Talk:Biopsychiatry controversy

From Wikipedia, the free encyclopedia

You have new messages (last change).
WikiProject Medicine This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
??? This article has not yet received a rating on the assessment scale.
??? This article has not yet received an importance rating on the assessment scale.
WikiProject on Psychology
Portal		 This article is within the scope of WikiProject Psychology, which collaborates on Psychology and related subjects on Wikipedia. To participate, help improve this article or visit the project page for details on the project.
B This article has been rated as B-Class on the quality scale.
Mid This article has been rated as Mid-importance on the importance scale.

Article Grading: The article has been rated for quality and/or importance but has no comments yet. If appropriate, please review the article and then leave comments to identify the strengths and weaknesses of the article and what work it needs.
WikiProject on Sociology This article is supported by the Sociology WikiProject, which gives a central approach to Sociology and related subjects on Wikipedia. Please participate by editing the article Biopsychiatry controversy, or visit the project page for more details on the projects.
B This article has been rated as B-Class on the quality scale.
Mid This article has been rated as Mid-importance on the importance scale.

Contents

[edit] Two articles

This article is about the scientific controversy in psychiatry; the Anti-psychiatry article is about the political implications such as activism, etc. Both still need reworking and will try to do the job in the following days. —Cesar Tort 00:32, 16 June 2006 (UTC)

[edit] Comments on "Unjustified focus on genetic factors"

I applaud the work and insight that went into this section. However, mention must be made of the basis for genetic factors being considered as plausible. You allude to, but do not make explicit, the notion that environmental factors act as triggers for the genetic factors. There are existing diseases outside of Psychiatry that can be used as examples. That is while you and I might agree that psychiatry is copping out, balance must be brought to bear to show that this idea is not terribly far-fetched. Diseases ranging from asthma to multiple sclerosis can be used.

There is another genetic concept that is more obfuscatory still: the idea that a disease can be "multifactorially genetic". That is, several genetic factors can contribute in some combination, with or without an environmental trigger. --Paul King 00:56 EDT, 06 January 2006 (UTC)

Hi. I was the person that contributed most of this section. At the time there quite a lot of opposition to further "justification" of the genetic theories. However, if you believe you can improve the section, please be bold Rockpocket 20:36, 6 January 2007 (UTC)
If content is already there, I make efforts to retain it unless I can see obvious factual problems. I just added general remarks about multifactorial inheritance for balance, and it looks like I set up your discussion and gave it more context. Thanks for allowing me to be bold. --Paul King 19:07 EDT, 06 January 2006 (UTC)

[edit] OR tag

I'm not seeing the genesis of this controversy (the basic background demonstrating that there is an actual noteworthy controversy -- or even, indeed, what "biopsychiatry" actually is). A quick skim reveals LOTS of "Critics say" weasel-wording, a definite red flag in my book. --Calton | Talk 00:45, 16 June 2006 (UTC)

I don’t understand. Only in the “General criticisms” section do the words “critics say” appear, i.e., only once in the whole article. —Cesar Tort 00:52, 16 June 2006 (UTC)
Ruleslawyering about the exact phrase doesn't address the actual objection:
  • "Critics say..."
  • "Critics of biopsychiatry often complain about..."
  • "... is seen by critics as unjustified."
  • "Some critics also claim..."
And how about the passive voice?:
  • "...has also been an issue of concern"
And what about the other problems? --Calton | Talk 01:03, 16 June 2006 (UTC)


It will be easy to supply the sources; as I said above, this is a draft. —Cesar Tort 01:25, 16 June 2006 (UTC)

Sources have just been added now. —Cesar Tort 03:23, 16 June 2006 (UTC)

The requests of the editors who have posted tags in the article are now fulfilled. It’s time to remove the tags. Any objection? —Cesar Tort 01:06, 17 June 2006 (UTC)

