Mental illness denial
|Not just a river in Egypt
|♫ We're not listening ♫
“”If you talk to God, you are praying; If God talks to you, you have schizophrenia. If the dead talk to you, you are a spiritualist; If you talk to the dead, you are a schizophrenic.
|—Thomas Szasz, famous denialist
Mental illness denial is the denial of the existence of mental disorders as real medical conditions.
“”I’ve got a cure for mental health issue[s]… Spank your children more.
Jehovah's Witnesses and other Fundies
Jehovah's Witnesses avoid any form of mind manipulation, be it through psychoactive drugs (except alcohol) or hypnosis. They believe that subjecting oneself to hypnosis exposes the person to demons, or more generally, makes them more susceptible to the influence of Satan. Similar views are shared by some Fundies, who turn out also to be Anti-vaxxers too.
L. Ron Hubbard's batty crusade
In the 1950s, L. Ron Hubbard published his book, Dianetics, and repeatedly submitted papers on the subject to psychological and psychiatric journals. Of course, the editors of the journals thought the idea of the Reactive Mind and the state of Clear was baloney, and they all rejected his submissions. Hubbard, however, continued to peddle his pseudopsychology and built up a cult following around Dianetics. He and his followers started up a bunch of schools and organizations to promote his bullshit.
After one of them closed down due to lack of funding and the American Psychiatric Association criticized Dianetics, Hubbard went into uber-crank mode, denouncing it as a conspiracy by psychiatrists to destroy his precious Dianetics. Hubbard's butthurt over a perceived conspiracy by psychiatrists helped lay the foundations for Scientology, one of the largest cults in US history. In the early '50s, Hubbard and his followers began to call themselves Scientologists and started various chapters and associations of Scientology. It wasn't until 1959, though, when the Church of Scientology would take on its more familiar trappings by introducing E-Meters and such. But we'll come back to Hubbard later.
Mental illness denial in anti-psychiatry
The anti-psychiatry movement was never really a unified movement in any way, more a collection of philosophers and activists who were vaguely interrelated and some who were not even totally opposed to psychiatry at all. Some opposed to core tenets of psychiatry believed in mental illness, while others didn't. Some like Clifford Beers instead promoted "mental hygiene". This section focuses on those anti-psychiatrists who deny mental illness itself.
An influential voice in mental illness denial was the American psychiatrist Thomas Szasz. Szasz used his post to attack the workings of the legal system. Szasz published The Myth of Mental Illness in 1961, which became a bedrock of American mental illness denial. He used his newfound platform to launch his crusade against the insanity defense and the practice of involuntary commitment. He argued that severely depressed people should not be prevented from committing suicide if that was their wish. Szasz's basic argument, which he repeated ad nauseam over tens of books throughout his life, was that 'mental illness' was a literalized metaphor because the mind (note: not the brain) was not a physical scientific object and therefore could not be subject to a biological disease. He argued that therefore the brain could only be subject to disease, but not the mind, and that psychiatry in the absence of consistent biomarkers for verification of mental diagnoses did not present the concept of mental illness as something that could be empirically falsified. Szasz also argued for the legalization of drugs, the end of involuntary commitment and lobotomies, and against the misuse of shock therapy. He was also a major critic of the idea that homosexuality was a disease. He did not advocate for the end of psychiatry as a discipline, though; he simply believed it to be a pseudoscience and argued that people should be allowed to see psychiatrists only if there was mutual consent.
Szasz's mental illness denial is not the only form of mental illness denial. He seemed to come more from a right-libertarian or neoliberal perspective, rather than a systemic perspective. In other words, Szasz had a tendency to assign all behaviours related to psychiatric diagnoses on the individual rather than on external factors. Rather than taking a "sick society" or "only meds cause mental illness" approach to biological mental illness denial, Szasz took a "people choose all behaviours" approach. An example would be how Szasz described how he believed drug addiction was entirely a matter of individual willpower and downplayed the effect medication has on the brain as far as withdrawal. This mindset, if adopted by patients, could lead to withdrawals that are too fast or unorthodox and unsafe drug withdrawal practices.
"Dacia Maraini: "Regarding the so-called insane persons, what does this new method entail?" Giorgio Antonucci: "For me it means that insane persons don't exist and that psychiatry must be completely eliminated."—Giorgio Antonucci
Giorgio Antonucci was a prominent Italian physician in the second half of the 20th century who was largely critical of psychiatry.
