Debunking the Anti-Psychiatry Movement

One of the problems with the antipsychiatry movement is they assert all of psychiatry, all doctors, all science is lying, pretty much all of the time. Any biological evidence for mental illness must be wrong, because if it isn’t, then psychiatry might make sense. Any evidence antidepressants help a brain must be wrong, because otherwise antipsychiatry views might come into question.

But seriously, does any rational, thinking person really believe all of science, all over the world, is lying?

 Antipsychiatry Viewpoints

For the purposes of this article I’ll define antipsychiatry as the viewpoint that mental illness isn’t biological (mental illness doesn’t exist) and psychiatrists do more to poison their patients than to help them. I’ll define antipsychiatry as those who think treatment shouldn’t include psychiatric (psychotropic) medication (psych meds). (Some antipsychiatry people are against psychology as well.)

Antipsychiatry folks have made their views quite clear to me through sentiments left in comments like:

• Taking medication is a chemical lobotomy
• Psychiatrists are all biased by virtue of being psychiatrists
• Psychiatrists are monsters and are only the most unintelligent of doctors
• Electroconvulsive therapy (ECT, electro-shock therapy) is rape
• Every study is biased as health care companies fund doctors, hospitals, studies and universities

And I could go on. Those espousing antipsychiatry viewpoints tend to be very loud.

All Psychiatrists Are Stupid, Psychiatrists are the Most Unintelligent of Doctors

Well, see, this is an idiotic argument on its face. I get antipsychiatry folks don’t like psychiatrists, but suggesting psychiatrists are the least intelligent of doctors has no basis in fact. I have met many psychiatrists. I am pretty darn smart, and I can tell you, I have yet to meet one that I think is generally of lesser intelligence. Lacking people skills? Yes. Ambivalent? Sure. But unintelligent? Nope; even the dumbest one I ever met seemed smarter than the average person.

Psychiatrist Qualifications

Psychiatrist qualifications are the following:

• A bachelors degree, generally with pre-med courses (4 years)
• Medical school (4 years)
• Psychiatric residency (4 years, 5 in Canada)
• Oral and written board certification exams
• Psychiatrists may further subspecialize into a subspecialty like neuropsychiatry or child and adolescent psychiatry (another year plus additional certification)
• “The total amount of time required to complete post-baccalaureate work in the field of psychiatry in the United States is typically 12 years of training.”

See, it’s pretty hard to argue psychiatrists are stupid. If you really think that, go through the 12 years of school and let me know how easy it was. Or do a meta-analysis on med school records based on specialty.

If you want to assert the claim that psychiatrists are stupid, then you have to provide some evidence.

Psychiatrists Lie to Patients

To be fair, everyone lies, and doctors, I think, likely “shade the truth” more than others. I think it would be pretty difficult to assert they are “lying” but not being as forthcoming as they should be, well, yes, many do fall into that category. (Sometime I’ll write more about this. It’s a more complex issue than you might think.)

However, the idea psychiatrists are willy-nilly lying to patients is quite absurd. I have yet to see and out-and-out lie and yet to see a single shred of evidence suggesting, psychiatrists lie to their patients. Does it happen? Oh sure, I have no doubt, but to suggest that all psychiatrists do it is patently fallacious.

Psychiatrists Are Bought by Drug Companies

One could argue the incestuous nature of the relationship between psychiatrists and drug companies. There’s no doubt advertising works (otherwise they wouldn’t do it) and I suspect some medications are overprescribed due to the influence of advertising of drugs to doctors and patients;[1] however, this is a far cry from saying they are “bought off.”

Do you know the most common medication for bipolar? Lithium. Know who makes money from lithium? Not really anyone because lithium is an old drug with multiple generics available. It is cheap and from a drug company perspective, no one cares about it.

Why Do Doctors Prescribe Specific Drugs?

I would say there are two main reasons doctors tend to prescribe certain drugs:

1. Free samples, which can often be given to a patient for more than a year (patients have a hard time paying for meds, including psych meds, in the US)
2. Information disseminated locally suggesting the drug is a good choice (information from other doctors, and yes, drug companies)

I would suggest in neither case are doctors “bought” by drug companies. In both cases I would suggest doctors are making what they consider to be the right decision, even if, perhaps, it turns out they were wrong.[2]

Again, this is a complicated issue that requires its own post, but again, I have yet to see evidence of widespread “buying” of doctors/psychiatrists. (Average M.D.s are actually quite different than psychiatrists in terms of prescribing practices, but that’ll have to wait for a later post too.)

Science is Lying. Scientists are Lying.

This, again, is one of the dumber arguments made by antipsychiatry. I read studies all the time and these studies come from every corner of the globe. You are as likely to see a paper from Israel as from Italy as from the US as from New Zealand as from Britain.

Every Country Has Tainted Science?

If anyone can explain how all the countries of the world have tainted science I’d like to hear it. More and more, people are recruiting scientists and patients world-wide to cover more variation in population (which comes with its own challenges, but I digress).

Every scientist is unethical? Every scientist is paid off? Seriously, you expect me to buy that?

For example, this paper from Switzerland on the neurobiology (biological evidence) of depression cites studies from Britain, the US, Germany, Israel, Japan and so on and so forth. Does anyone really think someone got all these scientists, from all these countries, together in a room and said, “Just to let you know, you have to show biological evidence of depression in your studies, but keep it on the DL.”

People Want Big Answers to Little Problems

Psychiatry, has issues. Medicine, has issues. Health care, has issues. I would never suggest otherwise.

But the doctrine of “psychiatrists are evil,” “psychiatrists only want to make money,” “psychiatrists don’t care about patients,” “psychiatrists don’t help anyone,” is just ridiculous. It’s hard to imagine the forces of greed and malevolence sustaining a person through 12 years of school. Is it possible? Probably. Is it likely? I think not. (If you want to fuck people and make money, there are easier ways. Some requiring no training at all.)

If Psychiatry is Evil, Then Science Must be Lying

And in order to maintain the belief that psychiatrists are evil, people have to believe science is wrong too. Because science contradicts the “evil psychiatrist” theory. Science refutes the “mental illness doesn’t exist” dogma. Science supports the positive impact of treatment on the body. Sure, science runs counter to conventional wisdom too, but that’s why we have it, to further refine our knowledge over time.[3]

Psychiatry is a Conspiracy

People want to believe there is a big conspiracy driving the problems in their lives and in the lives of others. It gives them something to rile against, something to fight, and something to blame. It stops people for having to take responsibility over their own choices. “The evil doctor made me do it.”

But the truth is not nearly so dramatic. In reality doctors, psychiatrists and everyone else is just trying to make the best decision they can with the information available. Some psychiatrists are unethical. Some mechanics are unethical. Some accountants are unethical. You know, like everyone else.

Scientists aren’t out to lie; psychiatrists aren’t out to make your sick; the world is not conspiring against those with a mental illness. We just don’t get it right all the time. No one does.

A Little Bit More:

1 This is an important point actually. Patients need to accept some of the blame here for insisting doctors prescribe whatever they saw on TV last night. 2 This is not to deny that doctors have never been bought off be drug companies because certainly in the past, drug companies were allowed to do all sorts of bribery-type activity, and doctors have been shown to be acting unethically based on these bribes. However, these egregious cases have been brought to life and laws have been enacted since. 3 You see this all the time with drugs that are pulled off the market. When they were studied, science thought they were fine, but when more people took them, they figured out they were not. And the evil doctors responded by reporting serious side effects and the evil FDA responded by pulling the drug from the market.