Yes. I object.
  • WP:MoS and WP:LEAD explain how articles should be arranged to provide context, this article does not follow these style guides and completely lacks an appropriate lead paragraph summarising the article.
  • The citation request for "In the psychiatric profession, people labeled with a DSM disorder are usually treated with psychiatric drugs (and sometimes, electroshock)." was deleted without one being provided. I would have thought there was evidence for a integrated approach to treatment, so one would expect the sentense to read "drugs along with x, y and z". Otherwise we risk misleading by omission. I would be interested to see the justification for a claim that people are "usually" treated with drugs alone.
  • I do not see how this citation [1] is proof that "graphical studies are [widely] shown in magazine articles as proof of a biological cause of mental disorders". It instead appears to be a link to an arbitrary list of articles someone at James S. McDonnell Foundation considers to be "bad journalism" (actually reading some of these seems to suggest to me that their justification for inclusion is biased by simply not understanding some of the science. Their criticism of this one in particular [2] is unfounded to anyone that understands how neurons are wired from the sensory organs to the amygdala). I would like to see at least one article, and preferably more, that specifically claims an MRI or PET proves a mental disorder has a biological cause. Some grant administrator's ignorance does not cut it as a verifiable source.
  • The citation for the very wideranging statement: "Medical students are taught that biological psychiatry has become more scientific recently; has many effective drugs, has demonstrated the genetic foundation of schizophrenia and is moving ever forward into more specific psychopharmacology" is a book by a notable critic. He doesn't appear to be an expert on current medical teaching and thus it doesn't seem like a verifiable source for such statements. I would argue that this statement be preceded by "Breggin claims..." or else some independent expert source should be provided that backs up those claims. A brief survey of the medical students i interact with disgreed with the first and third of those assertions about their education (the first being essentially meaningless, the third being clearly untrue, in their opinion).
  • I also have concerns that this article strays into promoting the controversy rather than describing it. But that is a common concern i have with such articles.
Address those, and i'll happily remove the tags. Rockpocket 07:21, 17 June 2006 (UTC)


Already addressed as requested. —Cesar Tort 17:41, 17 June 2006 (UTC)


This sentence should be changed, deleted, or a reference provided: "Most biopsychiatrists believe that the balance of neurotransmitters in the brain is the major biological regulator of mental health." Actually I think most researchers understand the primary neurotransmitters (serotonin, norepinephrine, dopamine), are only indirectly related to mood and emotion. E.g, neurotransmitter changes happen within minutes after taking an antidepressant, yet the therapeutic effect doesn't happen for weeks. Obviously a lot more is involved than a "balance" of neurotransmitters. This is widely known. You may be confusing pharmaceutical "cartoon" TV ads with what professionals actually believe. Joema 00:42, 18 June 2006 (UTC)
I didn’t write it. Just cut and pasted it from the old Anti-psychiatry article. Will try to modify it. —Cesar Tort 01:42, 18 June 2006 (UTC)


Firstly, there is still no summary introduction per style guidlines. We need one or two introductory paragraphs summarising what the entire article is about. Here is an example of what i mean (i'm not proposing this be included word for word, simply that something along these lines are needed prior to the TOC):
"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 minority of scientists, activists and psychiatrists. Critics contend the field is flawed in a number of ways. They argue the lack of biomarkers is evidence for a somatic, biological cause for mental illness. Instead a trauma model of metal disease is proposed. Critics also suggest biological psychiatry qualifies as a psuedo-science etc"
Secondly, changing "Medical students are taught" to "For popular imagination molded by the media" doesnt get around the fact this is unsubstatiated, speculative stuff put forward by critics. Where is the evidence that, in the "popular imagination" biopsych "has demonstrated the genetic foundation of schizophrenia"? Exactly which "media" has molded thought to believe "psychiatry has become more scientific recently"? This must be attributed ("Critics such as Ross have suggested...") or else specific sources be provided. Rockpocket 07:41, 18 June 2006 (UTC)
Source and intro already provided. —Cesar Tort 20:17, 18 June 2006 (UTC)
Thanks. I made two further minor changes. With that my concerns have been addressed, so i removed the context tag. It seems the OR has been dealt with two. Perhaps you could give notice to the person who added it that you tend to remove it. If they do not come back with comment, then i see no reason that needs to stay either. Rockpocket 01:39, 19 June 2006 (UTC)

I have no obvious objections, though it bothers me that the first sentence of the "History" section treats what Michel Foucault says as if it were incontrovertible fact. Other than that, let others hash out the POV and "undue weight" questions. --Calton | Talk 05:32, 20 June 2006 (UTC)

