AiA Library:Psychiatrogenics

Thomas S. Szasz
Dr. Szasz is one of the most important social philosophers of the past century. He is best know for his critique of the scientific claims of mental health professionals. But his writings are far more comprehensive, dealing with suicide, drug controls, and the exercise of social authority by physicians.

Thomas Szasz portrait
by Jerome Paul Witkin

The Case Against Psychiatric Coercion
"The systematic exercise of force requires legitimation. Formerly, Church and State, representing and implementing God's design for right living, performed this function. Today, Medicine and State perform it."

Interviews with Thomas Szasz
Interviews
"The discovery that all mental diseases are brain diseases would mean the disappearance of psychiatry into neurology. But that would mean that a condition would be a 'mental disease' only if it could be demonstrated, by objective tests, that a person has got it, or has not got it. You can prove — objectively, not by making a 'clinical diagnosis' — that X has neurosyphilis or does not have it; but you cannot prove, objectively, that X has or does not have schizophrenia or 'clinical depression' or post traumatic stress disorder. Like most nouns and verbs, the word “disease” will always be used both literally and metaphorically. As long as psychiatrists are unwilling to fix the literal meaning of mental illness to an objective standard, there will remain no way of distinguishing between literal and metaphorical 'mental diseases.'"
PsychotherapistResource.com. Interviewed by Randall C. Wyatt, Ph.D. (2001)

Curing the Therapeutic State
"I see psychoanalysis as a contractual conversation about a person's problems and how to resolve them. I tried to avoid the idea, which seemed to be particularly pernicious, that the therapist knows more about the patient than the patient himself. That seems to me so offensive. How can you know more about a person after seeing him a few hours, a few days, or even a few months, than he knows about himself? He has known himself a lot longer!...To me the whole idea of calling it 'therapy' is crippling. So there was a kind of understanding between the other person and me that we were having a conversation about what he could do with his life. That obviously involves adopting different tenets of sorts--different ways of relating to his wife, his children, his job. The premise was that the only person who could change the person was the person himself. My role was as a catalyst. You are making suggestions and exploring alternatives--helping the person change himself. The idea that the person remains entirely in charge of himself is a fundamental premise."
Reason. Interviewed by Jacob Sullum. (2000)

Ill-Treated: The continuing history of psychiatric abuses
(Review of "Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill," by Robert Whitaker)
"Psychiatry throughout its history has blithely relied on the gambler’s wisdom that you can’t beat something with nothing. It thus comes up with a continual series of absurdities and abuses disguised as therapy, only openly admitting the failures of the previous 'therapy' once a new one materializes. But contrary to popular belief, psychiatrists still don’t know what causes schizophrenia, don’t know how to cure it, and in fact don’t even seem to know what it is."
Brian Doherty, Reason, May 2002

How psychiatry is making drug addicts out of America's school children
"How do children as young as eighteen months become drug addicts? The answer is they were "diagnosed" and labeled as having a new "mental illness." Pediatricians and psychiatrists then "treat the mental illness" with some of the most dangerous and addictive substances known to man. The result for far too many of these children is a personal disaster."
Dennis H. Clarke

Tortures as treatments in psychiatric history
"Stansky described a schizophrenic patient who in a delusional state escaped from a mental asylum, then climbed an electric pole from which he was thrown to the ground. This left him in a serious physician condition for weeks, but also left him free of any psycho-pathological symptoms. In spite of the fact that this patient died due to the consequences of his fall, a new development of treatment had been inaugurated."

The Biopsychiatric Model of "Mental Illness": A Critical Bibliography (pdf)
"Today's dominant theory of serious"mental illnesses" posits them to be genetically determined (i.e., inherited), biochemically mediated (via "chemical imbalances"), life-long"brain diseases"(with associated specific neuropathologic changes) whose cause(s) and course is more or less independent of environmental factors is not supported by existing evidence. A critical review of the scientific available evidence reveals no clear indication of hereditary factors, no specific biochemical abnormalities, and no associated causal neurologic lesion(s). However, a number of environmental factors have been found to be related to their cause(s) and course(bibliography in preparation). It is also generally held that the anti-psychotic drugs are the mainstay of treatment and should, in most cases, be taken for a lifetime. In fact, the data indicate that neuroleptic drug treatment is not usually necessary (especially in persons newly identified as psychotic) if a proper interpersonal environment and social context is provided in alternatives to hospital care. It also appears that has drug treatment has resulted in less favorable long-term outcomes than was the case before anti-psychotic drugs were introduced. Furthermore, anti-psychotic drug treatment is associated with the induction of irreversible brain pathology (resulting in reduced intellectual and abnormal motor functioning) and shortened life expectancy. Pre-neuroleptic drug era long-term follow-up studies indicate that recovery can not only occur, but is to be expected in the majority of cases. Ergo, so called "chronicity" in "mental illness" is likely the result of its medicalization, institutionalization with its social network disruption, marginalization, discrimination and the less specific social consequences (e.g. poverty) that accompany these processes."
Loren R. Moser, M.D., Clincal Professor of Psychiatry, University of California at San Diego, former Chief, Center for Studies of Schizophrenia, National Institue of Mental Health

