Talk:Psychiatry/Archive 2

The following discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

savodnik's article

Recent LA Times article by a psychiatrist covering several criticisms of modern psychiatry. Francesca Allan of MindFreedomBC 02:30, 3 January 2006 (UTC)

Lab tests in Psychiatry

Francesca, stop deleting the reference to lab tests. They are frequently used in the diagnosis of psychiatric disoders, the most frequent example is TSH levels to ensure that the patient isn't suffering from a disbalance of thyroid hormone which can cause depression or anxiety. As for brain imaging, a CT scan in any first episode psychosis or new onset dementia is routine. djheart 05:16, 3 January 2006 (UTC)

It's the wording, djheart. The way it was worded suggested that mental illness could be diagnosed via lab test and that's patently false. Ruling out thyroid dysfunction is a good idea but that's not diagnosing mental illness. I don't know where in the world you are, djheart, but I can tell you that CT scans are the exception, not the norm, in psychiatric practice around here. Furthermore, when they are used, they can't diagnose mental illness either. Francesca Allan of MindFreedomBC 17:26, 3 January 2006 (UTC)

No, but if the psychosis is the result of cerebral vasculitis you'd rather that this is identified, uh? JFW | T@lk 17:44, 3 January 2006 (UTC)

Of course I would! But the sad reality is that physical diseases are not usually even considered, especially when you've already been slapped with a psychiatric label. Francesca Allan of MindFreedomBC 17:46, 3 January 2006 (UTC)

Pretending that medical procedures like lab tests and scans are actually used in diagnosis and treatment of psych disorders is dishonest. It would be closer to the truth to say that those procedures are used while the patient is still receiving medical care. Once those tests are over (assuming they're negative), then the patient is treated with psychiatry and there scientific medical procedure stops. Francesca Allan of MindFreedomBC 17:51, 3 January 2006 (UTC)

Lab tests and CT scans are used in what is called the differential diagnosis in medicine including psychiatry. Non-psychiatric medical conditions must be differentiated by purely psychiatric causes of the presenting symptoms. For example, you cannot diagnose someone with Major Depressive Disorder without doing a TSH test, which is sometimes forgotten by the family and emergency docs who refer patients to psychiatry (also the test takes 48-72 h to give back results so patients are often under the care of psychiatry before the results are in). As for the CT scans, ironically I live in the same country as you Francesca, and I can tell you that in Ontario CT scans for a first episode psychosis or a new onset dementia are indeed routine and a standard of care. djheart 21:33, 3 January 2006 (UTC)

Just read some of the 'clarifications' that were made to the lab tests section. Lab tests and medical imaging are useful to differentiate psychiatric illnesses from a long list of non-psychiatric conditions inluding: increased and decreased levels of cortisol, primary brain tumours, metastases to the brain from other cancers, epilepsy, drug intoxication, hepatic encephalophathy, stroke, normotensive hydrocephaly etc. etc. djheart 21:42, 3 January 2006 (UTC)

But the point is that these procedures (e.g. lab tests and brain scans) are only used to rule out true medical disorders. They don't "differentiate" psychiatric illness from medical illness. They are NOT used to diagnose/treat mental illness except by saying, for example, well we can't find a physical culprit therefore it must be mental. That should be reflected in the wording of the article. And if CT scans are routinely used in Ontario, then that's great, you're miles ahead of British Columbia. Francesca Allan of MindFreedomBC 23:21, 3 January 2006 (UTC)

In all areas of medicine ruling out is as important as ruling in when trying to diagnosis a patient. For example, if a 50 year old man comes in when a painful, red and swollen leg it is important to rule out a deep vein thrombosis with a doppler ultrasound. If that test is negative and the history is consistent than it will be treated as infectious cellulitis even though there is no lab or imaging test that can directly confirm the diagnosis. Psychiatry may be presently lacking in 'ruling in' diagnostic tests but this does not change the fact that lab tests and imaging are crucial aspects of the diagnosis of psychiatric signs and symptoms and that too should be reflected in the article. The present wording I think is satisfactory in not misleading readers in either direction... djheart 18:14, 4 January 2006 (UTC)

"Controversial"

