need for more research, not to dismiss the research which we currently have.

Objective evidence where? Please cite. It is accepted by the APA, NIMH, and all other institutions, apart from Pharma, that there are no objective scientific biological markers for a mental illness. And of course there aren't. It is a fantasy to believe that the mind can be examined under a microscope. It is a delusion to say that the mind - a concept not a physical thing - can be subject to a physical disease. It is unscientific quackery to think that an 'idea', similar to economics or politics, can be be sick - apart from metaphorically. All the research in the world can never support such a proposition. Ever. --Dirk Steele (talk) 17:21, 10 November 2012 (UTC)

The brain is a complex organism which has billions of connected neurons, similar to a computer. Our consciousness is merely a reflection of those neurons firing in particular patterns, just as your computer is presenting you with an image of its underlying circuitry. There is a TON of evidence regarding visual pathways, speech/motor areas, memory formation, reward pathways etc (ie components of one's "mind"). It's taken us a while to obtain this evidence, because the brain cannot be dissected similar to other organs. However with the advent of imagining, we can do this. It's easier to get information on processes such as speech, because people can speak on demand. Finding out about emotions takes longer, it's harder to make someone feel sad on demand.

Your computer has billions of connected neurons? You must use an Apple then! --Dirk Steele (talk) 12:25, 11 November 2012 (UTC)

So given we have already identified pathways associated with memory/reward, why is it that hard to believe that one day we will have solid evidence about which neural patterns reflect depression/anxiety? Of course whether these patterns are the cause or the effect is a different matter. Unfortunately this area of research has been hijacked by "biological psychiatrists", who argue that abnormal brain structure is the cause of depression, rather than patterns reflecting a sign. But the evidence is building up.

We may not have the answers now, but the evidence we are receiving is showing we are on the right path. Are you suggesting we just give up because we don't have conclusive evidence at this exact point in time?

Spoken like a true creationist nut. Yes - give up. The mind is a concept not a physical thing. It can never be examined by a medical instrument. Mental health and mental illness are not scientific topics - they are a belief system. Psychiatry, which claims to 'treat' the mind is a pseudoscience and it always will be. --Dirk Steele (talk) 12:25, 11 November 2012 (UTC)

(1a) Psychiatry and psychology are now researched with the same rigors as any other discipline in medicine/science.

I dispute this fact. Which is why pharma companies have been fined billions. (More than any other industry). Although I accept that science can be used to research this area it is obvious that rigorous standards have taken second place to financial gain. --Dirk Steele (talk) 18:20, 10 November 2012 (UTC)

I was referring to independent research, moreso in the field of psychology rather than medical psychiatry.

I am not talking about psychology. It is a different subject to psychiatry. --Dirk Steele (talk) 02:57, 11 November 2012 (UTC)

(2) Modern psychiatry does not (for the most part) work with diseases, it works with syndromes. Syndromes are constellations of symptoms which reflect an underlying cause. For instance, depression is characterised by persistently low moods, loss of interest, changes in sleep and appetite etc, which reflect an underlying process. The underlying process could be underlying social stressors, thyroid dysfunction etc. A syndrome does not need to be reflected in an investigation, and it is entirely wrong to dismiss a patient's symptoms simply because they cannot be detected on a blood test. Funnily enough there are a number of non-psychiatric conditions which are diagnosed in the absence of objective investigations.

Syndromes? or more 'weasel words'? Disease, illness, disorder, and now the new buzz word - syndromes! I know there are many conditions.. pain being the greatest example which cannot show up on a scientific objective test. But the whole of psychiatry.. not just a little part, but all of psychiatry is not subject to a physical (chemical or biological) test. It make one wonder what this 'medical' speciality actually is. It makes me think it is a pseudoscience. Also, I am not suggesting in the slightest that psychiatric patients symptoms are ignored. I do not believe, and am supported by scientific evidence, that these are not the result of a physical objectively identified disease. Dirk Steele (talk) 18:14, 10 November 2012 (UTC)

"Syndromes are constellations of symptoms which reflect an underlying cause." Yeh.. tell that to the birds and the bees and the butterflies and the bats. Oh don't forget human beings. All can fly. Why? --Dirk Steele (talk) 20:19, 10 November 2012 (UTC)

If you cannot understand basic medical terminology, you can hardly claim enough knowledge to argue if something is pseudoscience or not. The differentiation between "disease" and "syndrome" has been around a lot longer than psychiatry has. If you want to dismiss the concept of a "syndrome", consider heart failure. It is generally accepted to be a syndrome reflecting one of many underlying processes (ischemic heart disease, valvular heart disease, chronic systemic hypertension etc).

Nobody is arguing that there isn't an objective test (yet). However a collection of characteristic symptoms can certainly suggest a disease/syndrome. We are taught a doctor diagnoses through 70% history (what you tell them), 20% examination (targeted through the history) and 10% investigation (objective evidence).

I have chest pains (a syndrome). How does a medical doctor decide what the cause is? By taking empirical scientific tests and measurements and then and only then giving a diagnosis. Psychiatrists just guess. Which is why the kappa scores for the field trials for the DSM 5 are so rubbish. --Dirk Steele (talk) 02:57, 11 November 2012 (UTC)

(3) I completely agree that academic psychiatry, particularly the DSM-V, have become obsessed with categorising everything to the nth degree. This is entirely inconsistent with clinical practice, as every individual has a unique personality. What you will find is that most good psychiatrists/psychologists don't even think about the DSM-IV in practice, I only ever used it when making a court report or when trying to understand a paper.

I think you will find that the DSM is totally necessary for those clinicians to be able to claim recompense for their activity and for those who are treated to claim on insurance. Is there another more important document, apart from the ICD, that defines mental illness? Name it please. --Dirk Steele (talk) 18:03, 10 November 2012 (UTC)

I am fortunate to live in a country which has evil socialised medicine and doctors do not need to justify themselves to a pen pusher.