Psychotic Side Effects of Psychostimulants: A 5-Year Review
"Objective: To examine the rate of psychotic and mood-congruent psychotic side effects of stimulant medications in children treated for attention-deficit hyperactivity disorder (ADHD).
Discussion: Psychotic symptoms in the chart review appear to cluster in 3 groups: MPH-induced hallucinosis, slower-developing paranoia, and mood-congruent psychotic symptoms. All 3 kinds of psychotic side effects have been previously reported in case reports of children The frequency of developing psychotic side effects in large numbers of children treated with stimulants is not known. In our chart review, the frequency was 6%. As there is an inherent bias with such a review for low reporting of side effects, the findings are likely to underestimate the prevalence." [emphasis added]

[What a nice suggestion it is, after millions of children has been medicated with drugs like Ritalin, that a study look at how many of the kids develope "psychotic side effects, since the frequency of such symptoms is "not known." What could be more clear than that American and Canadian children are the unconsenting subjects of a massive drug experiment by drug companies and doctors. Is this not organized child abuse?]

Excerpt:
"A 50-state survey by The Courant, the first of its kind ever conducted, has confirmed 142 deaths during or shortly after restraint or seclusion in the past decade. The survey focused on mental health and mental retardation facilities and group homes nationwide." But because many of these cases go unreported, the actual number of deaths during or after restraint is many times higher. Between 50 and 150 such deaths occur every year across the country, according to a statistical estimate commissioned by The Courant and conducted by a research specialist at the Harvard Center for Risk Analysis. That's one to three deaths every week, 500 to 1,500 in the past decade, the study shows. "It's going on all around the country," said Dr. Jack Zusman, a psychiatrist and author of a book on restraint policy."

Effects of exercise training on older patients with major depression
"...after 16 weeks of treatment exercise was equally effective in reducing depression among patients with MDD."
Blumenthal et al. Arch Intern Med 1999 Oct 25;159(19):2349-56
[What sort of "brain disease" is depression if it is made better by walking? Why are people being given drugs with substantial side-effects if exercise works just as well, and has other well-known benefits? The psychiatric dosing of America is a disgrace. Drugs are no replacement for an active life. Convivial bingo playing would probably also work as well as antidepressants if studied.-- AiA]

Listening to Prozac but Hearing Placebo: A Meta-Analysis of Antidepressant Medication
"...there are two aspects of the data that have not been examined in other meta-analyses of antidepressant medication. These are (a) the exceptionally high correlation between the placebo response and the drug response and (b) the effect on depression of active drugs that are not antidepressants. Taken together, these two findings suggest the possibility that antidepressants might function as active placebos, in which the side-effects amplify the placebo effect by convincing patients of that they are receiving a potent drug."
Irving Kirsch and Guy Sapirstein, Prevention & Treatment, Volume 1, Article 0002a, June 26, 1998
[See also press release about this study. "The study suggests that antidepressants might function as active placebos, in which the side effects amplify the placebo effect by convincing patients of that they are receiving a potent drug."]

If the exercise finding doesn't give psychiatrists sufficient indigestion, how about this one. The May-June 2002 issue of The American Journal of Psychiatry will feature a report that shows, according to Associated Press:

"Mildly depressed older women tend to live longer than those who are not depressed at all, a surprising new study suggests...."'This is totally counterintuitive to what you expect to see,' said Dan G. Blazer, a Duke University professor of psychiatry and behavioral science...The results might support the theory that mild depression is a survival mechanism, he said...Blazer said the study may support a theory advanced by University of Michigan psychiatrist Randolph M. Nesse that says mild depression may allow people to cope more easily with their problems and remove themselves from dangerous or harmful situations...According to Nesse humans may need "low mood" or mild depression to deal with failure and disappointment. "People who don't have it waste their whole lives trying to do things they won't ever do," he said.

So much for the virtue of ambition. This study is either idiotic or millions of older women are being deprived of longer lives by having antidepressants shoved down their throats by doctors. Or both, more likely.

There really is no end to the quackery parading under the banner of psychiatry, and the case of John Dicke couldn't be more damaging proof. This psychotherapist has been disciplined by the state of Colorado for allegedly placing "synthetic and anatomically correct penises," commonly known as dildos, in the mouths and anuses of children he was "treating" for child abuse.

See, Psychotherapeutic Child Abuse: The Case of John Dicke. It contains a selection of articles. (Can there be doubt that psychoanalysts throughout the country will diagnose Dicke as having been made ill by his name, forcing him to do things out of his control? Ad absurdum.)

Psychological debriefing for preventing post traumatic stress disorder (PTSD)
"Single session individual debriefing did not reduce psychological distress nor prevent the onset of post traumatic stress disorder (PTSD)...There was also no evidence that debriefing reduced general psychological morbidity, depression or anxiety."
Rose et al., The Cochrane Library, Issue 2, 2002.