Cronian (talk · contribs) has littered the "pratice of psychiatry" section with several uses of the word "controversial". It is rather easy to label things such, but evidence is lacking. Also, this controversy is really just confined to the political opponents of psychiatry, and should be dealt with in the relevant section and not in the section that explains the practice of psychiatry as perceived by the field itself. I've allowed the exception of ECT, although I still think it is not correct to label it "controversial" just because Breggin and his lot make such a fuss. JFW | T@lk 17:41, 3 January 2006 (UTC)

You'd have to have your eyes closed to believe that evidence is lacking for the controversy over psychiatry. You've "allowed" an exception. How gracious of you. Francesca Allan of MindFreedomBC 18:13, 3 January 2006 (UTC)

I can't type with my eyes closed. But the article already has a "controversy" section, and Cronian was WP:POINT in the wrong section. By the way, there is no branch of medicine without scientific controversy. Thank God, that keeps it interesting. But outside attacks are not just controversy, especially when politically motivated. JFW | T@lk 20:00, 3 January 2006 (UTC)

Perhaps you could explain how my skepticism about psychiatry (which is based on years of psychiatric assault) could be considered an "outside attack." Even better, please enlighten me as to what my political motivations are. I agree with you that all of medicine encounters controversy. However, psychiatry is in a class by itself when it comes to disregarding patients' views, blundering along without recourse to science and throwing civil liberties out the window. Francesca Allan of MindFreedomBC 20:16, 3 January 2006 (UTC)

If you had just wanted to rearrange Cronian's contribution, fine, but that's never good enough. You take every opportunity to belittle people's very valid criticism of psychiatry. Psychiatry is a joke, more religion than medicine. If mental illnesses were actual illnesses, they'd be treated by actual doctors such as neurologists. I wonder if you will ever acknowledge all the lives destroyed. There's something horribly sadistic about psychiatry. I wonder if people become psychiatrists because of some deep-rooted insecurity that makes having authority over the defenceless seem attractive. Francesca Allan of MindFreedomBC 20:24, 3 January 2006 (UTC)

Your personal views are making reasonable debate impossible. I really suggest you stop projecting your misgivings about your own treatment on a whole professional field ("psychiatry is a joke") and on myself ("you take every opportunity to belittle people's very valid criticism of psychiatry"). I am not a psychiatrist, nor am I married to one, and you should start assuming good faith instead. There are numerous ways of providing NPOV without disrupting the flow of articles, the editing process and associated talk pages. It just requires patience, staying cool, discussions about fact rather than opinion, and a degree of distance from your own emotions about the whole thing. Constant annoyance and frustration cause Wiki-burnout, and after almost 2 years I can tell a case when I see one. JFW | T@lk 11:02, 4 January 2006 (UTC)

You make several good points here. I would just like to say that it's not just my own mistreatment that I am objecting to. I really do think psychiatry causes more harm than good and that the field should be dismantled. If I have disrupted the "flow" of articles, I believe that's probably a good thing because the overwhelming majority here seem wilfully blind to the harm that psychiatry causes. Wiki-burnout is a good description. I'm done here. Francesca Allan of MindFreedomBC 17:08, 4 January 2006 (UTC)

OK. I'm not actually accusing you of disrupting the flow of articles here. All I'm saying is that your attitude towards other editors is not very civil if you accuse them of "wilful blindness" to the harm caused by psychiatry. Perhaps the motive of these editors is to ensure NPOV, despite your perception. You are also unlikely to be listened to if you blanketly refer to a field of medical science by the terms you have been calling it. Such sweeping statements generally preclude an open discussion. JFW | T@lk 19:14, 4 January 2006 (UTC)

more bullshit from the psychiatric front

Now we're going to pathologize prejudice: http://www.washingtonpost.com/wp-dyn/content/article/2005/12/09/AR2005120901938.html Francesca Allan of MindFreedomBC 20:35, 3 January 2006 (UTC)

Ms. Allan, I've refrained from including myself in this discussion until now. Allow me to preface my future statements by saying I'm truly sorry that you have experienced what you call "psychiatric assault"; the fragility of the mind is one of the most frightening things and anyone who would prey upon one so maligned is truly a disturbed person. However to retaliate by denouncing what is--in earnest--a scientific endeavor to understand the workings of the mind (with the goal of helping those in need) is injurious to all parties involved. I work with psychiatrists, neurologists, and neuroscientists every single day. Every one of the people with whom I collaborate is truly a good person. You may disagree with the practice of psychiatry, scientific advances may show its tenants to be false, but that is only for time to tell and is not a battle that will be won in the discussion sections of an online encyclopedic article. The history of psychiatry is assuredly filled with many horrors--as well your past may too--but your anger and vengeance here is not helping anyone.