Again with Hubbard
This is where Hubbard comes back in. He saw an opportunity to further his crusade against psychiatry when he heard of Szasz's work and, in conjunction, the two formed the Citizens Commission on Human Rights (CCHR). Szasz never was and never became a Scientologist (ironically, Szasz is known as a staunch atheist), but the CCHR essentially became the anti-psychiatry front of the Co$ and acts on their direct order. The CCHR has been peddling its bullshit ever since, spewing some really batshit conspiracy theories claiming that psychiatry was responsible for World War I, Hitler, Stalin, and 9/11. They were also responsible for that Psychiatry: Industry of Death tour recently. Szasz himself never believed this nonsense, but acted as an enabler for the insanity coming out of the CCHR. Notable uber-quack Gary Null also has the CCHR to thank for his anti-medical anything position.
Loss of common cause and fractioning
After the barbaric practice of lobotomy ended, along with the de-institutionalization of mental patients (in some countries entirely due to anti-psychiatrists, eg Basaglia's Law in Italy as a result of Franco Basaglia), as well as a court ruling that protected those with mental illness under the Americans with Disabilities Act, the anti-psychiatry movement lost some of its traction. Growing tensions between secular anti-psychiatrists and Scientologists have also heavily weakened it — because of Scientologists' habit of infiltrating any organization that might further their cause, many anti-psychiatry groups have banned Scientologists from joining.
Arguments against mental illness denial
The most common argument by mental illness deniers is that there is no such thing as mental illness because there is no observable pathology. Szasz and others have been reformulating, repackaging, recycling, and regurgitating this argument since the '60s. This assumes that the brain works the same way as the heart or the liver, which is actually true. Some mental disorders may be defined as some point on the very extreme end of the bell curve where an individual is simply dysfunctional. Dyslexia, for example, may be defined as an extreme disability in reading skill. Thus, it is simply a category with which people may be labeled so they can receive extra help. This also precludes the fact that what was once purely a mental illness may later be found to have a biological basis. Senile dementia, for example, is being increasingly replaced with the diagnosis of Alzheimer's, which is now thought to be at least in part due to a build-up of neuritic plaque in the brain.
Yet another problem with this argument is that we currently do not have the technological means to view the chemical interactions of every synapse of every neuron at the same time, so there could be some dysfunction there that is unseen. There is also an example that everyone is familiar with: migraine headaches. This cannot be "seen" by current technology,
but no one would deny that migraines exist. Categorically not true, the validity of migraines is contested as separate from chronic headaches, as depression is questioned as separate from chronic sadness. Likewise, headaches cause 'mental pain', but if one were to give anti-depressants for migraines (as some doctors do), one would probably be irresponsible, as the pain from headaches is not the sickness, but rather the headaches themselves. The pathology of headaches are well understood (irritation of meninges and blood vessels) and therefore makes them falsifiable. Szasz and others also argued that some chronic sadness could be a 'brain disease' (not a 'mental disease'), but in the absence of falsifiable pathology, trying to 'cure' it alone would be dangerous overreach.
|This section requires more sources.
Advances in the research of neuroplasticity have made this even more silly. This discovery has shown that humans are able to add synaptic connections through their experiences.
This has been researched (with some good success) for treatment of Post Traumatic Stress Disorder, Obsessive Compulsive Disorder, as well as Generalized Anxiety Disorder. Subjects were given medication that interfered with memory recall and asked to read aloud their traumatic experience that would normally cause a flashback, or read aloud something that would normally trigger a maladaptive response. By exposure, and taking medication that interfered with the brain's ability to recall the memory with such vividness, several subjects were able to read their experience aloud without the same emotional response that would normally cause the unwanted behaviour or response. This is proof that while we can not actually "see" a mental disorder, we can treat it by physically interfering with how the brain recalls an event through use of medications that have been proven to interfere with the brain's ability to recall memory and make new neural connections. Turns out you can cure almost anything by suppressing memory of an event, wow, much science.
ADHD and autism denial
Often, ADHD is believed to be "diagnosing childhood."
One of the main problems with ADHD may perhaps be how vaguely the disability is defined. In West-Flanders, for instance, 20 individual doctors wrote 60% of Ritalin prescriptions. The minister of health found it so ridiculous that she spent €390.000 on experts that streamline the diagnosis and treatment of ADHD.
Critics of the neurodiversity movement may argue that its use of the social model of disability (instead of calling autism a tragic disease and should instead be seen as "just a harmless difference") amounts to autism denial. Members of the neurodiversity movement typically believe that autism is not an illness, but a neurological difference associated with both strengths and weaknesses that is not adequately accommodated in society. Critics, such as members of the autistic dark web or supporters of various autism scientific organizations such as those apart of the "Pathology Paradigm" or "charity" organizations like Autism Speaks, believe that this overlooks the severity of the problems some autistics face (though it's worth noting that some members of the neurodiversity movement are indeed severely disabled although many more are noted to be lower support needs).
