User talk:Cesar Tort/discussion/critique biopsych article

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Biological psychiatry article: A critique by Cesar Tort commented by Anarchist42

At User:Cesar_Tort's request, I am interspersing comments to this text... Anarchist42 00:01, 31 May 2006 (UTC)

Business partners I

As noted by Elliot Valenstein, the market value of drugs sold has been estimated to be 100 billion dollars annually. Considering how much money is involved, it’s no surprise to find that economic factors play a pivotal role in all stages of drug design, research, clinical trials, marketing and even in the concept of “biological psychiatry” itself. The pharmaceutical industry is the largest founder of medical research in the US and Canada. This explains why post-marketing detection of adverse effects of psychiatric drugs only comes from non-company physicians like the FDA’s, who have observed effects such as tardive dyskinesia and akathisia that the current article fails to mention.

The heavy reliance upon pharmaceuticals by both the public and the medical professions for all sorts of problems is well-known, and doesn't really need to be stated (just like one need not mention that politicians lie). As for the FDA, it can arguably be considered a biased source (i.e. in favour of the drug corporations). When one is trying to make a point, it is best to limit yourself to only the most salient and convincing points. Anarchist42 00:01, 31 May 2006 (UTC)

Political medicine

These adverse drug reactions must be mentioned, especially in the case of neuroleptics. In the 1975 US Senate hearings about neuroleptics “a long line of social workers, lawyers and youth advocates denounced such drugging as punishment of the most unusual and cruel sort. People so medicated, said one witness, ‘suffer a new and deadlier confinement’ than prisoners had ever known in the past” (Mad in America, page 180) [1].

Using out-dated references (1975 was 31 years ago) makes it look like you can't find any recent sources to back your argument, hence I'd advise against it. Anarchist42 00:01, 31 May 2006 (UTC)
P.S. NOTE: I used old sources because another editor suggested in a WP:RFAR page that the history of biopsych ought to be mentioned. —Cesar Tort 00:45, 31 May 2006 (UTC)

The Biological psychiatry article doesn’t even mention that neuroleptics are often administered involuntarily around the world!

Neuroleptics are not the only drugs administered involuntarily; a better point would be that psychiatrists can confine, drug, and electro-shock people against their will. This point supports the concept that psychiatry is unlike other medical professions and deserves greater scrutiny. Anarchist42 00:01, 31 May 2006 (UTC)

In the late 1960s and early 1970s, the United States shared with the Soviet Union the dubious distinction of labeling a larger percentage of its population "schizophrenic" than all other developed countries. Nor was the diagnosis of schizophrenia in the US free from political, racial or class taint. However, written appeals from Soviet dissidents, which had been smuggled out and given to the US Senate described neuroleptics as “the worst torture of all” (ibid., p. 216). Vassily Chernisov wrote: “Although I am afraid of death, let them shoot me rather than this” (this is one of the akathisia effects). Soviet dissidents stated that doctors used neuroleptics “to inflict suffering on them and thus obtain their complete subjugation”. On March 1976 former prisoner Leonid Plyushch spoke to the New York Academy of Sciences that “the purpose is to force the patient to change his political conviction”. Neuroleptics were a form of torture that could “break your will” (ibid, p. 217). Yet while American newspaper reports condemned the mistreatment of Soviet dissidents, on American soil exactly the same drugs were widely acknowledged to be effective.

Again, 30- to 40- year old references make your point look weak. Anarchist42 00:01, 31 May 2006 (UTC)
P.S. NOTE: I already explained this above. —Cesar Tort 00:45, 31 May 2006 (UTC)

Presently, neuroleptics and other psychiatric drugs, notably methylphenidate, are being prescribed to rebellious, though basically sane —like Soviet dissidents— adolescents and even children to control them [2].

The recent trend of using psychiatric drugs on children (sometimes at the request of teachers) is well-documented, and could be an excellent point suggesting that psychiatry has significant flaws. However, some consider Breggin to be a biased source, so try to find more "acceptable" sources in order to make your point more convincing. Anarchist42 00:01, 31 May 2006 (UTC)

Business partners II

Contrary to the article’s current pov, decisions in biopsych are not done by scientists but by business people. Certain journals have now been identified as taking huge sums of money from the pharmaceutical industry including the #1 psychiatric journal, the American Journal of Psychiatry. The current article omits basic historical info that explains much of what is happening in a market-driven society today. As explained by Valenstein in Blaming the Brain, in 1954 the industry’s professionals sales-force numbered 300 men to sell the idea of the allegedly “antipsychotic” drug Thorazine to the entire US mental health system. The same happened with antidepressants: the industry sold the idea to civil society that “depression is a flaw in chemistry, not character” and that “it’s a physical illness like diabetes or arthritis”: unproved scientific claims but widely promoted thanks to Big Pharma’s financial muscle. In fact, since the middle 1950s the media has been presenting the industry’s claims "as educational rather than promotional statements".