This article doesn't indicate that psychiatry is trying to make prejudice a pathology; rather it indicates that people are now researching whether extreme prejudice is the result of a neurological process. This seems completely rational and valid. Please try to remain civil here: everyone is willing to listen to your comments, but they are more prone to give them regard if you present them without anger or frustration. Semiconscious (talk · home) 21:54, 3 January 2006 (UTC)

I think you have completely misunderstood me. Nobody was "preying" upon a "fragile mind." I'm referring to general psychiatric treatment. I'm talking about solitary confinement, being thrown onto the floor, tortured with neuroleptic drugs, being lied to and threatened by doctors. But all that is just business as usual for psychiatrists. There is nothing scientific about psychiatry. It's just a bunch of subjective judgments applied against people who don't conform. As far as the article goes, trying to make every human oddity a psychiatric disorder is neither rational nor valid. It's just another excuse to teach people that they have no control, no personal responsibility whatsoever. I'm sorry but I'm done being civil with people who perpetuate hatred and prejudice. I am not going to sit idly by and let people write asinine comments about the glories of psychiatry without responding with the truth. The horror of psychiatry is not in its history -- it's now -- creating an epidemic of psychiatric labelling and medicating an ever-increasing segment of the population. Francesca Allan of MindFreedomBC 22:49, 3 January 2006 (UTC)

Ms. Allan: I don't misunderstand you in terms of this conversation at all. Phrases such as "But all that is just business as usual for psychiatrists" are so broad as to make your point invalid. Such actions (forced treatment, lying, threats) are not business as usual for any psychiatrist, but rather your perception and perhaps unfortunate experience. As I have said, I have worked with dozens of psychiatrists, neurologists, psychologists, and neuroscientists in research and clinical settings, in hospitals and in psychiatric care institutions. Over the years I have befriended (yes, befriended, not treated, as I am neither a doctor nor therapist) many patients who have opened up a great deal to me. Never once have I heard anyone--patient, therapist, clinician, or even colleague--mention any mistreatment. I have friends who have been on drug treatments and been placed into psychiatric institutions, and all of them were able to stop treatment, leave the hospital, and end therapy of their own volition without any repercussion.

There is no harm done in investigating potential underlying neurobiological causes for debilitating conditions. In the article you linked, the man mentioned in the beginning seems to have been unhappy with his situation. Was it biological? I cannot yet say. Is there harm in researching this to find out? No. However none of these points and none of your points are indicative of issues with psychiatry, but rather belie the underlying motives that individual people have. Do I agree with the use of medications for all "disorders"? No I do not. Does this bode ill for all of psychiatry? No it does not. Is this problem going to be solved here and now, on wikipedia? Probably not. Does it have relevance to this article? Yes, and it is already addressed in the primary article in the large section titled Opposition to and criticism of psychiatry.

It is clear that what I say here will not have an effect on your actions. I withheld from this conversation until today, and I have now said what I have intended to say. Nothing more will be said on this matter by me, as we clearly disagree. It is my impression that you are editing articles with a heavy bias, blaming an entire scientific ( see list of peer-reviewed psychiatry journals) field for terrible, but isolated occurrences. I'm not sure what your goal is here on wikipedia, but I do not think you will achieve it until you begin approaching it with a less accusatory, heavy-handed approach. Semiconscious (talk · home) 23:21, 3 January 2006 (UTC)

I am basing my comments on various abuses I have suffered in various psychiatric hospitals throughout British Columbia. Unfortunately, solitary confinement, forced drugging and threats are indeed the norm. These are not isolated occurrences. Many psychiatric survivors have similar histories to relate. My goal with wikipedia is to try to counteract the immense pro-psychiatry POV evident in all psychiatry-related articles. Psychiatry is not a "scientific" field. I have no idea why psychiatrists keep insisting that it is. If these were neurological disorders, as psychiatry claims, then they'd be treated by neurologists. It's very telling that neurologists decline to do so.