Thanks for your comments, Calton. I changed the phrasing of that sentence. Actually I don’t like Foucault: I abhor obscure prose with all my heart and most philosophers as well. The undue weight and pov forking was discussed at length in the lengthy RFAR process (see e.g. Wikipedia talk:Requests for arbitration/Cesar Tort and Ombudsman vs others/Proposed decision) and an agreement was reached.
I’ll remove the OR tag now. —Cesar Tort 05:58, 20 June 2006 (UTC)

[edit] Anti-psychiatrists who are not anti-organic basis

I haven't been following the development of this article. I just thought I'd throw an idea out there. There are those who are quite anti-psychiatry and yet do not dispute that there's a rough biological basis for phenotypes classified as psychiatric disorders. They may see psychiatric disorders as disabilities or neurodiversity that should not be medicalized. They see the immaturity of children, for example, as being a fact of biology, but the meaning given to said immaturity a fact of culture - i.e. disorder as a cultural construct. See, for example, [3], [4], [5],[6][7][8][9]. (For starters). Neurodivergent 16:04, 15 August 2006 (UTC)

The above references refer to autism: a subject that has been discussed extensively in Talk:Anti-psychiatry/Archive 5. —Cesar Tort 02:45, 20 August 2006 (UTC)

[edit] 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)
I don't know about schizophrenia, but discordance of autism in monozygotic twins seems to be about 8%. It can be up to 40% if you narrow the criteria. There is no evidence of psychogenic factors playing a role - none - even though stress has been proposed. Neurodivergent 16:20, 20 August 2006 (UTC)

According to Peter Breggin’s Toxic Psychiatry, the psychogenic theory of autism was abandoned for political pressure from parents organizations; not for scientific reasons. Clinician Frances Tustin has devoted her life to the theory. She wrote:

“One must note that autism is one of a number of children’s neurological disorders of psychogenic nature, i.e., caused by abusive and traumatic treatment of infants [...]. There is persistent denial by American society of the causes of damage to millions of children who are thus traumatized and brain damaged as a consequence of cruel treatment by parents who are otherwise too busy to love and care for their babies” (International Journal of Psycho-Analysis, Vol 72 (4), 1991, pp. 585-91).

I can understand why parents see this theory as offensive and it’s not my intention to offend anyone. However, for my own experience I know that my mother committed heinous psychological crimes with my sisters; but she has zero insight about her childrearing methods. I’m pretty sure something similar happens in the mind of many other dissociative parents: no insight at all...

By the way, Tustin has written books, and there is a book about her work [10]. —Cesar Tort 17:54, 20 August 2006 (UTC)

It is offensive, but scientifically that's irrelevant. The fact is that no study has attempted to determine if there's any merit to any psychogenic theory of autism. Peter Breggin is not an authority on autism by any means, and I would suggest his knowledge of autism approaches a negligible amount. Brain damage, such as that resulting from abuse, is not known to result in autism. That type of brain damage would be very unlikely to explain some of the cognitive features of autism (which we're starting to learn of recently), neuroanatomical features found, such as neuron density differences and grey and white matter volume differences; head circumference, and so on. Therefore, I'd discount any psychogenic or abuse-related theory without any autism-specific evidence to the contrary. Neurodivergent 20:04, 20 August 2006 (UTC)

There is some evidence. Do you know Daniel Goleman’s Vital Lies, Simple Truths? Goleman is the author of the bestseller about emotional intelligence. I don’t have a copy in English but since Spanish is our native language I can quote from the translation, La Psicología del Autoengaño:

“El nombre de la beba era Jenny [...]. La madre de Jenny era una mujer muy animada y extravertida que, en el primer encuentro, impresionó a Stern como una persona ‘invasiva, controladora y sobreestimuladora’. Cuando Stern inició la observación de Jenny y su madre, ambas habían desarrollado la siguiente rutina: cada vez que las miradas se encontraban, la madre, con excesiva vehemencia, comenzaba a hacerle muecas divertidas a su beba y a hablarle de una manera atropellada. Todo eso era demasiado para Jenny, que optaba por apartar la vista [...]. Stern dice que observar esa invasión pasivamente y sabiendo que no debiera intervenir era ‘casi físicamente doloroso; me generaba sentimientos de impotente indignación; se me cerraba el estómago o me empezaba a doler la cabeza’ [...]. A Stern le resultaba inconcebible que la madre de Jenny no se diera cuenta de lo agresiva que era su actitud [...]. Fue entonces cuando Stern comenzó a alarmarse. Su alarma se debía a que sabía que la evitación del contacto visual y de cualquier tipo de interacción cara a cara, durante la primera infancia, suele ser uno de los síntomas precoces de autismo infantil” (pages 173ff).