Information which suggests there is much use of the DSM in Aussieland. http://www.theaustralian.com.au/news/health-science/medical-bible-squabble/story-e6frg8y6-1226359242372 --Dirk Steele (talk) 11:09, 13 November 2012 (UTC)

(4) There have recently been meta-analyses which report that the efficacy of an antidepressant is only 1% better than a placebo. However these papers themselves have a number of problems given the vast number of studies they have tried to include. There's no point trying to say that a group of 14 year olds and a group of 84 year olds with symptoms of depression will have the same response to anti-depressants. Similarly, a number of weak studies were included, which include those which failed to show basic criteria for recruitment. Interestingly enough, the evidence for talking therapy is as strong (or as weak) as for anti-depressants. This and the discrepancies in the independent literature suggest that it is prudent to separate social causes of depression (for example, someone going through a rough divorce) from other cases (someone who feels depressed for no reason). What this ultimately suggests is a need for greater control in future research, as well as more research from independent institutions.

Are you making the claim that 'talking therapy' cures a real disease? Oh come on! You think that talking nicely can cure cancer, measles, diabetes, or tuberculosis? You must be a complete quack! --Dirk Steele (talk) 18:07, 10 November 2012 (UTC)

Now you're going compete off topic, I put talking therapy in the same boat as anti-depressants.

I will repeat again if you think that a disease can be cured by someone talking to you, or using the correct language then you must be mad. This idea is just so unscientific. Only metaphorical 'disease' can be cured by rhetoric. I.e it is not a true medical disease. I cannot see how everyone here cannot see this simple point. --Dirk Steele (talk) 12:18, 11 November 2012 (UTC)

(5) Child psychiatry is a very different field to adult psychiatry, given that the patient's lack insight into their behaviour/emotions and will not respond to therapies such as CBT. I wholeheartedly agree that ADHD is over-diagnosed in the US, and that many children are commenced on inappropriate medications. However in a system where the ability to diagnose and treat is restricted (such as Australia), many children have improved their concentration and academic performance. Ritalin is certainly not a cure (just as insulin is not a cure for diabetes), but it can do wonders. If you've never been exposed to child diagnosed with this, then you have no idea what you're talking about.

Cite the scientific papers that show that CBT does not work with children. There is also no evidence to say that academic performance is improved - in fact the researh shows otherwise. http://terrygingrasphd.com/adhd-brains-meds-not-enough-to-improve-grades/ . There is however research that shows that school teachers and administrators are pleased when they can control children's behaviour with class II illegal drugs. Most psychiatric 'disease' or 'syndromes' are cultural. A 'disability' is defined by the prevailing society and it's institutions. Dyslexia only occurs in societies that value writing. There is a view that autism may have been advantageuous in hunter gathering societies http://www.campacademia.com/blog/?p=1752 . ADHD, which was unknown when I was a schoolboy is the result of the change in school practises. http://www.ldawe.ca/DSM_IV.html. A true scientific disease has nothing to do with cultural behaviour or what is morally deemed as deviant. My sons were 'diagnosed' (without any scientific measurement) with ADHD so I do know what I am talking about. You do not. Dirk Steele (talk) 17:59, 10 November 2012 (UTC)

So they weren't diagnosed through one of the comprehensive diagnostic tools (110+ questions for at least 3 different parties)?

Which test is that? --Dirk Steele (talk) 03:07, 11 November 2012 (UTC)

CBT works with older adolescents who have insight into their emotions. It doesn't work with younger children who still rely on their parents for emotion support. This is a basic tenant of child psychiatry/psychology. Again if you don't do your research, you can hardly call yourself qualified to talk about what is pseudoscience. For a start, rather than googling to find single pieces of evidence, try reading up on attachment theory.

Scientific citation is required to show that CBT does not work on children. Thanks. I am fully aware of attachment theory.

All healthcare is culturally based to a degree. Why are obstetricians delivering babies when for thousands of years this practice was performed by midwives? Why are plastic surgeons performing cosmetic operations on otherwise well people? Someone who is paralysed will be more disadvantaged in one society than another. Similarly, in a more primitive society, ADHD would certainly have been beneficial. But society identifies and treats what it considers to be a disability, which given our current system of schooling and work includes ADHD. Are you suggesting that we stop treating diseases simply because they wouldn't have been problematic to our ancestors?

I am suggesting that disease should be defined in a scientific manner not by some quacks out to make a quick buck. --Dirk Steele (talk) 03:07, 11 November 2012 (UTC)

Just because something isn't recognised, doesn't mean it doesn't exist. To give you an example, post WW2 a number of soldiers exhibited symptoms consistent with post traumatic stress disorder (nightmares, flashbacks, anxiety etc). Back then there wasn't any mental health care, so many of them turned to alcohol and morphine to sooth their minds. Over time, research was conducted which identified similar symptoms appearing in different soldiers. This led to PTSD being recognised. Later on, genes were identified which showed which people were at a higher risk of developing PTSD. Now there is good evidence that PTSD can be treated.

PTSD is not a 'disease'. It is a reaction to trauma. Which genes? Citation required please. --Dirk Steele (talk) 03:07, 11 November 2012 (UTC)

(6) Similarly, if you think that alcohol, nicotine and drug addiction are a joke, then you need to get out of your house and go down to the shadier part of town. Funnily enough, there are recognised neural pathways that result in addiction.

I am addicted to ciggies, whisky and other nice but illegal drugs. I can, if I want to enough, give up these behaviours. Millions of people do this every day. I have given up nicotine many many times!! To say that a person cannot do this because of a brain malfunction or 'disease' is totally incredulous. Groups such as the AA who attempt to state that alcoholic addiction is an illness outside of a person's control and that one must subscribe to a higher power yet also claim that total abstinence is the cure are rationally insane. You have an ideological belief system which has nothing to do with science. Dirk Steele (talk) 17:50, 10 November 2012 (UTC)

If you're addicted than by definition you can't just give up those behaviours when you want to. Some people have the willpower and motivation to do so, but others need a lot of support. Interestingly this is a field which has less medical input than others, a majority of support is provided by social groups (such as AA). Nonetheless, there is strong evidence that medical support (methadone, disulfiram etc) can greatly improve the chances that someone can wean off their addiction.

Yes I can give up these behaviours if I want to. I have done just that. 'Medical' support was much less important than my will power. Although I do not dismiss 'help'. --Dirk Steele (talk) 03:07, 11 November 2012 (UTC)

I have no idea what you're talking about "higher power"s. As for whether total abstinence is good or not, try researching the mesolimbic pathway in the brain, there is a lot of evidence for its role in addiction.