Drop the 1954 reference and instead mention Neurontin, which was prescribed as a treatment for bipolar disorder and depression. It turns out that it was less effective than a placebo, and its manufacturer lied to and/or bribed doctors to prescribe it. The drug corporation recently settled the largest class-action lawsuit ever, after admitting to the large-scale fraud in court. Of interest is the fact that so many psychiatrists were willing to lie to prescribe it to their patients despite the complete lack of a single positive clinical study (not to mention the fact that the APA never apologized, nor have any psychiatrists been successfully sued for their part in the fraud).
Of interest is the recent admission by the APA that the "chemical imbalance" theory of depression has no basis in fact. The point I'm making is that if one looks in the right places, one can find excellent proof that biological psychiatry is as best a theory and at worst a fraud. Anarchist42 00:01, 31 May 2006 (UTC)

Presently another way that pharmaceutical companies increase the market for psychiatric drugs is to support parents groups that want to control their rebellious children through licit drugs, such as the National Alliance for the Mentally Ill or NAMI, which has grown rapidly in size and power since 1979. It’s interesting to note that parents that belong to NAMI abhor the Trauma model of mental disorders since they accept no blame for their children’s behavior. NAMI and similar associations are funded by Eli Lilly and other pharmaceutical companies. Even the NAMI Wikipedia article acknowledges this.

The NAMI is indeed a biased source, and using their own words is sufficient (find a good citable quote). Anarchist42 00:01, 31 May 2006 (UTC)

All of the above factual info ought to appear in a truly NPOV article.

"All of the above" is too much, and includes both ancient and (potentially) biased sources. Psychiatrists and their supporters will not be easily convinced, thus the need to be concise and use recent citations. Anarchist42 00:01, 31 May 2006 (UTC)

Loren Mosher

The December 1998 letter of resignation of Loren Mosher MD, former Chief of Schizophrenia Studies of the National Institute of Mental Health to the president of the American Psychiatric Association Dr. Rodrigo Munoz, epitomes why the article needs balancing correction:

Dear Rod:
After nearly three decades as a member it is with a mixture of pleasure and disappointment that I submit this letter of resignation from the American Psychiatric Association. The major reason for this action is my belief that I am actually resigning from the American Psychopharmacological Association. Luckily, the organization’s true identity requires no change in the acronym [...].
At this point in history, psychiatry has been almost completely bought out by the drug companies. The APA could not continue without the pharmaceutical company support [...].
No longer do we seek to understand whole persons in their social contexts rather we are there to realign our patients’ neurotransmitters. The problem is that it is very difficult to have a relationship with a neurotransmitter whatever its configuration.
So, our organization provides a rationale, by its neurobiological tunnel vision, for keeping our distance from the molecule conglomerates we have come to define as patients [...]. It saddens me that after 35 years as a psychiatrist I look forward to being dissociated from such an organization. In no way does it represents my interests. It is not within my capacities to buy into the current biomedical-reductionistic model heralded by the psychiatric leadership as once again marrying us to somatic medicine. This is a matter of fashion, politics and, like the pharmaceutical house connection, money.
In addition, APA has entered into an unholy alliance with NAMI (I don’t remember the members being asked if they supported such an organization) [so] that the two organizations have adopted similar public belief systems about the nature of madness. While professing itself the champion of their clients the APA is supporting non-clients, the parents, in their wishes to be in control, via legally enforced dependency, of their mad/bad offspring. NAMI, with tacit APA approval, has set out a pro-neuroleptic drug and easy commitment-institutionalization agenda that violates the civil rights of their offspring. For the most part we stand by and allow this fascistic agenda to move forward [...].
The shortsightedness of this marriage of convenience between APA, NAMI and the drug companies (who gleefully support both groups because of their shared pro-drug stance) is an abomination. I want no part of a psychiatry of oppression and social control [...].
Finally, why must the APA pretend to know more than it does? DSM IV is a fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than a scientific document [...]. The issue is what do the categories tell us? Do they in fact accurately represent the person with a problem? They don’t, and can’t, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder. So where are we? APA as an organization has implicitly (sometimes explicitly as well) bought into a theoretical hoax [...].
We seem to have forgotten a basic principle: the need to be patient/consumer satisfaction oriented. I always remember Manfred Bleuler’s wisdom: “Loren, you must never forget that you are your patient’s employee”. In the end they will determine whether or not psychiatry survives in the service marketplace.
Sincerely,
Loren R. Mosher, M.D. [3]


I am familiar with the above letter, but such a length quotation obfuscates your point - simply pick the best sentence, and link to the whole letter. Anarchist42 00:01, 31 May 2006 (UTC)

In a nutshell, the substance of the Biological Psychiatry article as it now stands represents little more than mere below the line advertising on behalf of the pharmaceutical industry. WP:NOT prohibits use of articles as a vehicle for advocacy or propaganda.

Referring to WP:NOT does not help your argument - it goes too far, and is not necessary to make your point (you're just giving your opponents an easy target, which allows them to avoid the real issues at hand). Anarchist42 00:01, 31 May 2006 (UTC)


Bogus imaging claims, genetics, etc

Financial interest aside, many of my 17 April 2006 points in this talk page weren't addressed. I will mention only a few:

I have learned from experience that it is much more effective to discuss one point at a time. Anarchist42 00:01, 31 May 2006 (UTC)

While it is true that psychiatric drugs produce changes in the activity of a neurotransmitter, in contrast to the article’s claims it has not been possible to demonstrate that any biochemical abnormality is associated with any of the subgroups of depression or psychoses. I’m afraid to say that this very complex topic could take us many days, if not weeks, to discuss. Meanwhile the article should retain a pov tag (which I shall not post).

