From: mdkline@rodan.acs.syr.edu (Mark D. Kline)
Subject: Re: Peter Breggin, _Toxic Psychiatry_ (Q)
Organization: Syracuse University, Syracuse, NY
Date: Sat, 12 Dec 92 20:51:41 EST

In article <Bz22Mw.B58@unx.sas.com> sasghm@theseus.unx.sas.com (Gary Merrill) writes:
>
>Of the two names mentioned explicitly in this discussion so far, both Breggin
>and Szaz are themselves psychiatrists with respectable academic credentials
>and histories of practice.  I mentioned the PBS series on the mind in an
>earlier posting.  Several other psychiatrists (some working at major universities)
>advanced concerns and criticisms mirroring those of Breggin.  This should be
>enough to dispell the "fringe group" accusation.

On the contrary.  Thomas Szasz, who just retired from the faculty at our
medical school here in Syracuse, is not respected in academic circles. 
There are lots of disreputable psychiatrists, unfortunately.

>What are the issues with which Breggin (and these others) are concerned?
>Well, the major issues are the following:
>
>	1. The "disease model" of what is called "mental illness".
>	   Modern psychiatry rests on this model, and the foundation
>	   is very shaky indeed.

The mistake is to lump everything refered to under the term "mental
illness"  as either "disease" or "not disease".  The disease model
is on very firm ground (genetic, epidemiologic, biochemical, 
etc) for such conditions as bipolar disorder & schizophrenia, much
less firm for conditions such as phobic disorders, or personality
disorders. 


>	2. The methodology employed in tests of "treatments" of the
>	   alleged "diseases".  Breggin's attack on this is quite
>	   specific, with repeated references to the literature.

The literature supporting current medical therapies (both pharmacologic
and psychotherapeutic) is actually some of the most methodologically
sophisticated among any of the specialities of medicine.  Breggin's
readings of the literature are generally not shared by most academic
psychiatrists.  Compare the psychiatric literature to the research
supporting common surgical procedures.  

>	3. Patients' rights -- particularly the right to refuse
>	   "treatment".

Everybody is in favor of patient's rights.   Everybody.  Nobody
argues against patients' rights.  But some people think the
"mental health establishment" is a conspiracy which only wants
to suppress social deviance.   Serious mental illness may render
it impossible for a person to understand their need for treatment,
or to consent to treatment.  

>	4. The fact that so often the "treatment" is more a matter
>	   of *control* than of curing any identifiable "disease".

There are many malignant diseases, like prostate cancer, which can
sometimes not be cured, but which can be kept under long term 
control.  If I had schizophrenia, I'd hope that somebody could help
me keep it under control.   The danger here is conflation of
controlling disease versus controlling people.   


>	   Consider:
>
>|> the reasonable ex-patients are involved in local mental health meetings
>|> trying to improve things.
>
>"Reasonable" by whose standards?  They don't make waves?  They are docile?
>
>Sure, when I give you one of a certain class of drugs your *behavior* changes
>(surprise!), and so I have *treated* your "disease".  And it's even a
>*successful* treatment since you are now acting as *I* think you should.
>And this I point to in support of my claim that you had a disease which
>I have now treated.  And if you don't conform to the social norms I endorse,
>then I will "treat" you some more because you have a "disease".

Most psychiatrists themselves conform less to social norms than other
members of the petite bourgoise.  We are an eccentric lot.  We could 
generally care less about "social norms."  Eccentricity does not equal
disease.   I refer you to the diagnostic criteria in DSM III.

>
>Breggin does not have to go far to find condemnations of psychiatric
>methodology and practice -- and often the condemnations are in the
>very words of the practitioners and theorists themselves.  There are
>ample quotations in his book from publications of the American Psychiatric
>Association and related groups that should appall anyone with an interest
>in and any understanding of scientific methodology.  Concentrate on the
>rapidly changing taxonomy of "disease", the decisions to now include,
>now exclude a particular condition, the criteria for "disease" identification,
>the criteria for "success" of treatment (how often is this the testimony
>of the "diseased" individual who at the time of testimony has been subjected
>to courses of psycho-active drugs and repeated ECT -- frequently against
>his own will or preference?).

Shall we give up on the treatment of mental illness, since new generations
of sophmores keep asserting that it doesn't exist?  


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