Sep 10

Psychiatry and Big Pharma: James Davies, Author of “Cracked”

Cracked: Why Psychiatry is Doing More Harm Than Good is by British therapist and researcher James Davies. In it he takes on psychiatry and Big Pharma.

According to the author’s literary agency, Davies set out to answer three puzzlers:

  1. Why has psychiatry become the fastest growing medical specialism in history when it still has the poorest curative success?
  2. Why are psychiatric drugs now more widely prescribed than almost any other medical drugs in history, despite their dubious efficacy?
  3. And why does psychiatry, without solid scientific justification, keep expanding the number of mental disorders it believes to exist–from 106 in 1952, to 374 today?

Cracked‘s publisher states that these questions “can be explained by one startling fact: in recent decades psychiatry has become so motivated by power that it has put the pursuit of pharmaceutical riches above its patients’ well being.”

From the author’s website, some of the ways Big Pharma has affected psychiatric care:

The charge sheet is damning: negative drug trials routinely buried; antidepressants that work no better than placebos; research regularly manipulated to produce positive results; doctors, seduced by huge pharmaceutical rewards, creating more disorders and prescribing more pills; and ethical, scientific and treatment flaws unscrupulously concealed by mass-marketing.

A relevant excerpt from the Publishers Weekly review of Cracked:

On the pharmaceutical front, Davies takes aim at Big Pharma’s tendency to ‘cherry pick’ positive clinical trial data to suit its needs. The results are drugs whose curative efficacy is questionable and which sometimes come with serious side effects (such as the ’emotional blunting’ that occurs in about half of all Prozac users). Further undermining the integrity of the psychiatric profession is the fact that many doctors, having received grants and/or speaking and consulting fees from Big Pharma companies, are essentially prescribing from within the deep pockets of their benefactors. The consequences for patients and the profession are obvious.

Others within the ranks of psychiatry who’ve been protesting the connection between their field and the pharmaceutical industry includes such notables as Irving Kirsch and David Healy. But it’s not only disgruntled psychiatrists who aren’t enthralled with the drug-related hijinks—others are catching on too.

The 2007 book Shyness: How Normal Behavior Became a Sickness, by Christopher Lane, revealed how a pharmaceutical company can use pathologizing towards unscrupulous ends. Lane concludes, “Before you sell a drug, you have to sell the disease. And never was this truer than for social anxiety disorder.” Paxil anyone?

Also on the topic of Paxil, Alison Bass wrote Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial, which Arnold S. Relman, M.D., from Harvard Medical School called “a richly detailed account of the disgraceful self-serving ties between drug companies and the psychiatric profession.”

A 2010 article by Tyler Woods, Ph.D., reports that 68% of members of The American Psychiatric Association’s task force writing the next (2013) edition of the DSM admit to “economic ties with drug companies.” How do you think this might affect their opinions regarding whether something belongs in the DSM as a mental disorder?

As therapists and clients become increasingly aware of the implications of pathologizing as well as the actions of Big Pharma, perhaps we can be more careful ourselves about not “buying into” the costly and misguided labeling of our problems.

Aug 08

Definition of a Psychiatrist (Urban Dictionary)

If psychiatry is the branch of medicine concerned with the diagnosis and treatment of mental disorders” (Free Dictionary), then the definition of a psychiatrist is one who practices in this field. Right?

Kind of surprisingly, given the iffy track record on behalf of social workers, therapists, and psychologists (see previous posts from this week), one top entry in the Urban Dictionary seems to agree:

A psychiatrist is a medical doctor (MD or DO, NOT a phd) who has graduated medical school and undergone at least 4 years of specialized training in mental illness and its treatment – be it pharmacological, therapeutic or otherwise.

A psychiatrist can practice in a hospital with very sick patients, or in an outpatient setting, such as a private practice or clinic.

Psychiatrists out there, I must warn you not to get a swelled head—there are many worse ones yet to come. Close by, in fact, is a definition of a psychiatrist that’s much less flattering: A dandified drug dealer.

An idea commonly held. Take, for example, the long-winded number three:

A modern-day cultured witch doctor who administers drugs and other ‘cures’ for mental conditions which more often than not only alleviate a patient’s symptoms mildly or at the very worst damage and cause irreparable harm to their brains. Most seem to be nihilistic misanthropes who are primarily concerned with their paychecks and the daily quota of Big Pharma untested drugs they can sell to misinformed and desperate people. In privacy, many of them likely sacrifice kidnapped children to evil spirits which ensures the continuation of their rotten and dehumanizing stranglehold on the psyches of those who have often times been subjected to quite enough pain and suffering in their lifetimes. The entire ‘science’ of psychiatry has dark ties to the elitist-backed philosophy of eugenics, which is obsessively focused on ridding the world of those people which are genetically ‘unfit’ by the ruling classes’ own godless standards. All around psychiatry is mostly a gigantic demonic sham and legal drug-pushing designed to rob willing victims of their money and remaining sanity and brain power.

Then there’s four:

A head doctor who gets paid to judge you. They love to make psycho babble comments to get you riled, then defend themselves with more psycho babble to make themselves sound more intelligent than they actually are. They like to affix imaginary disorders to people so they can write prescriptions for unnecessary meds.

And it doesn’t stop there. Number five definition of a psychiatrist:

A modern-day version of a witch-hunter. In medieval times they used to burn recluses or anyone else they considered ‘different’ for being witches, werewolves or vampires. These days we have psychiatrists to put away people who are just trying to get on with their lives. They seem hell-bent on handing out drugs like they’re sweets, probably because they have shares in the drug companies. Psychiatrists also make a fortune by finding excuses for thugs, murderers, rapists and thieves.

