Tuesday, December 04, 2012

Psychiatry beyond the current paradigm

Special article, with my name (see my book chapter on need for paradigm shift in psychiatry) as one of the 29 authors (first author Pat Bracken - see previous post), has been published in the British Journal of Psychiatry. An accompanying editorial by Arthur Kleinman, who I have mentioned in previous posts (eg. see entry), argues that academic psychiatry has been too biomedical. Perhaps it's easier for Kleinman to say this in a British journal, rather than in the USA where NIMH has dominated research (eg. see previous blog entry).
Congratulations to the BJPsych editor for encouraging this debate. I have said previously that I have been surprised by some of his comments from the editor's desk (eg. see post). He has made his position clearer in his current commentary. He seems worried that psychiatry may be no more than quackery. I'm not saying this to encourage a civil war in psychiatry, but his position could encourage neuromania (eg. see previous post). We need to move on from this.


Allison Holt, MD said...

I agree that we are all ready for a paradigm shift. Psychiatrists need to start looking at things differently, becoming more inspirational. These people are coming to us for help in a last ditch effort and all we can do is jam a pill down their throat and send them home. It's sad to see.

Anonymous said...

This profession deserves the low esteem it is held in and is going to be increasingly held in.

Human rights abusers, the lot of you.

Coming home to roost. Your quackery, and your toxic harm and destruction of millions of healthy brains, the gravity of your profession's crimes against humanity will not be known for a long time. But truth is starting to leak out.

Rejig the "paradigm" all you want, the problems of a human life, were never medical to begin with. And you've been out of your depth for centuries.

Stop assaulting people and only provide your quack "services" to those who actually DO "come to you for help".

Even the REAL doctors respect the concept of consent and don't do violence to those who CHOOSE to be their patients, and they have REAL science behind them.

What qualifies a third rate steaming pile of fallacious garbage such as the quackery that is psychiatry, to be COMPULSORY?

Psychiatry has nothing but brain damaging drugs to offer anybody in the entire world.

And even a large percentage of that pathetic and destructive offering is meted out in an "offer you can't refuse" human rights abusing violence.

Psychiatrists are a menace to humanity.

How many drug ads are in the hard copy of this "prestigious" journal?

Without the oxygen of their own hubris, the power to section, the unlimited bankroll of Big Pharma, and the public's credulity, psychiatry would be dead in the water.

Right now there's blood in the water, and BOY am I rubbing my hands together.

Idiotic biological reductionism and the trillion dollar drug industry may just have given psychiatry enough rope to hang itself. Let's hope.

Psychiatry itself is slowly committing suicide, and I for one won't be calling the Samaritans to get it "help".

Think of every desperate journal article about "paradigms" as one more light on the telephone switchboard at Samaritans, and nobody is going to pick up, ever, because a hundred thousand, half a million, a million quacks with bullshit ideas and theories, doesn't amount to a bona fide branch of medicine, never has, never will.

People will learn not to trust psychiatry. It's only a matter of time.

Down, down, down, down the sinkhole the credibility goes, with each passing year, with every new million kids drugged, with every new million adults shoved on disability, and one day the duck will be kicked off its perch, and there's be no one there to hear it quacking.

For these are the seeds sown by reckless harm and infinite hubris.

Anonymous said...

Actually I agree with both of the previous comments, in part.

I do agree that a paradigm shift is needed but I can't see psychiatrists as ever being inspirational. They would need brain surgery for that, excuse the language.

And I agree about the human rights abuse, having been grabbed and jagged by the handmaidens of psychiatry. The forced treatment really has to stop.

The critical neuroscience stance is definitely needed. In Scotland we've got the DAIS at Ninewells, or as I call it the place where they do brain surgery for mental illness. And if there's no such thing as mental illness then why do they have brain surgery for it?

Anonymous said...

" but I can't see psychiatrists as ever being inspirational."

That's absolutely right.

To my mind, for a person to be inspirational they need to have impressive achievements in their lives, and to have overcome adversity and triumphed in some way, or discovered something, or made the world a better place than they found it.

There are a handful of inspirational fighters and critics who work as "mental health professionals". They invariably are people who support our human rights.

