Is Psychiatry a Mental Illness?
By David Swanson
Bruce Levine’s books have been getting more and more thorough in their debunkings of the claims of psychiatry. His latest is A Profession Without Reason.
Some mental illnesses that have been eliminated include drapetomania, or the mental illness causing enslaved people to try to escape; and homosexuality, or the mental illness causing people to love people that somebody else might wish they wouldn’t. These mental illnesses have been eliminated by ceasing to call them mental illnesses.
Some mental illnesses that have been reduced by the good practices of psychiatry, although not yet thoroughly eliminated include . . . well, nothing. Mental illnesses and suicides are on the rise.
But it’s not even clear what we’re dealing with. In studies, different psychiatrists have been as likely as not to diagnose the same patient as having or not having a mental illness, and to disagree on which mental illness if any the patient has.
It could be that part or all of what is on the rise is simply diagnoses. But there’s no strong evidence that psychiatry is effectively treating mental illnesses in those it treats. The profession is widely and deeply funded by drug companies, and its treatments often involve drugs. But the drugs are no more effective than placebos or the passage of time, and often have negative long-term effects that simple placebos or doing nothing don’t have.
Drugs to cure mental illnesses are sometimes based on faulty science known to be faulty. Depression is not caused by a chemical imbalance or a shortage of serotonin. Yet psychiatrists tell people that it is and prescribe drugs as if it were.
Actual causes of depression include fear, poverty, and a lack of friends and loved ones. Socio-economic variables are more clearly associated with mental suffering than is anything bio-chemical. This is one of those well-established facts that U.S. culture has a well-established practice of avoiding — as with the similarly well-established fact that addressing socio-economic needs reduces crime more efficiently than does incarceration.
Also more clearly associated with mental difficulties than is anything genetic is childhood trauma. But somehow we never focus on developing a society that can better care for children in the way that we do on developing drugs for mental illnesses. Similarly, preventing pollution that causes cancer is just never as big a deal as curing cancer after it’s caused. I suppose people must buy all those drugs in all those commercials with all those warnings of seemingly catastrophic side effects, yet I’ve never seen a single ad warning that prescribing an inequality of wealth beyond medieval levels could result in fascism.
Psychiatry has a preference for claiming that things are genetically based, and for claiming that mental illnesses are permanent (but should be permanently treated). It was on this basis that, in the 20th century, the U.S. sterilized 70,000 people and Germany killed 300,000. But not long after Germany had killed most of the Germans diagnosed with schizophrenia, the prevalence of that disease in Germany was higher, not lower.
Leading U.S. psychiatrists today, sounding much like neocons selling a war, openly claim that it is a “noble lie” to give people a false diagnosis and a false cure, because this can have a placebo effect. But there are approaches with the potential to help more than that, and these are shoved aside by all the noble lying. Meanwhile, giving people actual placebos, to avoid the side-effects of drugs that are known not to work, is deemed “unethical.” So is failing to stigmatize people with the label “mentally ill” even when there’s nothing concrete to establish to independent observers that someone is “mentally ill.”
As Levine shows us, psychiatrists wish both to be and to not be neurologists. That is, they hope and struggle to find brain activity that corresponds to their illnesses, thus far without notable success. Yet they hope not to find solutions via neuro-surgery, as that would put them out of work. Nonetheless, they’ve moved — for both reasons of financial corruption and reasons of science envy — ever more toward drugs and other physical approaches, as opposed to recommending therapy or life changes.
Psychiatry also resorts, of course, to coercion, to forced medication, forced institutionalization, and such barbaric still-used-today practices as electroshock (despite no evidence that it works).
But what do we do with people who are really crazy? Who hear voices? Who are a danger to themselves and others? Well, apparently some 5% to 28% of the population hears voices. The remaining population could never lock that many people up. A proper approach needs to be specific to each case. But there seems to be greater success, in many cases, not in labeling people monsters and dealing with them accordingly, but in offering them friendship and respect despite their most fantastical delusions, and reducing their fears — something, in other words, like the polar opposite of social media. Peer groups of people with similar unusual mental states are able to aid their members without shame or stigmatization.