The "difference model" offers a newer approach to mental illnesses and disabilities. This, as contrasted with the "deficit model", varies from the other examples here in that it makes no factual denials. Promoters of the difference model, while acknowledging the symptoms of a person's mental illness, also look at the positives associated with some cognitive differences and take a more strengths-based approach.
In the most extreme form of the difference model, people believe that all people with mental illnesses should not be given treatment and that society should be "restructured" instead to accommodate them. They argue that mental illness itself is a construct. This idea of promotion of "accepting" overt mental illnesses might sound nice in theory, but to put such abstract premises into practice would be based at best on extreme levels of wishful thinking and would ignore and possibly even romanticize both the disabling aspects of many disorders as well as well as how such disastrous impacts typically have on both the affected individual's life and those around the individual. Imagining a world where conditions like schizophrenia, serious intellectual disabilities, psychopathy, pedophilia, and god knows what else to all be seen as "harmless differences" that should be "accepted" and "accommodated to" no matter what rather than to try the far more reasonable method to simply treat them so they could properly function, even if the affected people would wish to be treated themselves, would not only sound like a literal dystopic hell-scape, but also would not likely be able to realistically function as a sustainable society.
Most proponents of the difference model take more moderate positions. They believe that while people with mental illnesses and disabilities should have access to any treatment they want (such as therapy and medication), society should also be more caring and accepting, and open to the positive parts of neurodiversity. While this is claimed, this doesn't seem to be true for members affiliated with the neurodiversity sub-group of the autism rights movement whose members almost universally oppose most mainstream psychological treatments and therapies for the condition, which they see as "trying to remove the autism from the individual", and oppose any and all research into such treatments. While this might be argued to be a good thing for some autistics who do not want to be forced to take said treatments by those who claim to "always know best" for them, and are able to live relatively independently (such as people who are low-support needs), this put into practice would leave out any and all on the spectrum who would be okay with undergoing such treatments, or for people who are so debilitated by the condition that they cannot be expected to reasonably advocate for what they see as best for themselves. Because of this, it is frequently criticized for largely representing those who are low-supports needs or those who are self-diagnosed.
In the United States of America, cost-cutting "care in the community" initiatives partially prompted by these ideas have led to a low availability of long-term in-patient care for persons with mental illness. Most in-patient stays for mental-health complaints last only a few days in the United States, compared to several weeks in Sweden. People with mental illness report beneficial effects from long-term in-patient care, and due to the extremely high treatment drop-out rates for certain mental illnesses, long-term in-patient care for these conditions may be medically needed. However, this kind of care is not routinely available in the United States, and when it is available, it is extremely expensive. This lack of infrastructure is probably motivated more by the cost of public-health infrastructure and stigmatization of mental-health problems rather than pure mental-health denialism, but mental-health denialism may be used to justify the absence of adequate public treatment-programs.
In contrast to the "difference model," the idea that persons suffering debilitating psychiatric symptoms should be expected to conduct themselves identically to other people, viz. "snap out of it", is widespread. This is like asking a disabled person in a wheelchair to just get up and run a marathon.
A rational person might conclude that both societal support and access to treatment are important, as some people suffer tremendously from their conditions, while others need only a few environmental adjustments in order to live well.
In their defense
There are several who complain about the scientific validity of Psychiatry (and mental illness from a psychological and neurological perspective as well) who take the position of Karl Popper on what is and what is not science. In their defense, a strict Popperist would be largely forced to come to the conclusion that psychiatry is a form of pseudoscience, if only because it is often difficult to the point of impossibility to prove in a strict experiment what causes mental illness. In theory, one could provide drugs which should replicate the neural conditions which cause a mental disorder to a person who does not have a mental illness, and see if they develop this condition. For example, a common theory of what causes Major Depression is that a neural transmitter (essentially, a chemical that tells your brain to do things) called serotonin is reabsorbed by the neuron which released it (a process called "reuptake"). Many Anti-Depressant Drugs are chemicals which prevent this from happening, thus treating the neurochemical cause of depression. In theory, a group could develop a drug which would cause this excessive serotonin reuptake, and see if this causes Major Depression in their patients. This is, however,
considered hilariously unethical and thus very unlikely to happen.
The response to this point is threefold:
- Because we cannot ethically know that excess serotonin reuptake is the cause of major depression, but treating that seems to cure the symptoms, we can assume that it is the cause.
- This is essentially the problem faced by all medical professions, since none of them can ethically try to give their patients a disease to verify that (for example) HIV causes AIDS.