(7) Citing a legal case where charges were dismissed because of a mental illness claim does not reflect a problem with psychiatry, it reflects a problem with the legal system. Blame a lawyer rather than a doctor.

No way!! A lawyer cannot provide a diagnosis of mental illness. This decision must be performed by a psychiatrist. The fact that psychiatrists have greater legal powers than lawyers and judges is a fact accepted by society. Psychiatrists are the only people that can imprison a person without that person breaking any law and psychiatrists can make 'innocent' or not guilty those that have actually committed a crime. What the fuck! Madness rules --Dirk Steele (talk) 17:42, 10 November 2012 (UTC)

I don't know what weird system you live in, but where I live it is controlled by lawyers/judges.

Lawyers decide who has a disease or not? That is weird. --Dirk Steele (talk) 03:19, 11 November 2012 (UTC)

In our system, mental illness is only accepted as a full defense if it impairs the mind to the point where one cannot differentiate between right and wrong. Thus psychosis is accepted as a defense, but not personality disorders or depresson.

In our system, tribunals determine whether someone should be involuntarily kept in a hospital, and these are run by lawyers. Psychiatrists get their say, but so do the patients and their family members.

Not true. A lawyer cannot decide whether someone has a disease or not. Cite some evidence please. --Dirk Steele (talk) 03:19, 11 November 2012 (UTC)

It is generally accepted by a number of independent charities/organisations to be a very fair system which ensures that patients get the care they need with the minimal disruption to their rights.

If your system is different, then it is an issue you should take up with politicians/lawyers, not psychiatrists.

(8) There is actually evidence that lobotomies were efficacious in treating schizophrenia. These days we have the benefit of anti-psychotics (which, by the way, there is a lot of evidence for), but in the past they had to resort to whatever means they had. There have also been a lot of treatments in other fields of medicine which had terrible side effects, but which have now been replaced by others. Should we dismiss all of those fields because of their past histories? Also your comparison to Scientology is completely incorrect, the last lobotomy for psychiatric (rather than neurological) purposes was performed over 40 years ago, Scientology pushes its ideas today. See the difference?

Destroying parts of the brain will have many repercussions. Destroy my frontal lobes and see the difference in my activity. (not a lot I confess!) To claim efficacy in such situations is probably evil. The last lobotomy was not performed 40 years ago but still occurs today. http://www.brainphysics.com/surgery.php There are many who are calling for the nobel prize awarded to Egas Moniz to be rescinded. http://www.baam.emich.edu/baamnewsarchive/BAAMbnalobotomy.htm. To cut out or spey parts of a brain is biological madness. And yes, antipsychotic drugs do perform a chemical lobotomy - as proved by the scientific research. Your position is insane. Dirk Steele (talk) 17:36, 10 November 2012 (UTC)

101.175.157.194 (talk) 04:54, 10 November 2012 (UTC)

Anti-psychotics most certainly do not perform chemical lobotomies. They are much more specific to the symptoms, have less effects on other brain functions, and are more effective at treating psychosis.

Two major WHO studies have shown that the western model of treating mental illness with neuroleptics does not work as well as treatment practised in developing countries which do not use brain damaging drugs. --Dirk Steele (talk) 03:19, 11 November 2012 (UTC)

Unfortunately 50-60 years ago we didn't have widespread use of anti-psychotics. Schizophrenics would either wander the streets untreated, or be institutionalised for the rest of their lives. On the streets they were often violent towards innocent people (who, in their mind, were trying to kill then) and in institutions they were unable to be controlled. Unfortunately for the doctors, a lobotomy represented the only way to keep people safe. I'm not going to get into an argument about whether this was ethical or not, but at the time it was the only thing which could be done.

You must be jokin here surely! Even ironic? No, I am sure you do not want to get involved in ethical considerations. Ha! --Dirk Steele (talk) 03:19, 11 November 2012 (UTC)

You may also be interested in studies like this http://schizophreniabulletin.oxfordjournals.org/content/early/2012/11/20/schbul.sbs135.abstract which show how schizophrenia is not a deenerative brain disease and that any brain damae found is the result of anti-psychotic treatment. Hardly a cure. --Dirk Steele (talk) 20:10, 24 November 2012 (UTC)

If you want to judge modern psychiatry by the actions of a select group of psychiatrists many decades ago, consider that some of our knowledge on gastrointestinal surgery comes from prison camps a decade earlier where surgeons rescected and reconnected bowel. Should we dismiss that field on the same basis?

Ethics? No.. certain human beings can be sacrificed for the benefit of authorities surely? Are you really training to be a doctor? Really? --Dirk Steele (talk) 03:19, 11 November 2012 (UTC)

That these statements above can be written by someone who thinks they are 'Someone in the know' is actually amusing. The fact that they are written by someone who claims to be a medical student is frightening! I am scared as hell at this irrational thinking by someone who may 'treat' someone in the future. I am sure it will be a treat and not just a trick! Dirk Steele (talk) 18:28, 10 November 2012 (UTC)

Then you better never come to Australia. On my side, I'm wondering if you are trolling or drunk.

I have watched 'Border Control Australia' on the TV here. They would never let me in! I am not criminal enough. --Dirk Steele (talk) 03:19, 11 November 2012 (UTC)

With the greatest respect, it's clear that you lack basic knowledge about modern psychology/psychiatry, and that you are selectively quoting evidence in order to push your position. While I am very happy to have a discussion with you, right now it's akin to discussing engine types with someone who doesn't know the difference between a sedan and a truck.