The Bipolar disorder article went through many months of heated discussion, and it did not have a POV tag during that era - adding a POV tag to a rather young psychiatric article merely gives your opponents an easy target (as you are now no doubt aware). Anarchist42 00:01, 31 May 2006 (UTC)

Re other three claims in Biological psychiatry article:

[1] Modern brain imaging techniques allow noninvasive examination of neural function in patients with mental health disorders. With some disorders it appears the proper imaging equipment can reliably detect neurobiological problems which correlate with a specific disorder.

The specific imaging techniques, magnetic resonance imaging studies or other, ought to be mentioned in the text itself. For the moment suffice it to say that, for instance, the blood perfusion that can be seen with the imaging techniques is not considered a biomarker in the medical profession. “Biological marker” is physiopathology, histopathology or the presence of pathogen microorganisms in the patient. Psychiatrists recognize that they cannot demonstrate any of these true biomarkers in the behaviors listed in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-IV-TR. If they could do it, psychiatry as a specialty would have disappeared and its body of knowledge would have merged in neurological science. That “mental disorders are neurological” is not even claimed in the DSM-IV-TR itself.

That imaging claim is indeed bogus - so simply add a fact tag[citation needed] and let other editors either find the citation (if any exist) or delete the claim after a suitable wait (I find this a simple and effective method of answering bogus medical claims). Anarchist42 00:01, 31 May 2006 (UTC)
[2] Another source of data indicating a significant biological aspect of some mental health disorders is twin studies...

The entire genetic studies in biopsych are a muddle. Psychiatrist Colin Ross has stated: “It would be difficult to find a clearer example, at anytime in the twentieth century, of substandard pseudoscience dominating the ideology of a field”.

The concordance of twins for schizophrenia is an example of how bioreductionistic ideology drives interpretation. Twin study results argue as strongly for environmental as genetic etiology. It’s true that in theory biopsychiatrists acknowledge the environmental factor, but in practice it’s robbed of any clinical importance. For instance, some of the abusive NAMI parents are truly “schizophrenogenic”: they drive their children mad. Undermining the family milieu wouldn’t be necessary if the biological actually had a solid scientific foundation in so-called “biological” psychiatry.

[3] Lastly, by identifying the neurobiologic "final common pathway" into which most antidepressants funnel, it may allow rational design of new medications which target only that pathway. This could yield drugs which have fewer side affects, are more effective and have quicker therapeutic onset.

Last month I wrote: “This looks like a futuristic statement and as such violates Wikipedia’s policies”.

Finally, re the “Criticisms” section I’ll remove the autism paragraph for reasons extensively discussed in Talk:Anti-psychiatry/Archive 5. While I conceded mentioning autism in the main Anti-psychiatry article, in the small space devoted here to antipsych criticism such views only further psychiatry’s bioreductionist ideology. —Cesar Tort 00:15, 15 May 2006 (UTC)

Kim’s advice

Ok, I had a change to read through it, it was longgggggg. Personally, I would not do it that way [about Cesar's idea of posting the above in a talk page] for several reasons. First, it contains several seperate issues. What most likely will happen is that people read it and respond to a single item, or maybe a few, but not to all. This is especially true for controversial issues, the most controversial will dominate the discussion and the more valid ones might get snowed under. I personally would take a single issue, and start with a obvious one. You could take for example the FDA/European stuff, as that is well sourced, has reliable sources, and is quite logical to add to the article. This keeps the focus, you know that there are some others who agree, and the main issue seems to be where in the article to place it and how to word it exactly. If you had to write one paragraph on it, what would you write about it (with sources)? I would also see the issue more as adding new stuff to the article, stuff that is logical to have a place here. Ok, I have to go to bed! Kim van der Linde at venus 02:57, 16 May 2006 (UTC)

Thanks for the advice. Once more, I’ll follow it. —Cesar Tort 03:22, 16 May 2006 (UTC)
  • User talk:Cesar Tort/discussion/critique biopsych article