Unfortunately so many of the British critical psychiatrists are pro force, pro Mental Health Act, anti consent, and this is anything but inspirational.

It is easier for a camel to pass through the eye of the needle than for any psychiatrist who has coerced, who continues to coerce, to EVER be regarded as "inspirational".

James V. Kohl said...

I've argued unsuccessfully for several months on the psychiatry-research group that the concept of epigenetic effects on genes to behavior and back MUST be incorporated -- as recently detailed in a my published work:

"Integration of olfactory/pheromonal conditioning into clinical psychology: The American Society of Addiction Medicine (ASAM) policy statement"

The Public Policy Statement: Definition of Addiction (ASAM, 2011) represents a paradigm shift that may move the current practice of clinical psychology forward. It dictates the adoption and integration of neuroscientific principles that are required in order to understand differences between genetically predisposed brain disease, naturally occurring variations of behavioral development, and choice. These neuroscientific principles include focus on how sensory input influences behavior. The statement specifically mentions food and sex along with drugs and alcohol; each seems to chemically condition changes in hormones and in behavioral responses. Although no link between cause and effect is mentioned by ASAM, these principles could incorporate the GnRH neurophysiological mechanism and levels of LH, which link food odors and pheromones to chemically conditioned behaviors.

Medical practitioners from ASAM and neuroscientists are more likely than psychologists to be aware that effective FDA-approved therapeutic intervention frequently involves pharmaceuticals that alter feedback on the GnRH neuronal system (Grumbach & Styne, 1992), which is the central neuronal system that is essential to species survival in all vertebrates (Kotitschke, Sadie-Van Gijsen, Avenant, Fernandes, & Hapgood, 2009) via its integral involvement in the acquisition of food and in sexual reproduction. ASAM seems to think that clinical psychologists should become more aware of currently accepted neuroscientific facts, which may be important to their understanding of eating disorders and of human sexuality among other things that are not currently understood about the development of behavior.

Excerpted from: Human pheromones and food odors: epigenetic influences on the socioaffective nature of evolved behaviors

Anonymous said...

" The statement specifically mentions food and sex along with drugs and alcohol; each seems to chemically condition changes in hormones and in behavioral responses."

When a psychiatrist puts the words "seems to" in a sentence about biology and behavior, STOP LISTENING.

Anonymous said...

Psychiatrists / mental health nurses need to stop using aggression,restraints or other embarrassments/dehumanising methods & the decent psychiatrists need to start calling the abusive ones out instead of protecting their peers.Psychiatry needs to have a more unified model & address all factors simultaneously eg: genes, prenatal stress,social stress factors,viruses,B12 deficiencies,thyroid dysfunction,NMDA receptor antibodies,the fact that immune system genes are involved etc.The separation between psychiatry and neurology and other specialties needs to end as this "is it organic or is it functional" mindset needs to stop as this only reinforces stigma & delays interest in researching causes of mental illnesses.Most psychiatrists are stick in this notion that Schizophrenia-for example-is just a genetic disorder with some psychosocial triggers thrown in and here let's give him/her some dispersions/other anthropomorphic drugs,but these drugs don't work for a subset of people and they are left "to rot".In plain speech,most Psyche are up themselves.The whole culture/system needs changing & new life needs to be breathed into the treatments.Eg:psychology methods tailored towards Schizophrenia,peer support programs,exercise physiologists involvement,anti stigma programmes targeted towards the medical professionals themselves,psych wards turned into friendly wellness homes, care of doctors mental health,more closer communities/societies,the testing of all mental presentations for things such as B12 deficiency plus a hundred other things,the deeper awareness & study into causes such as viruses,toxoplasmosis,gastrointestinal antibodies/anaemia found in some,brain antibodies,cytokinesis inflammation etc.When it starts being looked at in some cases as an autoimmune disorder with genetic predisposition plus environmental stresses causing vulnerability then Psychiatry may become exciting again.Psyches need to get with the program-most don't even know that some with schizophrenia can have severe cognitive decline like dementia.

Anonymous said...

In my above comment dispersions etc should actually say risperdal/other antidopaminergic drugs.