If the practitioners of psychiatry aren’t generally well-regarded on the Urban Dictionary, psychiatry as a field fares no better. From that relevant page, here’s a part of one entry:

A profession that is seemingly obsessed with enforcing the status quo. Genuine emotional understanding, empathy, and deep interactions have been replaced by some supposedly ‘objective science’; a mere attempt to ignore the talent that some have with relating to others and medicalize emotions. Whether a person has a ‘disorder’ or ‘disease’ is not determined by whether someone has a visible ailment that has a specific biological cause, but by a system of observed behaviors that can wildly vary from psychiatrist to psychiatrist.

Another excerpt: Psychiatry is pseudoscience (fake) and a waste of money in society. It serves to control people, like religion, feeding them lies and absolute bullshit that they are expected to believe.

And another: A medical specialization satanized by people who have nothing to talk about and/or write self-help books. Usually they need mental counseling themselves, they just don’t have the IQ required to know who a good psychiatrist is.

Amazing how such unintelligent creatures can get through the required medical school. Then again, here’s one contributor’s dim view of said type of educational experience: any prolonged experience that includes alcohol, 8am clinics with rectal exams, lab coats with unexplainable stains, and unsurmountable [sic] debt.

Smarties need not apply.

Mar 13

“Side Effects” SPOILER: Shrink Boundaries and Ethics

Previously I posted a preview of Side Effects, a new film directed by Steven Soderbergh. That, of course, was before I’d seen it; now I want to say more. MAJOR MOVIE SPOILER AHEAD: Read this post only if you’ve already seen Side Effects and/or want to know how psychiatry is portrayed in it.

First, The Not-So-Big Revelations

It’s actually no revelation at all that medication “side effects” that may have led to a murder are a significant factor in this film.

On the other hand, it may be a revelation to some viewers just how enmeshed the relationship between psychiatrists and the pharmaceutical industry can be. It’s a common viewpoint and one that’s succinctly put by psychologist Tyger Latham in his post “In Bed with Big Pharma“: “…(T)he psychiatric field has allowed itself to be co-opted by the industry and failed to fully question the scientific merits of those psychoactive drugs which they prescribe.”

A related issue presented in Side Effects is the ease and quickness with which some shrinks make psychiatric diagnoses. Kelly Patricia O’Meara, author of Psyched Out: How Psychiatry Sells Mental Illness and Pushes Pills that Kill, points out in her movie-related post that “the psychiatrist merely has to briefly listen to the patient’s life complaints and, voila, the psychiatrist is able to determine the exact alleged mental disorder.”

Bigger Revelations

Read film reviewer Rex Reed‘s strongly negative critique of Side Effects and without warning, he spills one of the biggest plot spoilers: “What started as a cautionary thriller about drug abuse…now turns into a battle between two psychiatrists for the soul of their patient—one who keeps her medicated, the other who turns out to be her lesbian lover.”

Well. As we know that Jude Law’s character, Dr. Banks, isn’t the lesbian lover, hmmm…who could it be? The one well-known star that every critic mentions is another psychiatrist but then barely says a word about? The former shrink of Emily, the homicidal patient of Dr. Banks?

Anil Vora at Bi Magazine describes ensuing circumstances thusly:

The ‘surprise’ plot twist in the final act is that Victoria Siebert (Catherine Zeta-Jones) is bisexual. By this point in the film we have also learned that Siebert is self-serving, a corporate sellout, and a hypocrite. But she has also done something completely unethical. To get her to confess to this crime, Emily Taylor (Rooney Mara) seduces her. We learn that Taylor had previously seduced Siebert when she was Siebert’s client in therapy. Siebert had allowed herself to be seduced and had sex with Taylor.

What many viewers may not realize is that it’s the shrink who is always responsible for setting the boundaries. It doesn’t matter who seduces whom. Crossing this line is considered exploitative and highly unethical.

Siebert also plots to commit murder—an infraction so obvious it doesn’t need to be spelled out in ethics manuals. In the mind of internist Dr. Frank Spinelli, as expressed in his post titled “Harmful Side Effects,” another aspect to this situation that sucks is that “(i)n perpetuating the stereotype of the crazed gay killer, Soderbergh marginalizes gay people.”

Fellow member of the psychiatry specialty Helen M. Farrell writes in a Psychology Today post regarding some other ethics violations in Side Effects. For one, shock treatment is used as a threat against the patient, Emily; another is that, in an entirely vengeful act by Dr. Banks, Emily is eventually committed against her will to a mental institution .

Dr. Sasha Bardey, the specialist in forensic psychiatry who served as the movie consultant, has apparently indicated that the film’s plot is largely based on real cases or incidents. Therefore, Psyched Out author O’Meara asks: “…(O)ne has to wonder who is the real-life patient that has been committed to a mental institution because the psychiatrist wanted revenge?” In other words, does this actually happen? Do all the other things? How often?

And how about other actions of Siebert such as blackmailing another psychiatrist (Banks) and committing securities fraud?

In Conclusion

Don’t get me wrong. When I saw Side Effects, I was interested in the plot and didn’t always mind that psychiatry was being lampooned and criticized. I’m also okay with some Hollywood-type stretching of reality, whatever the topic.

But will the movie makers out there ever give shrinks a break? Present a more balanced picture? Can’t they lay off the tired ethics breaches, particularly that of becoming sexually involved with a client—especially when little is done to point out how wrong this is?

In the finale, after all, what are the actions that get Siebert into trouble? The securities fraud and conspiracy to commit murder, not having sex with a client. Because the latter is only an issue when the patient complains—and this never happens in popular movies.