If you genuinely want to discuss this, rather than just having an argument, pick up a university/college level textbook on psychology/psychiatry. I'd recommend Martin, Carlson and Buskist published by Pearson, which provides good independent commentary (including the controversies surround anti-depressants, imagining etc) and have a skim through that. It will only take a couple of days, but it will explain a lot of the things I've touched on here. Then we can have a discussion on the same level. 101.175.157.194 (talk) 23:50, 10 November 2012 (UTC)

I have a BA (hons) in psychology from Sussex University in the UK. Psychiatry is not the same subject. Clue... it has a different set of letters after the first five. I am quite capable, even when totally drunk, of having a discussion with you because your arguments so far have been pretty vacuous. However, you will need to cite some evidence to back up what you say. Dirk Steele (talk) 02:46, 11 November 2012 (UTC)

You scare me. It is no wonder that the ordinary joe has started to question medical science when it is presented by such jerks as you. Disgraceful. Dirk Steele (talk) 03:21, 11 November 2012 (UTC)

To the only person bothering to respond

Sorry, but because you have no account the only thing I have to go on is your IP address of 101.175.157.194. I would like to ask you to join the rest of the website in just sighing, facepalming, and moving on with your day when Dirk comes and spreads whatever new bit of nonesense he feels like blathering on about today. However, I'm going to say that aside from odd random nutters like Dirk, our website is a good place to BS and learn something new, so, please make an account and kick up your feet. --Logic and Empricism (talk) 04:12, 12 November 2012 (UTC)

I see you are responding. That makes two by my count! User Hamilton (Logic and Emricism (sic))is as irrational on this subject as is his spelling ability. He actually believes that such fantasies as Multiple Personality Disorder (whereby people can have up to 10 independent personalities) and Oppositional Defiance Disorder, (arguing too much with authority) are actually real medically proved brain diseases. Not to mention the Narcissistic Personality disorder, (one who likes himself too much) and Anti-social personality disorder are also brain diseases... and has no scientific evidence to back such works of fiction. He thinks that bad behaviour is caused by brain malfuntions (instead of being culturally deviant action) although other good behaviour shown by the same said individual is caused by his non-illness. Obviously delusions such as creationism and the belief that psychiatry is scientific must also be the result of a brain disease. --Dirk Steele (talk) 11:20, 13 November 2012 (UTC)

Oh and on the other thread, given your interest in economics, I posted a link to a paper on the economics of mental illness. http://econlog.econlib.org/archives/2006/09/they_called_me.html (choose the draft link for a doc download.) What do you think? Dirk Steele (talk) 11:28, 13 November 2012 (UTC)

Sorry for the delay in replying. Thanks for the invite! I did have an account on here a few years back, but I've forgotten what the username is :S. I tend to only get involved in internet debates when I have exams...

Dirk, with the greatest respect your Bachelor of Arts has given you some ability to analyse psychiatry from a humanities perspective, but it has clearly missed out on the scientific perspective. You seem to be intent on using personal experience and citing single studies rather than considering the entire body of evidence, so I'm not sure if you are really open to discussion or just enjoy arguing. If I have time, I will reply to your points in depth after exams.

Sorry in the delay in replying.. just back from a 7 day block. (you will learn that expressing certain heretical views here are frowned upon). Anyway, my mention of my degree is only in response to Hamilton who has advised me to take an intro into psychology. I claim no authority from my 1970s education. In fact I reject now the Fraud and Junk stuff that I was taught.. although I do retain a certain respect for Piaget and others. My interests since then have been more biological (W. D. Hamilton), philosophy of science (Popper) and cognitive science (Lakoff). Hope your exams have gone well.Dirk Steele (talk) 00:43, 22 November 2012 (UTC)

To pretend there are no biological influences on mental illness is just as foolish as pretending there are no social influences. A person's experience is a balance between their social experiences (personality style, stressors) and their biology (eg hypothyroidism manifesting as depression). The debate is not about whether either of these exists, but about how much influence they exert. Certainly when it comes to illnesses such as schizophrenia and bipolar, it seems quite obvious that there is a strong biological factor (why on earth would lots of people pretend to hallucinate?).

I, following on from Thomas Szasz, refute the idea of mental illness - given that the mind is a concept and cannot therefore be subject to disease - as defined by Rudolf Virchow as a cellular lesion within the body. I do not doubt that there is a biological element to what is defined as a 'psychiatric illness'. I reject that what is called a psychiatric disease is a biological illness such as is defined by medical science. It is not a 'disease' in the same way medical science defines disease since it has no etiology. I reject the concept that a persons behaviour (actually only 'misbehaviour' or deviance in thought)is caused by a medical 'disease'. I think it is a cultural disapproval of certain actions that cause a 'displeasure' or disapproval within the authoritarian institutions of a society.

Of course there are many reasons why people would attempt to blame their behaviour on 'hearing voices' that they have to obey. Oliver Sachs has written that auditory hallucinations are very common (And with little effort I can hear the voice of my mother as she scolds me!) Ancient greeks thought that voices came from gods. And of course the internet is full of blogs and youtube vids from those who claim that their 'bad' behaviour is caused by a disease - outside of their control. They are fakes. My children - when they were infants - useed the same excuse. 'I cannot help it!' 'It is not my fault!'. 'I did not mean it!'. So I believe there are many reasons why people might take advantage of these views. I have met many people in mental hospitals who claim such nonsense because they can get a bed and food rather than sleeping rough. --Dirk Steele (talk) 00:58, 22 November 2012 (UTC)

It is true that there is no objective test for mental illness... yet. This would almost certainly come in the form of neuroimaging. Over the last decade there has been a lot of research into neural pathways. We know where the centres for speech and motor activity are, we know the area which are activated when someone accesses their memory, and we are increasingly beginning to see how different emotions appear. A person's consciousness (mind) is not independent of their body, it is the result of neurons firing in different sequences. Furthermore the brain is not fixed, it is ever changing. This raises the possibility of whether mental illness would be reflected in these changes. There is a small amount of evidence that it is, and a lot of research is being conducted in this area. Now this is not to say that mental illness is CAUSED by changes in the brain, it could be that there are other causes (eg social stressors) which are simply reflected in the images. However, this area does raise hope for new treatments and the like.