Suggestions by Bookish

Useful links

  1. Against Biologic Psychiatry - an article by David Kaiser, M.D., in Psychiatric Times (1996, Vol. XIII, Issue 12).
  2. Bad Neuro-Journalism archive - The James S. McDonnell Foundation maintains an archive of the worst examples of journalism about the brain from the popular press.
  3. Debunking the science behind ADHD as a "brain disorder" - a position paper from the International Center for the Study of Psychiatry and Psychology (ICSPP).
  4. Challenging the Therapeutic State - special issue of The Journal of Mind and Behavior (1990, Vol.11:3).
  5. Biomedical bias of the American Psychiatric Association - an article by Duncan Double, MRCPsych, Consultant Psychiatrist and founder of the Critical Psychiatry Network.
  6. The limits of psychiatry - an article by Duncan Double, MRCPsych, Consultant Psychiatrist, British Medical Journal, 2002;324:900-904.
  7. Only 6% of drug advertising material is supported by evidence - an article by Annette Tuffs, British Medical Journal, 2004;328:485.
  8. On the Limits of Localization of Cognitive Processes in the Brain - an essay by William R. Uttal, Professor Emeritus of Psychology at the University of Michigan, based on his book "The New Phrenology" (MIT Press, 2001).
  9. Neuroimaging and psychological theories of human memory - introductory text for a symposium to be held in August 2006 at the Cognitive Psychophysiology Lab, Philipps-University Marburg, Germany (the text is in English).
  10. Antipsychotics, Economics, And the Press - an article by Steven Sharfstein, M.D., 2004 President of the American Psychiatric Association, which appeared in the APA newspaper "Psychiatric News" (2005, Vol.40:23).
  11. Letter of Resignation from the American Psychiatric Association - from Loren R. Mosher, M.D., former Chief of Schizophrenia Studies at the National Institute of Mental Health.
  12. Stop the disease mongering - New Scientist Magazine Editorial, 15 April 2006.
  13. One-Trick Training - a critique of the American Psychiatric Association's advocacy of bio-psychiatry which appeared in the APA newspaper "Psychiatric News" (2004, Vol.39:15).
  14. The emperor's new drugs - abstract from an analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration, published in the journal "Prevention & Treatment" (2002, Vol.5:1).
  15. Eli Lilly, Zyprexa, & the Bush Family - an article by psychologist Bruce E. Levine, Ph.D.
  16. DSM: The Bible of the psychiatric professon - President's Column, American Association of Community Psychiatrists, on the website of the Pittsburgh School of Medicine Department of Psychiatry.
  17. Schizophrenia: Medical Students are Taught it's All in the Genes but are they Hearing the Whole Story? - see Selected Publications by Jonathan Leo, PhD, Associate Professor of Anatomy, Western University of Health Sciences.


  1. Memorandum from the Critical Psychiatry Network to the United Kingdom Parliament - Written evidence to the House of Commons Select Committee on Health, April 2005.


Some observations on content density

From -- Bookish 17:05, 18 June 2006 (UTC)

In a number of Wikipedia articles on controversial topics (not just psych topics) it appeared to me that saboteurs used the tactic of introducing subtle digressions to disrupt the coherence of the text. It is also possible for advocates to do the same, inadvertently, by flooding the text with too much supporting material and a deluge of embedded links. I doubt that a typical reader follows more than a handful of links, internal or external.

Secondly, Michel Foucault is a philosopher. His book Madness and Civilization is listed in Category:Sociology books. Not many biopsych supporters would be impressed. If it was my article I would only mention him, and his book, on one line in the See also section. It might be better to find another source, e.g. [4].

  • Yes: I’m perfectly aware that Foucault is better for the Antipsych article. However, since sources are so demanding here, the brief historical paragraph needed a reliable source. —Cesar Tort 18:00, 18 June 2006 (UTC)

Thirdly, I would remove the whole Biopsychiatry as a pseudo-science section. All of those criticisms could equally be applied to trauma theories, rightly or wrongly. As far as I can tell, no part of psychiatry is based on falsifiable predictions that have been demonstrated to be true in all replication studies. There would be no controversy otherwise. Of course, that's particularly true for hypothetical Schizophrenia genes (see Another blank on schizophrenia gene). Only one such study has been successfully replicated (see Decode Genetics), and then only once.

  • Falsifiability criticism can not be applied to trauma theories for the reasons Colin Ross explains in his book The Trauma Model. In a nutshell, people on trauma therapy, e.g. in the European Soteria houses, fare much better than patients on neuroleptics. —Cesar Tort 18:00, 18 June 2006 (UTC)
Unlike most overworked doctors, I know the published studies demonstrate that patients who receive long-term supportive therapy fare better than patients who only receive drugs. That's not the point. Falsifiability is the point. -- Bookish 18:20, 18 June 2006 (UTC)
If trauma therapy works (take a look at the two discussions that start here [5]) and NRLs don’t as Robert Whitaker established, the burden of proof (falsifiability) rests upon the shoulders of bioshrinks. —Cesar Tort 19:27, 18 June 2006 (UTC)

Should Thomas Szasz be in the "See also" section? I will check how many books he has written in the past 40 years. All psychiatrists know what his views are. The only one I've read is The Myth of Mental Illness. Wikiquote has quotations by Thomas Szasz. -- Bookish 21:16, 18 June 2006 (UTC)

Szasz is already mentioned twice in References. I’ve read about ten of his books. Only one in all of Szasz’s books deals specifically with biopsych: Pharmacracy. The other books (critique of mental illness as a concept; laws and human rights; psychiatric newspeak, etc) are more suitable for the Antipsychiatry article.
Curiously, The Myth of Mental Illness, considered by many his most important book, is IMHO a pretty bad book. Just as Foucault’s Madness and Civilization Szasz’s prose is opaque. Fortunately people like Breggin and Whitaker have written clearer, less pedantic and much more didactic books. Of course, after The Myth of Mental Illness Szasz changed his style and wrote little gems such as Anti-Freud and others. —Cesar Tort 21:37, 18 June 2006 (UTC)

Rich media, poor usability

In the External links style guide for Wikipedia PDF documents come under the heading of "Rich media" (i.e. not standard web pages). It states: "there is a strong presumption against linking directly to rich media," and says there should be an "explicit indication of the technologies needed to access the content." The example given shows (PDF) in brackets after the title of the document.

