The acceptable limits of psychiatry D B Double

What are the acceptable limits of psychiatry?

There is a psychiatric orthodoxy

Peter Breggin on Oprah Winfrey Show September 1987

Peter Breggin on Oprah Winfrey Show September 1987 Complaint by NAMI that he acted irresponsibly when seemed to suggest that people should refuse to take medication

Peter Breggin on Oprah Winfrey Show (cont) The view that mental illness has biological causes is "all lies" repeated to justify giving drugs.

Peter Breggin on Oprah Winfrey Show (cont) The view that mental illness has biological causes is "all lies" repeated to justify giving drugs. He did not mean that people should stop taking their medication

Peter Breggin on Oprah Winfrey Show (cont) Maryland Commission on Medical Discipline ruled he did not commit a "legal violation or ethical impropriety"

My personal experience I currently work for a medical director that regards me as outside the acceptable limits of psychiatry

My personal experience (cont) When suspended I was told by two auditors of my practice from Royal College of Psychiatrists that I was outside the acceptable range of psychiatry

My personal experience (cont) Advised that my philosophy about psychiatry would need to be examined and my scepticism about the use of medication challenged

The fundamentalism of The American Psychiatric Association

Tom Cruise interview on NBC show "Today" "Before I was a Scientologist I never agreed with psychiatry… There is no such thing as a chemical imbalance … I'm not saying that that isn't real…. I'm saying that drugs aren't the answer"

Response to Tom Cruise interview on NBC show "It is irresponsible for Mr Cruise to use his movie publicity tour to promote his own ideological views and deter people with mental illness from getting the care they need."

Response to Tom Cruise interview on NBC show (cont) There is considerable investment in research and a vastly expanded understanding of mental illness, which is highly treatable.

Response to Tom Cruise interview on NBC show (cont) "It is unfortunate that in the face of remarkable scientific and clinical progress that a small number of individuals and groups persist in questioning the legitimacy of mental illness."

Fast for Freedom in Mental Health Asked for evidence for claims that mental illnesses are "proven biological diseases of the brain" and that emotional distress results from "chemical imbalances" in the brain

Response to Fast for Freedom in Mental Health Mental disorders are serious neurobiological disorders as (a) research has shown reproducible abnormalities of brain structure and function (b) evidence for a strong genetic component is compelling and (c) the mechanism of action of effective mechanisms have been elucidated.

What is psychiatry’s belief system?

Brain pathology as the basis for mental illness

What is psychiatry’s belief system? Brain pathology as the basis for mental illness Avoids complicated metaphysics

What is psychiatry’s belief system? Brain pathology as the basis for mental illness Avoids complicated metaphysics Provides professional respectability

What is psychiatry’s belief system? Brain pathology as the basis for mental illness Avoids complicated metaphysics Provides professional respectability Has scientific ambition of elucidating the cause of mental illness

What is psychiatry’s belief system? Brain pathology as the basis for mental illness Avoids complicated metaphysics Provides professional respectability Has scientific ambition of elucidating the cause of mental illness Based on faith, desire and wish fulfilment rather than logic

John Haslam as historical example Insanity is "a corporeal disease".

John Haslam as historical example "[T]he various and discordant opinions, which have prevailed in this department of knowledge, have led me to disentangle myself as quickly as possible from the perplexity of metaphysical mazes."

John Haslam as historical example "[F]rom the limited nature of my powers, I have never been able to conceive... a disease of the mind."

John Haslam as historical example Mental illness is "the peculiar and exclusive province of the medical practitioner" (his emphasis)

Historical foundations of modern psychiatry Wilhelm Griesinger

Historical foundations of modern psychiatry (cont) Wilhelm Griesinger M ental pathology and therapeutics (original German edition 1845)

Historical foundations of modern psychiatry (cont) “Mental diseases are brain diseases”

Historical foundations of modern psychiatry (cont) “Mental diseases are brain diseases” “It is only from the neuropathological standpoint that one can try to make sense of the symptomatology of the insane"

Historical foundations of modern psychiatry (cont) Baron Ernest von Feuchtersleben

Historical foundations of modern psychiatry (cont) Baron Ernest von Feuchtersleben The principles of medical psychology (originally German edition 1845)

Historical foundations of modern psychiatry (cont) "The notion, mental disease, must be deduced neither from the mind nor from the body, but from the relation of each to the other."

Historical foundations of modern psychiatry (cont) "Psychopathies have no seat; they are combined constitutions which appear in the disturbance of these functions by which the mind is manifested, that is, in the collective personality."

Examples of the biopsychological approach

Adolf Meyer's psychobiology

Examples of the biopsychological approach Adolf Meyer's psychobiology George Engel's biopsychosocial model.

Examples of the biopsychological approach Adolf Meyer's psychobiology George Engel's biopsychosocial model Arthur Kleinman's cultural perspective

Examples of the biopsychological approach Adolf Meyer's psychobiology George Engel's biopsychosocial model Arthur Kleinman's cultural perspective Biopsychological paradigm has always competed with the dominant biomedical model.

Synthesis of critical psychiatry

The threat of anti-psychiatry taints the restatement of the biopsychological paradigm

Synthesis of critical psychiatry The threat of anti-psychiatry taints the restatement of the biopsychological paradigm Psychiatry does not need to be justified by postulating brain pathology as the basis for mental illness.

Synthesis of critical psychiatry The threat of anti-psychiatry taints the restatement of the biopsychological paradigm Psychiatry does not need to be justified by postulating brain pathology as the basis for mental illness. This view is acceptable

"Psychiatry is naked," the child said. Psychiatry could not admit to that. It thought it better to continue the procession under the illusion that anyone who couldn't see its clothes was either stupid or incompetent.