Yet. ? How long do we have to wait. For 150 years psychiatrists have been saying 'yet'. Neuroimaging - if you read blogs such as Neurosceptic - is fraught with issues. I believe, like Szasz, that changes in the brain are caused by social stress. The belief that a social stress can be cured by a psychotropic drug is nonsense. Biological psychiatry is a pseudoscience. So is the idea that a medical 'disease' can be cured by talk therapy. Pure quackery. --Dirk Steele (talk) 00:58, 22 November 2012 (UTC)

Just as it is foolish to write off all the evidence for biological factors in mental illness, it is foolish to pretend the massive volumes of research on the various syndromes, their treatment and prognosis doesn't mean anything. Many people from many different backgrounds with many different personalities suffer from very similar constellations of symptoms, whether they be depression, anxiety, schizophrenia etc. And these people, despite having very different lives, seem to respond similarly to treatment (with the exception of those with personality disorders). Even if it was just that we're medicalising part of the human experience, when that human experience is pathological to the point where it causes great distress and dysfunction beyond what a normal person would experience AND that it can be treated, why is it wrong to do so?

While human experience may cause distress you must think about such 'conditions' as homosexuality. When it was a crime or a sin or defined as a mental illness of course it caused stress. Same with masturbatory insanity ot drapetomania. The actual distress is caused by a cultural conflict which has nothing to do with disease. Nazi Germany, USSR and China have all defined anti authoritarian views as resulting from a disease. So has the UK and the USA. Now we have Mad Pride which is a political movement which states that neural differences should not be defined as an illness. Human beings are unique and as such have different brains. Psychiatry is a primative primate view that all human beings should be the same and must have similar physical constructs. The new phrenology. I believe this view is wrong. Dirk Steele (talk) 01:11, 22 November 2012 (UTC)

Let me give you another statement - "medicine is a pseudoscience". A few centuries ago that would have been true, back then there was virtually no evidence for what doctors were doing, and most treatments achieved absolutely nothing. Someone could just have easily have said that medicine is simply taking parts of the human experience (heart attacks, broken bones) and that we should just let diseases run their course. But through rigorous application of the scientific method, the institution we have today was developed. That same scientific method applies to psychiatry and psychology.

I agree to a certain extent. Astrology was once thouht of a a science. But times change. Modern day medicine has become scientific. Astrology and psychiatry have not. Dirk Steele (talk) 01:15, 22 November 2012 (UTC)

Also nobody is claiming that personality disorders are solely the result of abnormal brain structure. If that it what you truly believe the other side believes, then you really need to pick up a textbook. 58.165.164.86 (talk) 06:49, 18 November 2012 (UTC)

Cite your references please that personality disorders are not the result of a mental illness. Which personality disorders? What textbook should I read? Thanks. Dirk Steele (talk) 01:15, 22 November 2012 (UTC)

Now I understand that some here can see that the idea of a 'disease' of the the mind is not scientifically credible - since the 'mind' is not an physical object that can be examined - it is an idea or concept - and so state that a mental illness is actually a brain disease. But it is neurology which is the medical speciality that deals with brain disease and not psychiatry. Even our language shows that these disciplines are not the same. Someone who has a neurological illness - say a stroke or a brain tumour or trauma - is never refered to as crazy, or mental or insane. The first thing that a neurologist will do is take pictures of the brain -MRI or EEG or whatever - and examine these. In the same way a cardiologist or a liver specialist will take x-rays or scientific empirical measurements to determine the illness. A psychiatrist never actually examines the brain! - the supposed object of his examination. He will almost never take an blood test, x-ray, MRI, or chemical test. Why not? Because there is a qualitative difference between scientific medicine and the pseudoscience of psychiatry. Furthermore if any psychiatric symptom is shown to have a physical cause - such as in neurosyphilis or epilepsy or hypothyroidism - it is taken away from psychiatry and moved to another medical discipline. (Of course 'talk therapy' cannot and never will 'cure' a physical disease - the idea is complete woo.) If all psychiatric diseases were shown to have a true physical cause, say schizophrenia was caused by a toxic parasite, it would no longer come under the province of psychiatry! Psychiatry would no longer exist! Dirk Steele (talk) 08:24, 22 November 2012 (UTC)

Um... personality disorders are not the result of mental illness. They can be a risk factor for things like depression, but not the other way around. What the hell did you learn in your degree?

I've already cited a textbook for you to read. You can find it (or a version) at most university libraries, and if you're open to the idea it can be found on various torrent sites.

I have looked at the contents on Amazon. I have read extensively most of the areas mentioned. hich parts of the book do you think I should brush up on? --Dirk Steele (talk) 01:00, 23 November 2012 (UTC)

If schizophrenia does not have a biological basis, then what is your explanation for people experiencing hallucinations and delusions? Do you believe they are faking it? Absence of knowledge of a cause is not absence of a cause.

All life has a biological basis. I do not think a delusion, such as god created the universe in 6 days or that one has been abducted by aliens is caused by a disease. As Sachs has shown hallucinations are very common and are not indicative of a disease. I do not accept the medical model of the conditions that are commonly called mental illness. Spiritual mediums have for many years claimed to hear the voices of dead people. Do you believe they are faking it? It is well established that when people hear voices they are actually using speech muscles as well using brain areas such as Broca's area. They are actually engaging in self conversation. We all have thoughts that spring into our head which we can mistakenly attribute not being from ourselves. Benjamin Libet's work is important here. When an artist or scientist has this 'inspiration' we applaud. When psychiatric patients experience this - they have a brain disease. How logical is that? I take this view http://en.wikipedia.org/wiki/Medicalization Dirk Steele (talk) 22:23, 22 November 2012 (UTC)

A person's consciousness is the result of the billions of neurons in their brain firing in certain patterns. If you want to argue that there's some other cause that's fine, but it would certainly be outside the realm of science. It would be the same as arguing that the software we run on a computer is not the result of electrical circuits firing (?) in different patterns in the CPU. 58.165.164.86 (talk) 09:24, 22 November 2012 (UTC)

I have no need to argue. I agree with you here. The fact is that we all have different brains due to our changing environments. My many years of playing a musical instrument means that my brain is probably different to non musicians. Differences in brains are not an illness. I think the psychiatric history of homosexuality demonstrates my view. Even if genes or biochemical differences are observed, homosexuality will never be a disease. Likewise with ADHD, which I think is the result of recent changes to school institutions and family disfunction/conflict. It cannot be treated 'medically' and it is an error to do so. I am influenced by Laing, Bateson Szasz, and more recently Richard P Bentall, and many other such psychiatrists/psychologist loosely associated with the (terrible term!) 'anti-psychiatry' although personally, like Szasz, I am no more anti-psychiatry than I am anti-religion. Dirk Steele (talk) 22:23, 22 November 2012 (UTC)

Alright, I can type up a long comment expressing my disbelief that someone claiming to be so well read doesn't understand the concept of a delusion, and cannot differentiate between normal cognitive processes, drug induced hallucinations and schizophrenia. But for the sake of my sanity, let me try to understand where you're coming from first.