  • Good advice. I’ll remove PDFs. —Cesar Tort 18:00, 18 June 2006 (UTC)

Brave New Brain

I don't understand why you included a reference to Brave New Brain, which promotes an extreme bio-psychiatric approach. Some visitors to the Wikipedia article might be supporters of biopsych who are looking for reasons to scoff at any criticism. Those who visit the Amazon page, and find that it contains favourable reviews, might say to themselves: "Wow! That's cool. Biopsych is the way to go!"

  • I’m perfectly aware that Andreasen sells biopsych. But at least she is honest enough to acknowledge that her profession has been unable to present biomarkers to the scientific community. See my article [6]. —Cesar Tort 18:00, 18 June 2006 (UTC)
That's not obvious on the Amazon page. Visitors will get opposite impression -- Bookish 18:13, 18 June 2006 (UTC)
Which is why I removed that link already. —Cesar Tort 19:27, 18 June 2006 (UTC)


www.madinamerica.com - the author's website.

  • Have you read what I have written in the talk pages of both the Whitaker and Mad in America articles? —Cesar Tort 18:00, 18 June 2006 (UTC)
I haven't been able to keep up with all the changes recently. That's why I prefer to post a few thoughts here. It's possible I may be duplicating things you've said already. -- Bookish 18:13, 18 June 2006 (UTC)

Jay Joseph, The Gene Illusion

Cesar: There's an article stub on Wikipedia about Jay Joseph's first book, The Gene Illusion. It has a couple of references which might be useful to you. -- Bookish 11:16, 17 June 2006 (UTC)

Introductory summary

Because of the ArbCom case the biopsych article is under close scrutiny from admins. It will have to meet a higher standard than would have been the case otherwise. To write criticisms first and leave supporting citations for later is asking for trouble. A who-said-what-and-where approach, with every statement derived from a reliable source, may be the only way forward under the circumstances. I have no wish to become involved in editing the text directly because the bar has been raised too high. My own feeling is that it might actually be more effective to keep the narrative text to a minimum and let the References - See also - External links sections speak for themselves. Nevertheless, I would be pleased to see the article develop into one of Wikipedia's better examples of how to handle a thorny subject.

I just read Rockpocket's suggestion for a brief summary. Basically, it's good, but there are a few points that would be better phrased another way.

  1. The phrase "vocal minority" has pejorative connotations. I think it would be better to rephrase it as "who are at present in the minority".
  2. "Instead a trauma model of me(n)tal disease is proposed." This is misleading. There have been a trauma models of mental illness within mainstream psychiatry for more than 100 years. It is only in past few decades that these have been brushed aside by mainstream orthodoxy.
  3. "They argue the lack of biomarkers is evidence for..." Actually, the lack of biomarkers is a flaw in the evidence.

My suggestion:

"The biopsychiatry controversy is an ongoing dispute over the scientific basis of biological psychiatry theory and practice. The debate is focused on criticism of mainstream psychiatric thinking, proposed by a vocal lobby of psychiatrists and scientists who are at present in the minority. Activist organizations support their views. Critics contend the field is flawed in a number of ways. They argue that the lack of biomarkers is a flaw in the evidence for a somatic, biological cause for mental illness. Instead they draw attention to trauma models of mental illness within the psychiatric literature which have been brushed aside as research efforts switched to the biological model."

Personally, I would be careful not to use the word "pseudoscience" too often. When I was at university I shared a student house with medical students. I'm familiar with the outlook most of them hold. Medicine is one of the most long-drawn-out and gruelling courses of study at university level. They tend to resent the implication that any part of what they were taught was misguided. -- Bookish 14:59, 18 June 2006 (UTC)

Selling Sickness

Here is a quote from a bestselling book, "Selling Sickness," by drug policy researcher Alan Cassels and journalist Ray Moynihan. -- Bookish 19:03, 11 June 2006 (UTC)

"Thirty years ago, Henry Gadsen, the head of Merck, one of the world's largest drug companies, told Fortune magazine that he wanted Merck to be more like chewing gum maker Wrigleys. It had long been his dream, he said, to make drugs for healthy people so that Merck could "sell drugs to everyone." Three decades on, the late Henry Gadsen's dream has come true."

Book details:

"Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning Us All Into Patients" by Ray Moynihan and Alan Cassels. Nation Books (July 28, 2006). ISBN: 156025856X.

I have a link to an online article about the book, but it isn't from a bona fide medical/scientific journal, so I'll put it here:

  1. Selling Sickness

Another book, on Wikipedia: Mad in America by Robert Whitaker (author).

Discussing links list

I added a link to the list on your talk page pointing to the letter on the moshersoteria.com website (maintained by Lars Martensson). That way interested readers could explore his site. When I'm browsing Wikipedia articles I don't always notice external links if they are refs within the article instead of in a "References" section or an "External links" section. Would you like me to transfer the complete list of links to the draft article, or would you prefer to make your own selections from it? -- Bookish 16:39, 11 June 2006 (UTC)

