Thursday, May 05, 2011

More heat in the debate about psychiatry

A review in Psychiatric Services is reluctant to recommend Richard Bentall's book Doctoring the Mind because it is said to be "incendiary and devisive". The reviewers are frightened that the book exaggerates issues for service users.

I'm not sure who's doing the exaggerating. Richard is said to suggest that there is a long-standing battle for supremacy between psychologists, "who are educated and trained to understand people and the human experience and to provide healing therapy", and psychiatrists, who are "indoctrinated with the medical model, have unwittingly carried Nazi-era notions of the genetic origins of psychosis into the present and are intent on pumping people full of as much useless, dangerous medicine as possible while simultaneously avoiding any conversation".

Richard is also criticised for saying that as many as 50% of psychotic patients would be better off without taking drugs, for claiming that the term "schizophrenia spectrum disorder" was introduced to get the results wanted in genetic research and for indicating that the National Alliance on Mental Illness is funded primarily by Big Pharma. Furthermore, he is said to provide no reference for his suggestion that child psychiatrists do not seem to be troubled by the as yet unknown long-term impact of psychotropic drugs on the developing brain and for his impression that medications are often prescribed by child psychiatrists without any serious attempt to understand or remedy the awful social circumstances in which psychologically disturbed children often live.

It's unfortunate that Richard's argument noted by the reviewers that "the case for a genetic cause of mental illness has been overstated by psychiatrists and that symptoms are much more the result of psychosocial stressors" including behaviour by families, gets lost in this polarisation of the debate. As I've indicated in a previous post, there seems to be some difficulty in having a calm discussion of these matters.

There were even some flames about my own Critical Psychiatry book (see another previous post), although I never managed to get a review in a mainstream psychiatric journal. Still there was a reasonably generous BMJ review. So maybe we should be grateful that books such as Richard's are at least being considered, even if dismissed, by mainstream psychiatry..

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