1) A person's cognitive experience is biologically based - I think we agree on this

2) If something is biologically based, then by definition there is objective evidence for it. It is more a question of whether we have developed a means to measure this objective evidence - do you agree?

Because your original argument was that psychiatry is a pseudoscience as it would never have objective evidence. Now you seem to be contradicting that.

So that means your position has changed, and that it is now whether we are over-medicalising parts of the human experience.

My position has not changed. We are not 'over-medicalising' - we are medicalising certain human experience that has nothing to do with medicine. We are defining unwanted behaviours as being caused by a disease. This paradigm is plain wrong. I have already explained that psychiatry deals with mental disorders. Neurology is the medical science that deals with the brain. When and if any psychiatric 'illness' is shown to be caused by a real physical pathology it is moved from psychiatry to the relevent medical speciality. (As what happened with neurosyphilis epilepsy etc etc.) What then is psychiatry? What sort of discipline is it? Psychiatrists do not even examine the brain as diagnosis is completed using subjective measures. In medicine we either have a disease or not. We either have measles or cancer or we do not have them. In psychiatry there is a spectrum - we can be a 'little bit schizophrenic dependin on the number of conditions we show (i.e display 4 out of 6). I therefore do not accept that psychiatric illness is a real disease. As Szasz would say 'mental illness' is a metaphor not a valid scientific concept. --Dirk Steele (talk) 11:28, 23 November 2012 (UTC)

Well I completely agree, and most clinicians I've met would as well. The problem is that academic psychiatry has spread its net too wide (especially in the DSM4/5). The prime example is depression. In clinical practice and a lot of the literature, depression can be distinguished into psychotic depression (characterised by delusions and catatonia), melancholic depression (characterised by somatic symptoms) and non-melancholic depression. The first two occur in older patients, are strongly associated with a family history (suggesting a genetic link) and are highly treatable by antidepressants/ECT but not CBT. In contrast, non-melancholic depression is likely a combination of a person's personality and their response to a social stressors. It often does not respond to antidepressants (they have a placebo effect) but can be treated with CBT. Unfortunately the categorisation in the DSM does not reflect this at all.

The DSM4/OCD10 are in the words of Ben Goldacre 'total crap'. And he used to be a psychiatrist. But what other document is used to define in detail a mental disease?. I, and many others, do not agree that ETC 'treats' anything - it causes brain damage. Its efficacy is highly questionable. --Dirk Steele (talk) 11:35, 23 November 2012 (UTC)

So if you're willing to take the view that we need to reclassify mental illness into psychiatric conditions which need medical intervention (schizophrenia, bipolar, melancholic depression) and psychological conditions which need support and therapy (anxiety disorders, non-melancholic depression, conduct disorder) I would completely agree with you! It's something we need to do, and the fact that we haven't means 1) people are receiving medication which isn't helping, 2) people aren't receiving the therapy that they need and 3) people like yourself think that psychiatry is a pseudoscience. I blame the influence of the drug companies.

However the fact that this reclassification isn't occurring does not mean that psychiatry is a pseudoscience. It means that one institution that publishes one book isn't getting it right. This institution does not represent psychiatrists around the world, nor is it responsible for just 1% of the research being conducted.

1% - not true. Any research paper on a mental illness has to use the DSM. --Dirk Steele (talk) 11:35, 23 November 2012 (UTC)

But if you're arguing that mental illness can never exist - that it is simply medicalising parts of the human experience, then you really need to open your mind. If you have ever met a schizophrenic, bipolar sufferer or melancholic depressive, you will be able to see their experiences are not normal. Take hallucinations for example. They can be "normal" (if someone restricts their sleep) and they can be induced (through drugs etc). But in a schizophrenic they are recurrent without any external cause, and cause a person to become completely detached from reality. There is a very big difference.

Not 'normal' in this instance does not mean a disease is the cause. It could be the result of trauma. Maybe the bi-polar (I have been diagnosed as such and have in my time met many with mental illness). Perhaps my 'highs' are higher and of course then my lows are lower because of my experiences and my personality. You may say that schizophrenic symptoms have no external cause but there are thousands of psychologists/psychiatrists that would disagree. Being 'detached from reality' is a subjective cultural sociological relative term. You will need to explain this in more detail for me to understand. --Dirk Steele (talk) 11:53, 23 November 2012 (UTC)

You can argue all you want that people who suffer from schizophrenia/bipolar/melancholic depression are just having "normal" human experiences and don't need treatment. But if you take that view, how can you justify treating someone for a heart attack? Isn't that part of the normal human experience? How about someone with end stage kidney disease? In practice that is defined by an arbitrary number, one person with a low GFR (amount of urine produced) can have quite different symptoms from another? So why treat them? Surely that's just part of the human experience as well? What about giving Tamiflu when someone has influenza? It is a lot less disabling than even the most benign of mental illnesses. Surely that must be part of the human experience, why on earth would we treat it? If you want to write off the "hard" mental illnesses as simply being part of the human experience, then you're going to have to write off most of modern medicine as well. 129.94.178.74 (talk) 05:43, 23 November 2012 (UTC)

You are not being logical here. A heart attack or other medical conditions are caused by a lesion in the cell which causes the body to function abnormally. By stating this is a normal human condition you are changing the category of the meaning. If I made consider an analogy. Some of the greatest suffering is caused by 'madly falling in love' and being 'heartbroken'. Note the metaphorical use of language here - are you aware of the work of George Lakoff rearding framing metaphors?. Now to suggest that these two conditions can be treated by medical science is ludicrous(although I am expecting psychiatry to 'invent' these diseases very soon!) Or maybe you do not think this and are willing to medicalise the obsessive mania and grief caused by the normal human condition of being in love. I am sure that these can be treated by altering the biological composition of the brain - maybe ECT will work here also. The fact is that the significance of a golden wedding ring cannot be analysed by scientists looking at the chemical composition. Likewise with the mind and the brain. Dirk Steele (talk) 11:44, 23 November 2012 (UTC)

So let me get this straight...