I already inserted three of your references, including Mosher’s. This is an open article which anyone can edit (Anarchist42 has already added a phrase to the autism debate). You can transfer all of the references if you wish. I’ve included the ones that I’ve read (and liked). —Cesar Tort 17:10, 11 June 2006 (UTC)
I'm reluctant to mess with the draft as it's your enthusiasm and energy which is bringing it to life. I agree with Anarchist42, take care with the autism issue. Have you seen how many articles there are in Category:Autism?
At present, the number of references I've collected is too long to put in the External links for the final article, and I haven't even started on the bogus 'genetic predispositions' material yet. I'm continuing with the old list for the moment because that saves me having to check whether I'm duplicating items you've already found and included somewhere.
One thing I noticed though, some of the links embedded in the text send people to PDF documents. According to the leading web usability expert, Jakob Nielsen, PDF is bad for online reading. -- Bookish 17:49, 11 June 2006 (UTC)
Re the bogus genetic predisposition material have you seen references to Jay Joseph’s 2006 book? [7]. He is the foremost authority on this material. PDFs are difficult but some high quality articles are in that format such as the one about the “Therapeutic State” I included in the Szasz paragraph. —Cesar Tort 18:22, 11 June 2006 (UTC)
Yes, I've visited that site before. My feeling is there shouldn't be a huge number of external links embedded in the text of an article. It's probably against some Wikipedia guideline somewhere. Personally, I prefer to see references collected in one place (e.g. Books, Articles and External links). Articles can have (available online) to add the link at the end of the item. I firmly believe the quality of links matters more than the quantity, but I'm one the people Jakob Nielsen is talking about when he says "Users Hate PDF". I didn't click on any of the PDF links, so I haven't read them. People would only find out they are high-quality articles if they are desperate to read lots of supporting material. -- Bookish 19:03, 11 June 2006 (UTC)
I forgot to mention, have you seen this Wikipedia article: David Healy (psychiatrist)? -- Bookish 19:57, 11 June 2006 (UTC)
I'm not sure whether the links I've collected match what you're looking for. I'm surprised you didn't use "The New Phrenology" by Professor William R. Uttal, because you need a citation for bogus imaging claims. I added a couple more links for now. I'll wait and see how the article develops before rummaging through my collection for more. I thought it was best not to link to Wikipedia's article on the Food and Drug Administration because it is subject to two NPOV disputes. -- Bookish 12:14, 12 June 2006 (UTC)
I did mention the Healy article. I have only included the links I’ve read but will try to read the others today (and use the Uttal link of course). —Cesar Tort 15:17, 12 June 2006 (UTC)

Touchups

From Bookish 20:03, 19 June 2006 (UTC):

I will personally award you a barnstar as soon as all the touchups are out of the way. Previously, when I read through the article, I was trying to look at it from the point of view of a medical student who believes in the biological model, but wants to know why not everyone does.

Some additional thoughts occurred to me about the wording. Would it be a good idea to put descriptions in the See also section, or is that against one of the Wikipedia guidelines?



The following paragraph doesn't read smoothly. For instance, one phrase duplicates dominant/dominated:

According to institutes devoted to criticize biopsychiatry such as the International Center for the Study of Psychiatry and Psychology, presently the dominant force in the field is dominated by reductionist ideology that defines somatic variables as factors in the causes of mental disorders. Research in biopsychiatry is therefore confined within the same lines of medical illnesses. In (the) words of another critic, Alvin Pam (1995), “Given this stilted, unidimensional, and mechanistic world-view, research in psychiatry has been geared toward discovering which aberrant genetic or neurophysiological factors underlie and cause social deviance”. According to Pam, the “blame the body” dynamics in the field, that typically offers medication for mental distress and disorders, shifts the focus from disturbed behavior in the family to putative biochemical imbalances.

Suggested alternative:

Organizations critical of biopsychiatry, such as the International Center for the Study of Psychiatry and Psychology, point out that the dominant reductionist approach postulates somatic variables as causative factors in mental disorders. Consequently, research in biopsychiatry is confined to the medical illness model. In the words of a clinical professor of psychiatry, Alvin Pam (1995), "Given this stilted, unidimensional, and mechanistic world-view, research in psychiatry has been geared toward discovering which aberrant genetic or neurophysiological factors underlie and cause social deviance". According to Pam, the "blame the body" approach, which typically offers medication for mental distress, shifts the focus from disturbed behavior in the family to putative biochemical imbalances.

There are a few other places where touchups would help, e.g. "In words of who is probably the foremost..."

Good advice! I already followed all of your suggestions. —Cesar Tort 20:58, 19 June 2006 (UTC)


From Bookish 23:21, 19 June 2006 (UTC). More touchups:

(1)

In words of who is probably the foremost critic of his own profession, psychiatrist Thomas Szasz:

A missing word, but better to make it shorter:

In the words of psychiatrist and veteran critic of his own profession, Thomas Szasz:

All psychiatrists know about Szasz and his opinions.

(2)

On the other hand, neurology scientists such as Elliot Valenstein claim...

The name for "neurology scientists" is "neuroscientists". Neurology is a medical specialty (non-psychiatric). It is safer to write:

On the other hand, Elliot Valenstein, a psychologist and neuroscientist, claims...

Don't use the phrase "such as" ( 9 times in the text). Skeptics will say "And who are the others?"

(3)

Theodore Lidz, Jay Joseph (2006)

That's the date for his second book. The date for The Gene Illusion should be:

Theodore Lidz, Jay Joseph (2003)

(4)

"and others" ( 4 times). Who are the others?

(5)

...genetic lesions have been proposed to be mechanistically responsible for...

The whole paragraph seems confusing and contradictory to me. The entire paragraph needs to be worded very carefully. A few small changes won't be enough.

Therefore while twin studies and other research suggests that personality is heritable to some extent,...

