Author: McLaren, Niall
Source: Ethical Human Psychology and Psychiatry, Volume 18, Number 1, 2016, pp. 48-57(10)
Publication date: April 1, 2016
Title: Psychiatry as bullsh*t
Objective: As part of the philosophical project of distinguishing science and nonscience, an ancient concept, bullsh*t, has recently been redefined and explored. This is not science or does it meet a strict definition of pseudoscience. This article explores the extent to which this concept pervades psychiatry. Conclusion: By even the most charitable interpretation of the concept, the institution of modern psychiatry is replete with bullsh*t.
The renowned cosmologist, Carl Sagan (1996), said, “. . . at the heart of science is an
essential balance between two seemingly contradictory attitudes—an openness to new ideas, no matter how bizarre or counterintuitive, and the most ruthlessly sceptical scrutiny of all ideas, old and new. This is how deep truths are winnowed from deep nonsense.”
Psychiatry, as I have briefly shown, is stuffed full of “deep nonsense,” better known
I believe it is now appropriate to label the drive to find a biological basis for mental disorder as pseudoscience, just because the huge endeavor hangs from little more than blind hope. It would be very nice to see psychiatrists expose their own ideas to “the most ruthlessly skeptical scrutiny” but there are now so many academic and other careers dependent on this industry that it would take a revolution to clear the air.
Using a series of case examples McLaren argues that psychiatry is especially stuffed with bullsh*t.
McLaren opens with a reference to the Princeton philosopher Harry Frankfurt and his now famous article from a 1986 debate republished in 2005 on a branch of nonscience termed in Greek skatou taurou.
“One of the most salient features of our culture is that there is so much bullsh*t. Everyone knows this” (Frankfurt, 1986). After analyzing the various elements involved, he concluded that bullsh*t is neither pseudoscience nor fraud but constitutes a field in its own right. The liar, he argued, is intimately concerned with the truth.
He knows the truth but he hopes to lead us away from it and from the fact that he knows it:
Telling a lie is an act with a sharp focus. It is designed to insert a particular falsehood at a specific
point in a set or system of beliefs, in order to avoid the consequences of having that point occupied
by the truth. This requires a degree of craftsmanship . . .
Although lying is subject to “. . . austere and rigorous demands . . . ,” the “bullsh*t artist,” on the other hand, has no regard for the truth. His productions are “. . . more
expansive and independent, with mare spacious opportunities for improvisation, color, and imaginative play. This is less a matter of craft than of art.” As such, they are neither necessarily true nor necessarily false but are designed to create a particular impression in the audience. bullsh*t is “expansive and creative,” which is possibly why we do not regard it as so malevolent as an outright lie. We are enraged if we believe somebody is lying to us but we tend to be amused or disdainful, or at least less fussed, if we determine the speaker is simply “spinning a line of bull.”
....Selections from the paper.......
McLaren posits two reasons why eminent people have not done their homework, being
1. The fable of the Emperors new drugs germane - the tendancy to not appear foolish by revealing ignorance, and
2. The Campers Nightmare- "But i thought you were bringing the can opener."
In the corridors of psychiatric power, everybody assumes somebody else has shown that mental activity can properly be seen as neural activity, amenable to investigation by scanners, genetic studies, and the like.
This assumption is wholly without warrant. It matters not that every senior psychiatrist in the world appears to believe the claim, it remains bullsh*t of the very highest order, worse because it is embraced by the people who like to see themselves as “key opinion leaders.” The higher one goes up the academic ladder, the heavier the burden of responsibility to ensure that the basic facts are in place.
The Biopsychosocial Model
I believe the illusory “biopsychosocial model” lulls our trainees and junior psychiatrists into believing that there is a model “somewhere” and they don’t have to think too hard about the critical issues because they have all been sorted out by much smarter people. I am of the view that this is bullsh*t of a very
high order. Not formal deception, as Frankfurt defined it, just the fear of questioning the status quo (again) mated to a desperate need to conceal psychiatry’s intellectual inadequacies.
