I’ve been having a pretty good time on book tour. I’ve been able to share a stage with a couple of friends–Mitch McCabe in DC, and last night in Cambridge, Errol Morris, who, as Mitch filmed, graciously did not upstage me. My mother was there. So were a bunch of friends, old and new. Ben Nugent, the guy who figured out that Allen Frances and I had a bromance going, showed up. So I had fun.
I’m not sure the audience, which was overflow, did. Or at least a segment of the audience. That’s because they are disappointed that I am not an antipsychiatrist. That is to say, they feel that I don’t go far enough in my critique. I don’t say all psychiatrists are avaricious sociopaths, or that all psychiatric drugs are poison for all people, or that psychiatry is a criminal conspiracy to turn us all into Shrink McNuggets. I just think that their diagnostic system stinks, and in this many psychiatrists, including the head of the National Institute of Mental Health, agree with me. I’m not sure what we should do about that, which is the source of another complaint I’ve been hearing–that I don’t offer a solution. I have to say I don’t understand that. HOw did it get to be my job to reimagine psychiatric diagnosis? Why isn’t it enough to show what is wrong with it and how it got to be that way? Do we need happy endings that badly?
Anyway, the fact that I am getting thrashed by the antipsychiatrists will probably not persuade Allen Frances that I am not one of them. I don’t care all that much what Frances thinks of me, but as his bromantic partner I do care about how he feels, and sometimes it would appear that he might regret having gotten in so deep with me. He says not, but I’m not so sure.
I’ll let you be the judge. He sent me his review of my book. He promised not to publicize it, but he didn’t say I couldn’t. So here it is.
Thanks for ‘book of woe’. Here is my review of your ‘unmaking of psychiatry’. This is just between us and donna- I won’t ever do an unmaking of the unmaking of psychiatry
Reportage A+ Thorough, well organized, entertaining, accurate, lively. You missed your calling.
Writing style B+ The book is a good fast read- you are constitutionally incapable of ever writing a dull sentence or an uninteresting paragraph. But you were right to worry that this doesn’t sparkle as much as your usual.
Originality C: I marveled at how much I learned from all your previous books and articles . This one seemed pretty much to skim the surface- it doesn’t take any great genius to trumpet the limitations of psychiatric dx. I know- I have been doing it for 30 yrs. .
Moral compass D: Too many conspiracy theory pot shots and wise guy cracks that disregard the possible harm inflicted on patients- which is mentioned only in 1 quick inconclusively reflective paragraph at the end. Unlike the creator of Liebowitz you go really easy on yourself after bombing Caseno. The human element of patient suffering and need is remarkably missing and you totally lack a plan B. You do scorched earth- I don’t.
I know your narrow focus on unmaking psychiatry is just the scorpion being a scorpion, but this is why Plato decided that comedians and poets were dangerous to the Republic.
I certainly have no regrets re time spent with you- both because on a personal level you are so much fun and because it is possible that your portrait of psychiatry might have been even more fun house distorted without our dialogues.
But I can’t answer positively to the one utilitarian question that matters so much more to me than it does to you- does this book make the world a better place for patients to find peace and hapiness?
Of course, your counter argument could easily be that with APA and NIMH as its friends, psychiatry doesn’t need enemies. You would be right- the self inflicted harm and harm to patients inflicted by APA and by the recent bone-headed NIMH announcement are orders of magnitude worse than you at your worst. Not much consolation though. You call it a noble lie when I defend psychiatry so as to encourage those who very much need it not to lose trust- I call it adult responsibility.
So maybe it’s not a bromance after all. Maybe it’s an Oedipal thing.
I have some doubts you will post this, but I’ll give it a try after reading your Hurt Feelings entry above. I was at your the Wash DC event, and am certainly one of those you accuse of being an “antipsy-chiatrist”, and otherwise reacted to in a remarkably thin-skinned way.
Did you really feel so “thrashed” by being asked a question about major issues you did not cover in what now looks like just an in-house catfight with other psychiatrists rather than any real concern with actual patients, especially those subjected to psychiatry against their will?
I am NOT antipsychiatrist, but am anti-Forced Treatment, which I invited you to comment on, and which you declined to do. Could it really be you don’t understand the difference?
As a matter of fact, I greatly admire some long ago psychiatyrists you may never have heard of, such as Karen Horney, Harry Stack Sullivan, and Abraham Maslow. I can’t imagine them reacting in the defensive manner you did.
Nor am I one who is looking for “happy endings” in your not so subtle slam at the maturity of those who did not come to fawn and flatter.
I’m disappointed that such an obviously bright guy (at least with regard to the DSM) is too thin-skinned to engage in an honest discussion without immediately descending to a slew of ad hominem comments.
Ron Thompson
Of course I’ll post this, Ron. I can see you have a strong opinion, and it’s worth hearing. I can also see that I have disappointed you and I am sorry for that. I don’t remember the encounter, although I do remember the question about forced treatment. It didn’t register with me as very charged, but apparently it was, and I missed that entirely. So that’s my bad.