What other research? These are questions skeptics will ask.

Cherry picking

Don't worry, I'm giving careful thought to the paragraph that needs re-writing. Composing words is harder work for me than creating images (like the coloured graph).

The list of external links is quite long now. I was wondering whether it would be better to remove one or two, or sub-divide the section into:

  • External links
  • Criticisms from psychologists & the medical profession
  • Methodolical problems
  • Other critiques

That way you can add more without making it too cluttered. Better than [1][2][3][4][5][6][7][8][9] in the narrative text, which most people will never click on. Maybe you could remove the first link to Critical Psychiatry Network (Biomedical bias of the American Psychiatric Association). You already have David Kaiser's article at the top. The UK parliament website is a better example for the Critical Psychiatry Network. Duncan Double's website has good articles, but the site is so badly designed it's a nightmare to find them all. -- Bookish 00:28, 21 June 2006 (UTC)

Perhaps converting existing references to the “ref” method of citation will solve this problem? —Cesar Tort 07:21, 21 June 2006 (UTC)

No direct involvement

Copying my remarks from your discussion page to the biospych talk page was a provocative thing to do. I was in the middle of re-writing the paragraph which mentioned twin studies. Now I will have to throw away the draft. The twin studies issue has become part of the biopsych talk page. From now on Rockpocket is likely to quibble over twin studies whatever I write.

That puts an end to me re-writing the paragraph. Earlier, on this page, I wrote: I have no wish to become involved in editing the text directly because the bar has been raised too high. I was willing to contribute indirectly, on your discussion page, but by moving my comments without asking, you have involved me directly. No thanks. The biopsych article is under close scrutiny for reasons that have nothing to do with me. -- Bookish 12:55, 21 June 2006 (UTC)

I’m really sorry, Bookish but Rockpocket responded to you here in this subpage before I moved his reply. Once he responded to you here the discussion was no longer a private one. What I did was giving a message that this subpage is for us only and that third parties’ comments will eventually be moved (but now we see it’s not a private subpage!). You may finally understand what I told you before: why I didn’t want to mess with the genetic section when it was in the Anti-psychiatry article and why I had asked you to write me thru email... —Cesar Tort 14:44, 21 June 2006 (UTC)
Why should I have to move from page to page to find out what happened to my own words? How would I know on which page Rockpocket originally added his response? It can't be undone now, because the issue has gone on record on the biopsych talk page. It could have been dealt with here. As I pointed in Some observations on content density, there have been many tentative research studies suggestive of a link between gene regions and schizophrenia, but with one exception, replication studies have failed to provide confirmation. Rockpocket's 3 PubMed abstracts are an irrelevance unless there are replication studies to back them up. Twin studies, however, are the staple of this kind of research.
The point is, if it was my article I would have tackled the issues in a completely different way. I have no wish to get entangled with justifications for material I didn't write. -- Bookish 18:38, 21 June 2006 (UTC)
Rockpocket added his response in the Laing section above. I too don’t wish to be entangled with a section I barely contributed to write; and still think it’s important to have some email privacy to avoid further misunderstandings. There’s no real privacy in Wikiland.
By the way, the RFAR case is now officially closed. I came up out of this messy process virtually untouched. Time for a wiki-vacation? After I made major edits today in other wiki articles I may start soon my 4th book, Mis diecisiete años: pain at its purest form. —Cesar Tort 19:35, 21 June 2006 (UTC)

Autism mess

Re Anarchist's comment in Edit summary: “avoid equating autism with bad parenting”. Presently autism, as a subject, is a total mess. But I’d be very happy to hear your comments.

Have you seen my debate about autism in Talk:Anti-psychiatry/Archive 5? —Cesar Tort 20:18, 10 June 2006 (UTC)

Sorry, I haven't yet. I'm always suspicious of claims that any disorder is caused by "bad parenting"; after all there are a lot more "bad parents" than mentally children. A friend of mine has twins, only one of which is autistic, which makes me doubt the "bad parenting" theory. I suspect that most "mental illneses" result from a combination of numerous factors, and that any simplistic explanation or theory just leads to simplistic treatment. - Anarchist42 22:01, 11 June 2006 (UTC)
I also know a family in which only one of the monozygotic twin became seriously disturbed or schizophrenic. The environmental cause is explained in that archive. Have you seen the movie Shine by the way? —Cesar Tort 23:35, 11 June 2006 (UTC)

Request

Hello Cesar. I really don't wish to get involved in this effort you are initiating here on your subpages. But could i ask that, when you are finishing moving the sections of anti-psychiatry to your new article and are happy with the results, you consider reworking the anti-psychiatry article so that it is more cohesive in describing the development of the activist movement (with the scholarly criticisms themselves now in the the new article). If you don't wish to do this, could you let me know when you are happy with the content and i can make sure the two articles are suitably different in content? This, i think, is the best way to avoid a future merge. Thanks. Rockpocket 22:50, 10 June 2006 (UTC)

Sure: I’ll rework the Anti-psychiatry article once the new article is finished and I remove that section. —Cesar Tort 23:02, 10 June 2006 (UTC)
Thanks. Rockpocket 23:04, 10 June 2006 (UTC)

One article will deal with the scientific issues, the other with the political implications. —Cesar Tort 18:58, 12 June 2006 (UTC)

