Guest post: It’s worth running a simple filter

Originally a comment by Morgan on Psychiatry is an important skeptical and social justice issue.

Making demands about alternatives before you’ll bother to learn the truth about it seems callous, in addition to incurious.

Look, here’s the thing: you sound like a crank.

That doesn’t mean you’re wrong, but from what you’re saying, it’s more likely that you’re a crank than not. So before giving what you have to say much time or attention, it’s worth running a simple filter of asking what your views are, in case they’re “people need to regulate their orgone energy via crystals” or something else that would clearly indicate you’re not worth the effort. What you’re saying may seem obviously reasonable to you, but to me as an outside observer it’s not obviously different from any wooish alt-med claim about how, for example, AIDS isn’t caused by a virus but by poor nutrition / immorality / sinister Western drugs. It doesn’t help that the way you talk about “biopsychiatry” comes off to me as suspiciously dualist, like the idea that mental phenomena are based in the biological action of the brain and that treating or managing them may require medical interventions is just obviously false for some reason.

Your response does shift the odds away from crank, but it’s still vague enough not to be particularly compelling. Okay, so if I’m understanding you correctly, your contention is that much of psychiatry, in particular the diagnoses in the DSM and the pharmaceutical treatments for them, are so poorly evidenced as to be worthless – what’s labeled “schizophrenia” or “depression” is so poorly defined, ad-hoc, and lacking in scientific grounding that it doesn’t make sense to talk about “a mental illness” called schizophrenia. The obvious problem there, then, is that people do have issues that lead them to be diagnosed, and they do take medicines prescribed for their diagnosis, and at least some of those people do improve when they’re medicated (and notice a definite pattern of worsening if they stop). So maybe all such problems are the result of traumatic or stressful experiences or conditions, and there should be more focus on heading off mental health problems by reducing poverty and improving parenting and so on – sure, that’s not in principle a bad idea. But once someone ends up with an issue, are you saying the fix is to solve all the problems in their life that might have led to it? That’s not really useful to many, probably most, people actually trying to live their lives unable to remedy structural oppression. Are they to seek intervention, but definitely not drugs? So what about when they’ve tried everything they could, and it’s the drugs that seemed to actually made a difference? Is that always just the placebo effect? Or is the solution that

…some problems that have been falsely labeled as disorders in order to sell drugs are really the pains of human living, part of the human condition in an imperfect world, and will pass.

? That’s kind of a convenient out – if the approach you advocate doesn’t work, just wait for the problem to go away by itself. The problems that are leaving you unable to function are just the pains of human living, tough shit, suck it up. You say you don’t want to stigmatize or minimize, but surely you can see where what you’re saying has that effect regardless of your desires?

In the other thread you ask:

If you think I’m being a bad advocate, what do you suggest?

My suggestion: have a clear summary that you can link or paste of what you are saying, and what you’re not. Be aware that “psychiatry is totally wrong and you don’t need your pills” is a claim made by a lot of people for bad reasons, and you’re going to have to work to distinguish yourself from those people – you may feel you’re doing so by recommending books or linking articles, but that doesn’t actually set you apart. Saying “we should be skeptical about this” is not as small and unobjectionable a statement as you seem to think when in effect it’s “we should disregard an entire branch of medicine as pseudoscience and any ways in which people find it’s helped them as accidental”. If you think the problem is pharmaceutical treatment of mental health problems but still think people will need professional, evidence-based, medical assistance to deal with them, then maybe focus your criticism a bit more, since as far as I can see that would still require psychiatry to gather and understand that evidence and provide that assistance.