I also think it’s unfortunate that you’re taking personally what actually happened in Cambridge. I did take a little poetic license in my description. No one thrashed me, but some people registered the same disappointment as you did, that my book is insufficiently patient/activist-oriented. That’s a fair criticism; the book is definitely not that.
But the group obvjecting to that wasn’t the same group that wanted me to provide a solution. That comes from the defenders of the DSM, who seem to be saying that my job is not complete unless I recommend an alternative. This criticism is much harder to think of as fair, and that is why I called it looking for a “happy ending.” It seems to have spilled over to you, so I must have been unclear..
And that’s about all I can take responsibility for here, Ron. I hope that gives you something of what you are after.
Gary,
I appreciate your response. It is certainly useful to take up the task of debunking the DSM. I note how ironic it is this volume is cluelessly referred to as the “bible” of psychiatry, because that is not metaphorically but quite literally true. In other words, the bizarre result of psychiatry successfully elbowing itself into Real Medicine (shame on the AMA for allowing this to happen) is that it has instead morphed into an oftentimes sinister(when not absurd)Secular Religion, and the DSM is indeed the Bible of this religion.
I’m a veteran of numerous battles with organized Psychiatry and its mymridon shock troops in the NAMI organization (you’ve heard of?), both on the ‘medical’ and on the Legal front. I used to campaign for this militant group to rename itself the National Alliance For The FAMILIES Of The UNMANAGEABLE Mentally Ill, which would have reflected its true agenda.
Back in 1993, during the debate over ‘Hillarycare’
I was the only one among my colleagues who argued against insurance “parity” between Physical and Mental care. My colleagues said we should first get the “parity” and then argue against the “parity” that meant, in true Orwellian form, regarding voluntary physical and involuntary mental care as morally indistinguishable.
Well, we got the parity, and have been totally defeated with regard to preventing insurance coverage for unwanted, unsuccessfully refused ‘care’.
I have no quarrel with the usefulness of your work, or your integrity. But I will suggest, and I don’t mean this disrespectfully, you will always be primarily a dilettante if you don’t look at the central reality of the psychiatric profession, which is its possession of the unique tool of Forced Treatment, which, unfortunate- ly, the rest of Society is entirely comfortable with.
Trying not to go on too long here, I can only invite or challenge you to have a conversation with me sometime about this genuinely large issue. The true measure of psychiatric intellectual dysfunction (and I repeat again I’m an admirer of psychiatry in its interpersonal ‘golden age’, the middle third of the 20th century)is that it is screwing up our view of Human Nature with its reductionist drive to explain the Mind exclusively in terms of the Brain, and the accompanying substitution of Drugs (misidentified “medication”) because true (interpersonal)care may too labor intensive and because, as dishonest as the thinking behind the Drug Craze is, they sometimes work(for the same reason that astrology, positive thinking, and the other more recognized religions work, i.e. suggestibility and a motive to Believe).
Waay back in 1991, I hosted, along with a school psychologist who had been fired for refusing to recommend Ritalin for students as demanded by his prinicpal, a Debate at St Elizabeth’s hospital here in DC, permitted and encuraged by its Superintendent Rober Washington. If you would like to see a copy of my participation in the debate (I don’t have it available electronically)give me a snail-mail address and I’ll send it to you. (Don’t know if you read the letter to a Nami official I handed you at P&P)
Sincerely,
Ron Thompson
I should have added that the Debate I mentioned had six participants, three to a side, and the topic was:
PSYCHIATRIC DRUGS: Wonderful Revolution or Ongoing Catastrophe.
rt
Gary Greenberg
Well, I guess, not unexpectedly, it’s the end of any dialogue. But it might have been interesting, if you truly glimpsed the need for full-scale intellectual combat with the whole paradigm of “biological” psychiatry, to compare reactions to the lengthy and preposterous article in the Washington Post today by Monica Hesse on the launch of the DSM-V.
She manages at one and the same time, to both praise and condemn this new “anvil of a book” without any awareness of this dominating contradiction throughout her article.
She mentions you, but only to note the title of your book without further comment. She leaves until late in the article the information that the head of NIMH is “reorienting its research away from its categories”, i.e. rejecting it. Which one might think was news that should have led her story rather than added on toward the end?
She mentions my sometime friend Bob Whitaker, without noting that his book is sternly critical of psychiatry.
In other words she exactly reflects the longtime Culture of the Washington Post whihc has been mindlessly accepting of “biological” psychiatry for decades, as I peresonally know from half a dozen face-to-face interviews with three reporters and an editor over the years which never led to a single critical story or investigative project by the Post.
Put another way, the Post faithfully and mindlssly accepts the general public view that “biologi-cal” psychiatry is a branch of Real Medicine even as she quotes several figures from the heart of the psychiatric establishment who say, THIS IS NOT TRUE.
I guess, understandably, critics have to admit their defeat before cluelessness this profound.
Ron Thompson
ps And of course Ms Hesse makes no mention of Forced treatment, that other pillar of “biological” psychiatry – besides the lack of scientific, laboratory evidence for any of its 157 categories – which should cause its banishment from any association with real medicine.