A Chemical Imbalance
This trope has gained ground and is bandied around in the daily press, on TV and the internet.
Joanna Moncrieff is perfectly blunt: "For decades now, people have been told that depression is a chemical imbalance and that antidepressants work by correcting that imbalance. This view is not supported by evidence, and is misleading as to the nature and effects of antidepressant drugs"(Moncrieff, 2015, p. 303).
Instead, we have clear evidence that psychiatry is colonizing, as it were, normal psychological
states and reactions and claiming them as “mental illnesses” (Horwitz & Wakefield,
2007; Whitaker, 2009; Whitely, 2010).
A state of discomfort, such as grief, is converted by fiat to “a mental disease” for which drugs are de rigueur, but that is not the point here.
We can presume patients and the general public did not invent the expression “chemical imbalance of the brain” to describe the cause of the various mental disorders. We can be fairly sure it did not come from the older psychiatrists trained in psychoanalytic or other psychodynamic approaches, nor the few who wholeheartedly adopted the behaviorist model. By a process of exclusion, it had to arise in the complex of academic psychiatrists and drug companies who so strongly advocated the biological model (Whitaker & Cosgrove, 2015).
One thing psychiatrists never do is talk about their ghastly past. (Whitaker 2002)
Take away the drugs and ECT and what does psychiatry have left?
The general public, governments, and funding agencies have been convinced that the correct response to feeling a bit off color is to reach for the pill bottle.
I have summarized (McLaren, 2012) how the levels of disability caused by mental disorders are tracking remorselessly higher, for example:
In the UK, the number of days of disability due to depression and neurotic disorders rose from
38 million in 1984 to 117 million in 1995, i.e. far from causing an improvement, the rapidly growing
use of antidepressants was associated with 200% increase in disability.
For decades, doctors have been subject to a tidal wave of disinformation regarding psychiatric
We are told they are “safe, effective, nonaddictive” so that withholding them is negligent. However, we now know this is false: A prolonged investigation of the so-called Study 329 (Le Noury et al., 2015) has revealed that the manufacturers of the antidepressant paroxetine actually falsified their results so they could make this claim.
In fact, the drug is not safe, it is not effective and it meets every known definition of addictive. The company was fined U.S. $3 billion for this little escapade but it didn’t bother them much, they made more than 10 times that amount from sales. The manufacturers of risperidone, an antipsychotic, did much the same thing (Brill, 2015).
There is now a copious and rapidly growing literature to show that psychiatric drugs are dangerous and ineffective and people who start them seldom manage to get off them.
To cap it off, we know that people who take psychiatric drugs in the long-term die, on average,
19 years younger than their undrugged peers (Frances, 2014).
This probably satisfies most definitions of “dangerous.” This is probably outright criminal fraud but the millions of doctors, psychiatrists included, who calmly parroted the drug companies’ propaganda
were, at the very least, guilty of feeding bullsh*t to their patients.
THE VERY MODEL OF A MENTAL DISORDER
All fields that claim to be scientific share one feature in common: a model of their field of study. A scientific model must be rational, articulated, publicly available, capable of making testable predictions, and of a form that can be criticized. It is not widely known, certainly not by psychiatrists, that there is currently no model of mental disorder that meets these criteria. Doubters should ask any psychiatrist they meet the following question:
What is the name of the model of mental disorder you use in your daily practice, your teaching,
and research? Specify the original publication in which the model is set out as a series of testable propositions and three seminal works in which its application is tested against the canons of science and in practice.
You will not get an answer, just because there is no such model. That is not entirely the fault of psychiatry; we don’t yet have a model of mental order (otherwise known as a model of mind) so a model of mental disorder is necessarily not in sight. However, psychiatrists always act and speak as though they have a very firm grip on the nature of mental disorder.
To paraphrase the Nobel laureate immunologist, Peter Medawar,
“they can be excused of dishonesty only on the grounds that, before deceiving others, they have taken great pains to deceive themselves” (Medawar, 1961, p. 106).
Source acknowledged: Skyler