They Call Him Crazy
Rodney Yoder may be one of the nation's most dangerous mental patients. So why is there a movement to free him?
"As academics go, psychiatrists are a lot like economists: their field is presented to the public as pure science, but there's a lot of shouting in the back office. Are drugs overused? Can treatment really work if it's involuntary? Is something like "delusional disorder" a brain disease or a behavioral problem or both? These debates are far from settled. Sometime in the past decade, it became a requirement of polite conversation to say that schizophrenia and other mental illnesses are "no different" from pneumonia. But the latest neurological research has offered only the roughest idea of the precise mechanism by which a disease such as schizophrenia arises. Scientists are decades away from being able to use a brain scan to diagnose something like Yoder's alleged personality disorders."
Time, July 15, 2002

Mental Illness on Trial: The Rodney Yoder Story
"Rodney

Yoder has been improperly imprisoned in a "therapeutic" prison-like "mental health" lockup for ten years above and beyond the years of prison time he served for an assault charge in which no one was killed or even seriously injured. This is a prime example of the inexact "science" of psychiatry used in the service of state tyranny. Recently the Illinois court refused to let Rodney present several impartial psychiatric experts to testify to his sanity. Thousands of pleas on his behalf to the Governor and other officials have been met with cold disdain. He remains incarcertated only because the same one state-employed psych is allowed to give the only "expert testimony" at his yearly hearings."
www.stopshrinks.org, no date.

The Emperor's New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration
"This article reports an analysis of the efficacy data submitted to the U.S. Food and Drug Administration for approval of the 6 most widely prescribed antidepressants approved between 1987 and 1999. Approximately 80% of the response to medication was duplicated in placebo control groups, and the mean difference between drug and placebo was approximately 2 points on the 17-item (50-point) and 21-item (62-point) Hamilton Depression Scale. Improvement at the highest doses of medication was not different from improvement at the lowest doses. The proportion of the drug response duplicated by placebo was significantly greater with observed cases (OC) data than with last observation carried forward (LOCF) data. If drug and placebo effects are additive, the pharmacological effects of antidepressants are clinically negligible. If they are not additive, alternative experimental designs are needed for the evaluation of antidepressants ... our data suggest that the effect of antidepressant drugs are very small and of questionable clinical significance"
Kirsch et al. Prevention & Treatment, 5;23 July 15, 2002

Antidepressants: A Triumph of Marketing Over Science? (Commentary on The Emperor's New Drugs)
"In a meta-analysis of the Food and Drug Administration (FDA) database of controlled trials used in the initial approval for the most popular antidepressants, I. Kirsch, T. J. Moore, A. Scoboria, and S. S. Nicholls (2002) found that antidepressants demonstrated a clinically negligible advantage over inert placebo. These results are surprising, because they come from studies underwritten by the drug manufacturers. This analysis probably overestimates the antidepressant effect because placebo washout strategies, penetration of the blind, reliance on clinician ratings, use of sedative medication, and replacement of nonresponders may penalize the placebo condition or boost the drug condition. These findings do not appear to justify the popularity of antidepressants, which may have been fueled in part by publication bias and outstanding marketing. Psychotherapy may offer an effective alternative with fewer medical risks."
Antonuccio et al. Prevention & Treatment, 5;25 July 15, 2002

An experimental comparison of Pycnogenol and methylphenidate [Ritalin] in adults with Attention-Deficit/Hyperactivity Disorder (ADHD)
"Participants received Pycnogenol, methylphenidate, and placebo, each for three weeks, in a randomized and counterbalanced order. Although ADHD symptoms improved during treatment, neither methylphenidate nor Pycnogenol outperformed the placebo control, as measured by self-report rating scales, rating scales completed by the individual's significant other, and a computerized continuous performance test."
Tenenbaum et al, J Atten Disord 2002 Aug;6(2):49-60

Personality characteristics and the risk of breast cancer: A prospective cohort study
Many physicians continue to hold, and studies continue to debunk, the superstition that major chronic diseases are caused by emotional stress and "personality types" (by which they mean "disorders"). Thus we've seen everything from ulcers to heart disease erroneously attributed to psychogenic causes. The result of this psychiatric pseudoscience is that there are delays in finding real causes and many people suffer and die from maltreatment.
"These results remained unaltered when the level of extroversion was determined as the average of the 1975 and 1981 reports. There was also no increase in breast cancer risk in relation to type A behaviour and hostility. Furthermore, we observed no substantial joint effects of personality characteristics on the risk of breast cancer. In conclusion, our data do not support the existence of an important role for personality in the aetiology of breast cancer."
International Journal of Cancer 2002;100:361-366.

Parents may face jail over compulsory drug orders (UK)
Parents of children diagnosed with attention deficit hyperactivity disorder (ADHD) will face jail under proposals in the new Mental Health Bill if they refuse to drug their children, a psychiatrist has warned. . . "The Bill is so punitive it dispenses with all civil and human rights. Parents who have reservations about pumping their children full of drugs to control them would be classed as denying their children treatment," he said. "It's only a matter of time before parents find themselves in breach of such orders which are fully backed by the courts."
Charles Begley, Independent.co.uk, Sep 29, 2002

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