A notorious case of a man detained and shackled to his bed while receiving ECT as an involuntary patient raises critically important questions for institutional psychiatry. These relate to the fundamental premises on which the mentally-disturbed are detained and forced to take treatment against their will. There is, however, very little prospect of psychiatrists willingly answering questions which threaten their livelihood.
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The project to develop the successor to fourth edition of the Diagnostic and Statistical Manual of Mental Disorders has been under way for 10 years, yet it is still several years from completion, and the field trials, the most difficult and expensive part, have not even started. This article explores the reasons why the project is struggling, arguing that the defects the Diagnostic and Statistical Model-V (DSM-V) Committee has found are not chance or random problems that can be overcome by more money but rather represent serious conceptual errors in the very basis of the ideas underlying the project. As a result of these errors, it is predicted that the entire notion of valid categories of mental disorder will collapse in self-contradiction. One of the most recent suggestions for a new disorder, psychotic risk syndrome (now APSS), is used to demonstrate how the principles of science cannot accommodate the unstated ideological demands driving the DSM-V project.
- Go to article: Cells, Circuits, and Syndromes: A Critical Commentary on the NIMH Research Domain Criteria Project
The US National Institute of Mental Health (NIMH) has recently declared a new research program for psychiatry, the Research Domain Criteria (RDoC), as the successor of the long-standing Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic program. However, the new program is based on a series of assumptions that, on analysis, lack any formal scientific standing. Essentially, as presently conceptualized, the RDoC program is no more than ideology masquerading as science, and thus cannot achieve its stated goals. It is argued that the program will lead psychiatry into intellectually sterile areas because it is in fact the wrong research program for the present state of our knowledge.
Theories of psychiatry do not exist an intellectual vacuum. They must mesh at many points with other bodies of knowledge. Biological psychiatry tries to prove that mental disorder and brain disorder are one and the same thing. This has no rational basis in any accepted theory of mind. This article examines two other philosophical theories that biological psychiatrists might use as their rationale: Dennett’s functionalism and Searle’s natural biologism. However, these avowedly antidualist theories fail, as they secretly rely on irreducibly dualist notions to complete their explanatory accounts of mind. Biological psychiatry is thus an ideology, not a scientific theory.
Electroconvulsive treatment (ECT) is widely used in the Anglophone world but much less in the rest of the world. In some places, it is so severely restricted as to be a rarity; in others, it is banned. Comparative data indicate there is no scientific justification for this discrepancy. Instead, there is a prima facie case to say that the major impetus behind ECT usage lies in the financial rewards it generates for psychiatrists.
Objective: An empirical examination of the scientific status of psychiatry. Method and Results: Analysis of the publications policy of the major English-language psychiatric journals shows that no journal meets the minimum criteria for a scientific publishing policy. Conclusion: Psychiatry lacks the fundamental elements of any field claiming to be a science. Furthermore, its present policies are likely to inhibit scientific development of models of mental disorder rather than facilitate them. The psychiatric publishing industry is in urgent need of radical reform.
- Go to article: Kandel’s “New Science of Mind” for Psychiatry and the Limits to Reductionism: A Critical Review
Background: The current psychiatric literature carries numerous papers arguing that the correct approach to mental disorder is to see it as a special form of brain disorder, whose precise biochemical and genetic causes will be revealed by the normal methods of laboratory science. In particular, these claims are repeated in numerous papers outlining and advocating the new Research Domain Criteria project of the U.S. National Institute of Mental Health.
Material: An extensive search of the literature shows that not one of these biologically oriented papers ever provides citations or references to authorities such that the claim “mental disorder is brain disorder” is established to the standard required of valid scientific claims.
Discussion: As it stands, the notion that mental disorder is brain disorder is unsubstantiated. In particular, no authorities in the field of biological psychiatry have ever demonstrated that they have a formal theory of mental disorder, or a model of mental disorder to guide their daily practice, their teaching or their research.
Conclusion: This means that biological psychiatry has the status of an ideology only, and the many papers arguing its case meet the definition of propaganda.
Four decades after the publication of the concept of Engel's “biopsychosocial model” for medicine and its subsequent enthusiastic embrace by psychiatry, it is widely accepted as a valid alternative to the reductionism of biological psychiatry. However, unlike models in mainstream science, the original model has not been developed or expanded. Despite widespread efforts to “talk it up,” Engel's “biopsychosocial model” has failed to have any lasting impact on psychiatry. The reason is simply that it doesn't exist. The logical flaws in Engel's original concept are explored, and some consequences noted.
Objective: As part of the philosophical project of distinguishing science and nonscience, an ancient concept, bullshit, 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 bullshit.