But what about all the deeply ingrained stories that point toward established practice? What about John Nash whose story in “A Beautiful Mind” involved him being saved by medication? It was a lie. The reality was that he recovered despite and after getting away from forced institutionalization and medication, and that what helped him was the support of loved ones and friends. He also explained how he learned to identify unreliable thoughts, lessons that could be helpful even for people suffering to a much more limited degree — far more helpful than walling off the “ill” from the “well” as if there were no spectrum running unbroken from one to the other.
While homosexuality is no longer an illness, there is an illness called Oppositional Defiant Disorder for people who aren’t obedient enough. There’s one called Conduct Disorder for people who do things society disapproves of. These seem to tell us more about the fears of the psychiatrists than about the patients. We live in a society that slaughters and eats non-human animals for fun, that locks millions of people behind bars for no good reason, that routinely knowingly destroys the prospects for future life on Earth, that invests in wars and nuclear weapons, and that largely believes in the claims of popular religions no less absurd than the delusions of any patient. If every nutty belief got you labeled mentally ill, who would remain among the well? If Vladimir Putin’s insane warmaking renders him impossible to negotiate with — even for people who regularly engage in insane warmaking — something’s got to go: either the entire profession of diplomacy, or the habit of labeling entire people (as opposed to a few of their beliefs or actions) crazy. Surely the change that occurs when a former U.S. client (Noriega, Gadaffi, Hussein) falls out of favor is not a medical change.
We’ve also got a disease called Anti-Social Personality Disorder, or what’s commonly referred to as the permanent and alien malignity of “the sociopaths.” This is thought to explain much or all of what’s wrong with politics. We’ve had very progressive and caring commentators in recent years propose swift identification and sterilization of “the sociopaths” to right much of what is wrong with the political and business world — despite the complete inability to identify who the sociopaths are in any scientific way, meaning of course that they would be identified in a biased manner by the same sick society that created both the problems blamed on them and the final solution devised for them. My point is not that politicians don’t do horribly evil and cynical things miles removed from what many of us could ever imagine doing, things we have a hard time even thinking about. My points are these: you can eliminate oligarchs by taxing their wealth; you can democratize a government through mass nonviolent action; you can compel the same power-hungry politicians who do evil to do good through public pressure; and Nietzsche was right: insanity is rare in individuals but the norm in entire societies.
We even have mental illnesses largely for victims of war (Post Traumatic Stress Disorder), as well as some for people made to worry about their weight (Anorexia and Bulimia). We have Phobias for people afraid of various things. But Levine makes a case that the severity with which sufferers are treated is largely a product of the fears of those doing the diagnosing and prescribing. Or rather, not fear, but “tension.” Levine does not define “tension” but uses it as the general cause of unfair treatment. If homosexuality causes tension in the minds of some people, then they are inclined to label it an illness. I would have liked an additional chapter on how to reduce tension.
Levine wants a major break from current psychiatric practices. He uses the term “complete” (a “complete break”) but I don’t think he can mean that. He also uses it to describe Baruch Spinoza’s break with popular religion, something that clearly was not literally complete. After reading these thoughts of mine, you might be surprised to discover that half of Levine’s book is about the 17th century philosopher Spinoza, whose thinking Levine uses to critique psychiatry, and whose experiences with prejudice and pseudo-science in his day allow for some striking comparisons to the doings of today’s psychiatrists.
Levine is a bit more taken with the relevance of Spinoza than I, even suggesting that only Spinoza’s prejudice against women lets us know he wasn’t perfect, as if perhaps his radically outdated philosophizing doesn’t need any general updating other than that. I think, on the contrary, what’s valuable here is the fact that someone so monumentally out of step could nonetheless have many basic lessons to teach a prestigious postmodern profession.