Hello Cesar. I just wanted to congratulate you on your work in the biopsychiatry controversy article. It is fairly obvious that i was against splitting the two, but my argument was based on content, not principle. However, i'm happy to note that i do think you have managed to make it sufficiently different from anti-psychiatry to warrant its own existance and i think is - as much as these POV-forkish type articles can be - a good encyclopedia article. Thank you, also, for addressing my concerns so promptly and graciously. Rockpocket 01:49, 19 June 2006 (UTC)

pace Godwin’s law

I wonder why Rockpocket restored "twin studies and other research"? The whole point of recent touchups was to improve the quality of the article. And that includes removing allusions to unspecified research (Rockpocket didn't provide any references). It reminded me of an article at ScienceNews.org: Same Difference. Which also reminded me of a paper in Cognitive Therapy and Research (Vol.1:2, 1977): An Experimental Study of Confirmatory Bias in the Peer Review System. -- Bookish 21:17, 20 June 2006 (UTC)

I put it back because it is misleading to imply that twin studies is the only such evidence for genetic associations with mental disorders, especially as their credibility is disputed in the next sentence. If you or CT would like citations, then by all means use the {{fact}} template and i can provide them. Rockpocket 05:21, 21 June 2006 (UTC)
A few examples : [8] [9] [10] Rockpocket 06:22, 21 June 2006 (UTC)
What you say about disputed "credibility" is not true. That's an error of scientific logic on your part. It is an axiom of Popper's principle of "falsifiability" that any hypothesis could be disproved. It remains true that twin studies are the staple of this kind of research, as they have been for more than a century. Still, by quibbling over it you've revealed your POV. Much needed work on improving the quality of the article could be stalled by this kind of interference. -- Bookish 16:40, 22 June 2006 (UTC)
My POV in this is faily obvious. However, it doesn't matter what my POV is when i have provided verifibale sources for the content i replaced. I don't disagree that twin studies is the staple of this kind of research, especially historically. However, as genomic technology gets cheaper, genome scanning becomes more and more viable. Which is why association studies are beginning to be replicated and progress is being made. Therefore it is misleading to give the impression that these suggestive studies rely on evidence from twin studies exclusively. It simply is not true (as those sources demonstrate).
Quite how the quality of the article can be stalled "by this kind of interference" is unclear to me, perhaps you can elaborate? Cesar simply deleting something, without justification, to give an misleading simplified impression of a complex field is hardly an improvement, and replacing the content and providing verifiable sources is hardly "interference". Moreover, it appears to me that you have yet to actually contribute content to the article directly. Criticism of other's attempts to improve is easy but ultimately unconstructive, contributing an alternative yourself is much more helpful. As i said before, if you can make that section better, by all means lets see what you have. Rockpocket 17:50, 22 June 2006 (UTC)
It's obvious from the content of this page that I have contributed a large amount of constructive material for Cesar to make use of in an article that is essentially his creation. Talk about the pot calling the kettle black! Without an explanation, your three PubMed abstracts are not really adequate to demonstrate that other approaches have an equivalent scientific pedigree to twin studies. I assume that was what your were trying to imply. Would you like to spell out exactly what systematic methodolical approach the three studies are recent examples of? It's up to you to spell out the alternatives, if they are clear to you. -- Bookish 18:16, 22 June 2006 (UTC)
Who is saying "other approaches have an equivalent scientific pedigree to twin studies"? You said that, not I, and neither does the article. Therefore i am not obliged to justify their merits, nor am interested in spelling out the alternatives, as i (personally) do not think the section reqires such detail. Its simply important (in my opinion) to illustrate that twin studies are not the exclusive tool which scientists have used to find these suggestive associations. They may be the best, they may be the most common, but they are not exclusive. That is clear from the sources i provided.
Let me explain to you what happened. Without justification, Cesar deleted the bold text from this section:
The reasons offered for the relative lack of genetic understanding is because the links between genes and mental states defined as abnormal appear highly complex, involve extensive environmental influences and can be mediated in numerous different ways, for example by personality, temperament or life events. Therefore while twin studies and other research suggests that personality is heritable to some extent, the genetic basis for particular personality or temperament traits, and their links to mental health problems, is currently unclear
I replaced it because it is a more accurate, and informative, reflection of reality with it in. You questioned why. So I provided references. One of these references [11] says the following (my bold):
Twin studies show that co-morbidity within anxiety disorders and between anxiety disorders and depression is explained by a shared genetic vulnerability for both disorders. Some family studies support this conclusion, but others suggest that co-morbidity is due to one disorder being an epiphenomenon of the other.
Now, please tell me why the above reference, specifically the words in bold, is not an appropriate source for the assertion that i reverted? That is all i did and that is all i am interested in discussing. Should you feel you can further improve this section by rewording, then please do so. But please do not continue to infer greater meaning behind this very simple and justifiable edit. A little good faith would not go amiss. Thank you. Rockpocket 01:56, 23 June 2006 (UTC)

With all due respect, rockpocket, and pace Godwin’s law, trying to understand schizophrenia and its causes from a strictly genetic perspective is something morally aberrant and an unimaginable idiotic enterprise that will always fail: it’s like trying to understand Judaism by analyzing the genes from Jews! —Cesar Tort 15:16, 22 June 2006 (UTC)

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