- There is a reason Mr. Popper, while highly respected, is no longer the king of philosophy of science. A strict Popperist would be forced to conclude that the majority of science is, in fact, unscientific.
Psychiatry as a science has developed, which means that diagnoses have become more precise and better defined. Historically, diagnoses such as hysteria, idiotism, or homosexuality were common. The underlying illness could be poorly understood, misdiagnosed, or even nonexistent. Likewise, the treatments applied were historically often ineffective, not evidence-based and even harmful to the patient. A minority of mental illnesses have been dismissed in recent times as non-existent; most notably drapetomania and sluggish schizophrenia. Drapetomania was coined by physician Samuel Adolphus Cartwright in 1851 to refer to the condition exhibited by slaves wanting to escape. Sluggish schizophrenia was coined by Andrei Snezhnevsky, who as one of the chief architects of Soviet psychiatry, broadened the symptoms of schizophrenia to include any pesky political dissidents and even those indirectly affected by alcoholism. Snezhnevsky rose to a position of authority in the vacuum left after the purges of Soviet psychiatrists between the 30's and 50's. Both these supposed disorders had obvious ideological motivations.
Along with the majority of the German medical community in the Nazi era, psychiatrists and physicians acted in accordance with the T4 euthanasia program designed to kill the mentally disabled and emotionally distraught. However, this occurred in a vacuum of psychologists, as after the Nazis' rise to power in 1933, several prominent psychologists such as the Freudian school had left Germany, their works largely destroyed.
- Steven Novella's five part series on mental illness denial: Part I, II, III, IV, V
- The Nature of Things (Canada only) - shows different treatments all using neuroplasticity as the basis for treat multiple mental illnesses.
- The Myth of the "Myth of Mental Illness", Ratbags
- Trump campaign CEO wanted to destroy Ryan by Jonathan Swan (10/11/16 03:47 PM EDT) The Hill.
- Hubbard timeline L. Ron Hubbard Media Resources.
- Szasz's Myth of Mental Illness
- Mental Illness vs Brain Disorders: From Szasz to DSM-5 by Awais Aftab (February 28, 2014) Psychiatric Times 31:2.
- Mervat Nasser. The Rise and Fall of Anti-Psychiatry. Psychiatric Bulletin 1995, 19:743-746.
- Dacia Maraini intervista Giorgio Antonucci" [Dacia Maraini interviews Giorgio Antonucci]. La Stampa (in Italian). 26 July 1978 and 29–30 December 1978.
- Collection of articles on the exhibit as well as general articles on CCHR at Xenu Directory.
- See this Wikipedia talk page on Null detailing CCHR contributions to his projects.
- The homepage of the Anti-Psychiatry Coalition puts it bluntly: "No Scientologists, Please."
- Neuritic (senile) plaques, University of Oklahoma College of Medicine
- Cluster-migraine: does it exist? by Angela M Applebee & Robert E Shapiro (2007). Curr. Pain Headache Rep. 11(2):154-7. doi:10.1007/s11916-007-0014-x.
- Top 10 Unexpected Migraine Treatments medically reviewed by Ed Zimney (2007) Everyday Health.
- Greenberg D, Aminoff M, Simon R (2012-05-06). Clinical Neurology 8/E:Chapter 6. Headache & Facial Pain. McGraw Hill Professional. ISBN 978-0-07-175905-2.
- De Block: elke provincie krijgt ADHD-specialist (26/11/15) Knack.
- A Course in Abnormal Psychology: Models of Psychopathology, Lecture 16 by David L. Gilles-Thomas Counseling Center Village, University at Buffalo (archived from November 16, 2005).
- Five Broad Models of Mental Illness
- [The autism rights movement] https://web.archive.org/web/20080527025140/http://nymag.com/news/features/47225/
- The Controversy Around Autism and Neurodiversity
- A medical condition or just a difference? The question roils autism community.
- Short-term outcome of inpatient psychiatric care—impact of coercion and treatment characteristics by Tuula Wallsten et al. (2006) Social Psychiatry and Psychiatric Epidemiology 41:975–980. doi:10.1007/s00127-006-0131-6.
- Ethical benefits and costs of coercion in short-term inpatient psychiatric care by L. Kjellin et al. (1997) Psychiatr. Serv. 48(12):1567-70. doi:10.1176/ps.48.12.1567.
- Dropping out of treatment: A critical review by Lawrence Lundwall & Frederick Baekeland (1975) Psychological Bulletin 82(5):738–783. doi:10.1037/h0077132.
- Lavretsky H; The Russian Concept of Schizophrenia: A Review of the Literature; Schizophrenia Bulletin 24 (4): 537–557