Over a week Person A gradually becomes more and more paranoid. He believes that satellites are reading his thoughts, and that agents from the government of Ecuador are trying to kidnap him. There are no rational explanations for these beliefs. Person A eventually attacks a stranger who he believed was a government agent. He was admitted to hospital, and after treatment with anti-psychotics his symptoms remit. He has insight that his thoughts and behaviours were completely deranged.

All human beings suffer from irrational thoughts. All of us suffer from confabulation, confirmation bias, cognitive dissonance etc. So do you and I. George Bush and Tony Blair had paranoid beliefs that Iraq had weapons of mass destruction and paranoid thoughts that Iraq was a threat to 'national security'. They killed hundreds of thousands of innocent Iraqi civilians including women and children. By diagnosing a 'disease' model of human behaviour you completely ignore both context and agency. What makes you think this is a medical matter to be cured by 'treatment' with psychotropic 'medicine? I notice you use the cliche of a mad murder whose behaviour is 'sick' In the theocratic state this person is possessed by the devil. Today in the theurapeutic state this person must have a brain disease. Our metaphors used to explain deviant behaviour are based on old ideas of purity and disgust and linked to moral notions. Not scientific at all. You have this irrational belief. --Dirk Steele (talk) 04:29, 24 November 2012 (UTC)

Funnily enough 'Blair' synchronicity led me to this video just today http://www.youtube.com/watch?v=grOPYw2fZUg&list=UL I suggest if you are serious about being a medical practitioner you may want to evaluate other videos made by this woman in this series. Dirk Steele (talk) 14:09, 1 December 2012 (UTC)

Over a two week period, Person B becomes more and more grandiose. He believes that he is Jesus, spends $400k of his life savings on buying land to build his "church", and then starts visiting prostitutes. He is admitted to hospital, treated using mood stabilisers and anti-psychotics and his symptoms remit. Within a couple of weeks he makes a full recovery, and then begins to realise that his marriage has broken down and he has virtually no money. He has insight that his behaviours were abnormal.

He had a very good time then ran out of money! He now has insight that his choices in life led to past good times but a tough future. Don't we all have to make this decision in life? (Impulse control we learn as children?) What has this to do with medical matters. Like a policeman who sees every act as a potential criminal activity you seem to view every human activity and choice as a potential disease. There are thousands of people who have grandious plans or believed themselves to have a religious vision that they want to spread to the world. How can you frame this as a medical brain disease? --Dirk Steele (talk) 04:36, 24 November 2012 (UTC)

Person C is an elderly lady who is admitted to hospital with a fractured hip. While there she suffers some mild thrombotic events, and a couple of weeks later becomes very catatonic. She refuses to interact with anyone, and lies in bed repeating "I want to die". After a single course of ECT her mood completely changes, and she says she has hope and wants to get back to her family. Her depression returns later in her admission, this time it is treated early with antidepressants and she makes a full recovery.

Camus states 'There is but one truly serious philosophical problem and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy.' We all make this choice. What has this got to do with medical disease? It is a moral question. You can damage a brain with ECT so that people cannot think. It is not a 'cure' in my eyes. Dirk Steele (talk) 04:48, 24 November 2012 (UTC)

There is also good evidence to suggest that the authority of the physician actually encourages the view that his intervention has helped and that results based on a checklist such as the HAM-D are not reflective of the results but of confirmation bias. I can cite papers on this. Dirk Steele (talk) 09:55, 30 November 2012 (UTC)

Person X is a man who divorces his wife. He feels very distressed about this.

Normal behaviour - what is your point? That this is some kind of illness? --Dirk Steele (talk) 05:00, 24 November 2012 (UTC)

Person Y is an elderly man who has no family, and lives in public housing on a disability pension. He feels very lonely and begins to contemplate suicide.

Normal behaviour - what is your point? --Dirk Steele (talk) 05:00, 24 November 2012 (UTC)

Person Z is a man who just wins the lottery. He becomes very euphoric and spends all of it on drugs and girls. He becomes very distressed about his spending of the money.

Yes - he becomes very distressed that he has run out of money and cannot afford the great times he had. He chose to live for the present and not for the future. Is this anything to do with medical science?

George Best - a famous British footballer - like David Beckham, said 'I have spent most of my money on drugs and girls (He dated a few Miss Worlds)..the rest I have wasted.' Is this anything to do with medicine? Dirk Steele (talk) 04:54, 24 November 2012 (UTC)

In my personal opinion, A, B and C are true "psychiatric" mental illness. Their cognition and behaviour is very abnormal, cause them a great deal of distress and cannot be explained by external stressors. These are the patients who I would consider referring to a psychiatrist and treating medically.

They cannot be explained by you as having 'external stressors' only because you do not see them. They can be explained by me and others. Many choices we make are in hindsight mistakes that cause us stress. You as a doctor think you can cure this 'disease?' Ha! You jest - life is not like this. Even 'paranoid schizophrenics such as Breivik or mass shooters can act in a totally logical manner depending on belief structures and situations encountered. How do you define a 'psychiatric' illness? --Dirk Steele (talk) 05:04, 24 November 2012 (UTC)

X, Y and Z have what I would consider to be "psychological" mental illness. While they are under distress, their behaviour is the result of external stressors. While I would consider referring X and Z to a psychologist (they could certainly benefit from supportative and CBT therapy), I would not consider medication unless their symptoms became a lot worse or well beyond what was normal. Person Y may need a psychiatric referral but not for medication, but because he is suicidal and (in Australia at least), psychiatrists are responsible for scheduling patients.

I do not understand. What is a 'psychological' as opposed to 'psychiatrical' illness. How do you define illness here? Explain further please. Thanks --Dirk Steele (talk) 05:04, 24 November 2012 (UTC)

If you cannot appreciate that mental illness cannot be simply clumped into one category (from your perspective - normal behaviour) then there's absolutely no point continuing this discussion. There are external influences on diseases such as schizophrenia and bipolar (highly emotive environments exacerbating symptoms etc) but these in on way come close to explaining the spectrum of symptoms they experience.