—Cesar Tort 20:38, 20 August 2006 (UTC)

Where to start? First of all, one case report is not "evidence" in the sense I'm coveying, any more than a parent reporting that a child has "regressed" after vaccination is evidence that thimerosal causes autism. Second, all this report suggests is that the mother conditioned the daughter to have an aversion to eye contact, which happens to be a symptom of autism. It does not say it turned the daughter autistic. Neurodivergent 21:25, 20 August 2006 (UTC)
That may be "pretty lame", Neurodivergent, as you state in summary edit. But biopsych theories about autism are lame too. —Cesar Tort 21:38, 20 August 2006 (UTC)
I actually agree that all current theories suck badly. But psychogenics is the oldest theory and it hasn't made any headway. Ok, the US is biased against psychogenic explanations. But then why hasn't it made any headway in Europe, France in particular? Neurodivergent 22:19, 20 August 2006 (UTC)

This is a good question but to answer it properly is extremely complex. All has to do with the development of empathy from our simian ancestors throughout prehistory and history. According to some psychohistorians, the Nordic European countries are in a more advanced level of childrearing than Americans. This means that, generally speaking, many Americans are emotionally blinder about the psychological perils in socializing their children than Swedish parents. However, this does not mean that Nordic people are fully empathetic toward their children; only that, for example, they give much less Ritalin to them than Americans do. A truly empathetic person, e.g., Stern in Goleman’s case, can see the colors of emotions that some abusive mothers simply can’t because the way they themselves were treated and emotionally handicapped during their own childhood. Though tentative, Goleman’s case gives the picture of what psychohistorians call different psychoclasses. In a nutshell: to understand autism one must understand psychoclasses first. —Cesar Tort 22:49, 20 August 2006 (UTC)

[edit] 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.


[edit] 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. [11].

  • 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 [12]) 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)

[edit] 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)

[edit] 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 [13]. —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)

[edit] 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)

[edit] 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)

[edit] 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).

[edit] 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? [14]. 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)

[edit] 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.

[edit] 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)

[edit] 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)

[edit] 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 : [15] [16] [17] 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 [18] 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)

[edit] Help requested

Um, about the point of the article. The paragraph that reads:

"Modern biopsychiatric practice strives to create and use explicit diagnostic criteria for mental illness, the DSM. This method of practice is often called neo-Kraepelinian after Emil Kraepelin, and later Eugene Bleuler, who advocated such an approach"

is lovely in its own way... but biopsychiatric researchers (in my experience) seem to think that the DSM is almost completely useless, on the fundamental grounds that the DSM is not biological. The DSM is a behavioral book. The DSM is what you give to clinicians, not researchers, and it's therefore filled with things that amount to "seems sad all the time" instead of "lower than average concentration of dopamine in the intraneural conjunctions of the upper cerebellum under live sedated dissection of mouse model." "Seems sad all the time" is not a biological statement. "Lower than average concentration of dopamine" is a biological statement.

Fundamentally, I don't think we can accurately -- or simultaneously -- say that (a) biopsychiatry is all about neurochemistry and (b) the DSM, which contains almost nothing about anything even remotely physical, is a biopsychiatric book. A plain old psychiatric book, I freely grant you; and it is certainly used by people with biopsychiatric beliefs -- but the DSM, itself, is a behavioral book, not a biological one.

Is someone else willing to clean this up? I haven't got the time.66.124.70.108 00:18, 20 December 2006 (UTC)

Your point is taken. I’ll try to do the changes. —Cesar Tort 00:24, 20 December 2006 (UTC)
Good points here. Clean up looks fine. JohnsonRon 20:03, 5 January 2007 (UTC)
Retrieved from "http://en.wikipedia.org../../../b/i/o/Talk%7EBiopsychiatry_controversy_4b7f.html"