So, in accordance with your comments above, I guess it was just my "perception" that I was locked up and drugged almost into oblivion. Look, the only reason we have mental health legislation is to inflict treatment on the unwilling. Are you seriously suggesting that psychiatrists don't use the involuntary treatment provisions? Because everybody you happen to know was free to walk away doesn't mean that we all were. Please try to understand that your experiences may not reflect the experiences of everybody else. The fact that the system is set up to allow the kind of abuse that I suffered is wrong, terribly wrong.

"Does this bode ill for all of psychiatry? No it does not." Yes, it certainly does. Attempting to dress up prejudice as a neurobiological disorder is a disaster. So is turning shyness into "social anxiety disorder." And bored, unengaged children into having "attention deficit hyperactivity disorder." The whole endeavour is extremely suspect. In the long run, the only parties who will gain by this will be drug companies. The rest of us will be a nation of compliant, bovine drug-takers. Francesca Allan of MindFreedomBC 23:42, 3 January 2006 (UTC)

But this is your criticism, which is unnotable on Wikipedia unless it can be traced to either influential spokespeople, well-known advocacy groups or other reliable sources. So far you've not cited a single useful source that could be used to equalise the article's presumed POV. Instead you literally rave and rant about the presumed failures of psychiatry. If you are associated with MindFreedom, you can ask its press officer/PR advisor to give you a list of useful sources to conduct a real NPOV discussion. JFW | T@lk 11:06, 4 January 2006 (UTC)

Hi, Jfdwolff. You'll note my ranting and raving is all contained on the discussion pages of psychiatry-related articles. As far as I know, there is no NPOV rule for discussion pages. Contrary to what you state here, throughout most of the related articles, I have contributed, balanced and posted various links to reliable sources. Francesca Allan of MindFreedomBC 17:02, 4 January 2006 (UTC)

But discussions on talk pages are for actual article content. The link you posted above has no direct bearing on what will be in this article; you just posted it to vent your frustration. That is WP:POINT, sorry. JFW | T@lk 19:10, 4 January 2006 (UTC)

drug marketing abuses

While IMO psychiatry does (usually) have its merit, requiring separate citations for the fact that doctors often prescribe advertised drugs instead of cheap/better/none ones would suggest that psychiatry is different from any other branch of medicine. This would pretty much be a lunacy.

I haven't ever taken a psychiatric drug, however:

• it is hard to go to a doctor and see him use a pen without a drug company's logo or see him wear an uniform without badges bearing such logos.
• the company I'm working at provides some management software for doctors. We have systems for dentists, regular doctors and even a dedicated system for a Regional Center of Penal Psychiatry. While our psychiatric system deals with patients' deposits and not gifts from drug companies, we have enough contacts to see this practice in action.
• I have also personally talked with a person who does such marketing (a distant family member).

For non-hearsay evidence, you may also check for example the loratadine vs desloratadine controversy.

Thus, while no one provided direct evidence for this abuse specifically in psychiatry, this practice is far too ubiquitous in all drug-using types of medicine to be put in any doubt.

On the other hand, you may want to strike down this section and replace it with a link to an article about drug marketing abuses in general, as an article about psychiatry is no place to deal in detail about issues not specific to psychiatry.

Claimed bias removal

The following paragraph:

"Another concern regarding the practice of psychiatry centers on the issue of involuntary treatment. Such concerns center on issues of civil liberties and personal freedoms. In the US there are many restrictions in place to attempt to maximize the desires of the patient with the need for treatment. Most states allow involuntary treatment only in the most severe cases where a person poses an immediate threat to themselves or others or if they are unable to provide for themselves basic needs such as food, clothing, or shelter (see Laura's Law). Furthermore, children are allowed to be placed into an institution at the will of their parents or legal guardians. [1]"

was removed by User:FETuriousness with the comment Got rid of obvious bias. I wrote this paragraph in response to previous claims of bias (by both sides). While the language may not be perfect, the facts are all correct. If FETuriousness would care to elaborate here before making sweeping changes, or if they would care to fix what they percieve as bias, that would be a more appropriate course of action. Semiconscious • talk 07:46, 7 February 2006 (UTC)

The above discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the appropriate discussion page, such as the current discussion page. No further edits should be made to this discussion.