You're obviously very well read in the field of "anti-psychiatry". I've read a lot of those books as well, and I think they raise some very valid points. However, it is rare to find a book from the last decade which outright says that mental illness does not exist. They make some very valid critiques about research and management, criticisms which are especially valid in the US (which has massively overprescribed psychotrophic medications). However, the need for a better path does not mean that the current path is entirely invalid, nor does it mean that the destination doesn't exist.

I think I am well read in the total field of psychiatry. No one says that the 'conditions' that are defined as a mental disease do not exist. Only that those 'conditions' should not be defined as an illness of the brain. This is a myth that underpins the ideology of modern society. The fact that 'bad' behaviour is not the fault of the person and of their choices in life but are blamed on a medical disease. This is a religious ideology in the same way that bad behaviour in the past was blamed on the devil. Have you read any Thomas Szasz? --Dirk Steele (talk) 05:16, 24 November 2012 (UTC)

The difference between you and I is that I've had the benefit of not only reading about psychology/psychiatry, but seeing and treating hundreds of patients in inpatient and outpatient settings. To quip our dean on our first day of medicine - "to study medicine without books is like going to sea without maps; to study medicine without seeing patients is to not go to sea at all". Until you have met a group of people who genuinely suffer from schizophrenia/bipolar/melancholic depression, you have absolutely no idea what their experiences are like, and whether their claims and the treatment they receive is valid.

I have met with many many people who have been diagnosed with a mental illness. I myself have been dianosed as bi-polar. Unless you have experience - existential experience - of these things how can you claim to know what they really are more than I do. The fact is you have no idea what it is like. You just like to feel superior. Dirk Steele (talk) 05:20, 24 November 2012 (UTC)?

To give you an example. I used to think that the sentences given to offenders in our country were horrendous. I went online and read a number of newspaper articles and victim's advocacy groups pushing for tougher penalties. I formed a very strong view that judges were out of touch with community expectations and required stronger guidelines. However, after discussing this with my partner (a lawyer), I came to realise that this wasn't entirely the case. There are a number of factors which influence sentencing behaviours which need to be considered. While I still think the system needs a lot of reform, I appreciate that there is a fair bit of validity in what we've got at the moment.

You confuse criminal justice with mental disease? I do not understand the point you are trying to make here.

And for your information, everyone over the age of 35 has some degree of fatty streak and atherosclerosis. Every. Single. Person. The reason why we consider some cases to be pathological and others not is because of the degree of symptoms (stable angina) and the risk of more serious events occurring. Atherosclerosis is a much more integral aspect to the human experience than schizphrenia and bipolar (which only affect between 0.5% - 1% of the population), so if you believe we shouldn't treat schizophrenia, how can you justify the use of stents and lipid lowering medications? 58.165.164.86 (talk) 23:51, 23 November 2012 (UTC)

You have here made a scientific empirical observation about a physical object which may have statistical repercussions about health. This has nothing to do with a 'mental illness'. I am saying that the conditions that are called 'schizophrenia' are not objective, rational nor amenable to 'treatment' in the medical sense. All attempts to do so will fail. This failed paradigm needs to change before a 'solution' can be found. But thanks for the debate. I may be wrong. My ideas here have resulted in multiple bans and blocks - so I expect my answers to your further questions may have to wait a while. But good luck with your exams. Our objectives are the same... to alleviate the suffering of human beings. We only differ on the paths... Dirk Steele (talk) 05:32, 24 November 2012 (UTC)

<-- I'm going to put this in the nicest way I possibly can. I'm hungover and it's a hot day, so this may come across as being very mean, but it has to be said.

You do not have a clue what you're talking about.

You've made a number of statements in this discussion that show how little you understand about modern psychiatry.

You do not know appreciate what delusions are, and cannot differentiate between paranoid schizophrenia and political/religious beliefs. You do not understand the basic mechanism of action of psychiatric medications. You do not appreciate the difference between normal grieving and the loss of function associated with depression. You do not seem to understand that there is a very big difference between modern psychiatry and psychiatry 40 years ago. Etc. Etc. Etc.

I am not going to point out every one of your mistakes, nor am I going to try teaching you. It would take me ages to go over the basics, and I don't believe you are genuinely interested in learning about the other side.

If you do want to learn more, try going to your local university/college library and picking up a textbook of psychiatry. Hale's Essentials of Clinical Psychiatry has a great, concise discussion of the evidence up until 2003, and the New Oxford Textbook of Psychiatry can fill in the blanks between 2004 and 2012.

When you have read a bit more of the scientific texts (rather than the blog articles and books which call psychiatry a pseudoscience) then you may have a better appreciation of psychiatry. At the very least, you would be able to debate without making simple, elementary mistakes. 124.183.74.17 (talk) 00:09, 15 December 2012 (UTC)

Hello person with an IP address 124.183.74.17. I hate to say this, but it has been said several times by people with varying degrees of understanding of psychiatry and mental health in general that he doesn't know what he's talking about. He has variously claimed to have done an undergrad in either psychiatry or psychology, and gone all the way to claiming to have done decades of work in the mental health field. He is full of shit, since he's also admitted to being diagnosed with ODD. Some very qualified people have destroyed his arguments, partly by pointing out, as you did, that he lacks an understanding of even basic terms and concepts, and the suggestion that he take a class or read a book has been made several times.

Hate to make you waste your time responding to him. The folks here on the site have basically resigned to the fact that he's at best a mindless troll and until he changes his posting/editing style greatly, we've basically moved to containment mode. Please make an account, most of what happens here is not at all like this.--Just relax, and stay funny (talk) 01:46, 15 December 2012 (UTC)

Can we just leave?

Obviously, this guy is a just a troll here for a good argument. It's been made clear, like, 7346995311478473626262718 times that he has no idea what he's talking about, and he isn't listening to perfectly good evidence that doesn't support his viewpoint. How about we just ignore him? 121.220.212.163 (talk) 11:30, 5 December 2013 (UTC)

How about practicing what you preach? This thread is at the top of the Forum index only because random unregistered users can't help jumping into an year-old discussion.--ZooGuard (talk) 12:14, 5 December 2013 (UTC)