Wednesday, March 10, 2010

The Madness of Psychiatry

Psychiatric problems exist. I'm not denying that. I have had several brain-physiology-based psychiatric cases as clients over the years. The two profoundly schizophrenic cases stand out in my mind.

In one case, the client used to march around his parents' back yard at night, waving a butcher knife in the air at God, screaming at God that God should not be asking him to stab his family! The newest medication worked wonders on him: He became so normal that today he can laugh at some of the goofy things he would say and do.

In another case, a minister friend's sister was the schizophrenic. She loved it when I paid a visit to their household to talk about her case. No medication worked for her at all. She was "as crazy as a bug in the rug." I used to tease her about God talking to her. She loved, and was greatly amused by, my teasing. What amused her so much was that I believed that her voices were fake. Profound belief in the reality of the voices is one of the hallmarks of schizophrenia. I have read that some suspect that the reason why schizophrenics can't be shook from their belief in the reality of the voices is that the real disease of schizophrenia is runaway feelings of fear arising from bad brain chemistry or wiring, and that the schizophrenics, being otherwise rational, cause the voices in their heads by a mighty internal effort, to rationalize the crazy levels of otherwise groundless fear filling their heads.

A wonderful, wonderful Vietnamese girl I used to babysit, little Nhu, heard me mention once to her mom, who wished to major in child psychology, that there was a fascinating group of portraits of cats by artist Louis Wain which, when arranged in the order of their production, reflected the artist's journey into insanity. The little girl pushed me for years to find the series. Here it is...

Though psychiatric problems are real, one has to be very, very, very, very cautious about our psychiatric diagnostic and treatment system. I can't say "very" enough times. Our father used to tell us, when we were kids, "Beware of friends who say, 'I want to be a psychiatrist when I grow up.' In almost every case, they want to do that because they have psychological problems needing to be solved."

Our father's prejudice was too broad a brush. Nonetheless, they reflect the profound skepticism one must have toward the psychiatric diagnosis and treatment system. It is so dangerous and twisted.

The 2008 movie The Changeling, based on a true story, was about a woman in 1928 whose child disappears, who is later replaced by an impostor by police. The impostor is too short, and circumcised. When the mother contests the child's identity, she is committed to an insane asylum by police as "delusional." The insane asylum refuses to let her out unless she admits that she is crazy!

Well, the system really is like that, to this day. In 1973, in the famous Rosenhan Experiment, a psychologist tested the competence of the system. He dispatched people with zero psychological deficit and no psychiatric treatment history at all to 12 different psychiatric hospitals, where each complained of having heard voices once, but otherwise acted perfectly normal and happy.

In all 12 instances the people were diagnosed as psychotic. All were described as suffering from ongoing symptoms of psychological illness. All were prescribed psychotropic drugs. None were allowed to be released unless they admitted that they were mentally ill and agreed to continue taking antipsychotic medication. Some took months to get out -- even after Rosenhan visited the institutions and verified the existence of his study!

Interestingly, in several of the cases the genuinely crazy patients committed with Rosenhan's fakes could tell that the fakes weren't really crazy.

The psychiatrists could not, in any case.

Rosenhan did a flip-side experiment. He told a well-known teaching hospital that he had sent several fakes into the wards, and challenged them to distill the fakes from the mentally ill patients.

In reality, there were none.

The hospital selected 41 out of 193 as eligible for the diagnosis of "normal."

I think that psychiaty is extremely prone to error, for a variety of reasons. (1) The psychiatrist's personal pride (-- "How dare you imply that you are competent enough to think that my diagnosis might be mistasken!!!") (2) Money. I have seen my share of reports finding psych patients eligible for release just as the coverage ran out! (3) The innate "softness" of the evidence of psychic dysfunction.

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