Critical Psychiatry

OCTOBER 8, 2024

Terry Lynch , who wrote a chapter for my Critical Psychiatry edited book, has posted a video asking why doctors pay so little attention to trauma in the lives of people with psychiatric diagnosis. As Terry says, Robert Spitzer, Chair of the DSM-III taskforce (see eg. previous post ), when asked in an interview whether psychiatric diagnosis shouldn't always take into account a person's life circumstances replied "If we did that then the whole system falls apart".

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Critical Psychiatry

OCTOBER 8, 2024

Ive changed the name of this blog before (see eg. previous post ). Im not convinced its really made much impact in terms of attracting more readers (see eg. another previous post ). Im making another attempt to see if expressing what this blog is about in more everyday langauage, avoiding the use of the term psychiatry, makes a difference. As mentioned in another previous post , mental health has come to mean the conditions and practices that maintain mental health.

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Critical Psychiatry

OCTOBER 16, 2024

Zhang et al ( 2024 ) have published a systematic review and meta-analysis of the incidence of antidepressant withdrawal symptoms. More than 40% experienced such effects. This figure is higher than the 15% estimate from another recent systematic review (see previous post ). As I pointed out in that previous post, so-called withdrawal symptoms also occur in the continuation arm of randomised controlled trials (RCTs), when such withdrawal symptoms wouldn't necessarily be expected in this group as p

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Critical Psychiatry

OCTOBER 22, 2024

As Ive said before, psychiatry tends to treat people as machines (see eg. previous post ). Newtonian physics sees existence in terms of cause and effect rather than meaning. Modern science is based on experiment and has a comprehensive, mechanical, rational approach to nature. External observation is seen as the basis of worthwhile, definite knowledge.

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Critical Psychiatry

OCTOBER 25, 2024

Scientific knowledge is seen as the most respectable form of knowledge (see eg. last post ). It is based on the scientific method of reasoning about observations to develop hypotheses which can be tested. Biomedical psychiatry claims primary mental illness is brain disease, or at least that brain abnormalities are a factor in its cause. Mental illness of course shows through the brain.

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Critical Psychiatry

OCTOBER 27, 2024

Ive said several times (see eg. previous post ) that biomedical psychiatry wishfully thinks that primary mental illness will be shown to be caused by brain abnormality in some way. It even commonly acts as though that has already been proven. People are encouraged to think that there is something wrong with the brains of people who are mentally ill.

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Critical Psychiatry

NOVEMBER 4, 2024

I've said before it's been difficult to get the message of critical/relational psychiatry accepted (see eg. previous post ). People are being encouraged to see themselves as their brains. It's almost become heretical to suggest otherwise. Of course the belief that what we think, feel and do are caused by our brains is plausible. This assumption must not be questioned, though.

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Critical Psychiatry

NOVEMBER 9, 2024

I was hoping the new government would revisit the Parliamentary Scrutiny Committees report on the last governments draft Mental Health Bill. This would have also given an opportunity to produce a new Bill taking into account the recent WHO/OHCHR guidance to countries on mental health legislation (see previous post ). Instead the new government has produced a Bill not that dissimilar to the draft Mental Health Bill of the last government (see eg. blog post from DHSC Media Centre and version of am

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Critical Psychiatry

NOVEMBER 13, 2024

I responded (follow my Twitter thread ) to a tweet by Justin Garson (mentioned in previous post ). What he said was:- I cant fathom how a psychiatric diagnosis would ever be useful to anyone except as a tool to get accommodations or drugs. As far as understanding myself who I am, why I act and think as I do it contributes nothing. I do understand what he means (see eg. previous post ).

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Critical Psychiatry

NOVEMBER 23, 2024

Linda Gask, who I have mentioned before (see eg. previous post ), has reviewed Conversations in critical psychiatry (2024) edited by Awais Aftab (see her review and eg. my comment about the book in a previous post ). As she says, reading the book reminds her of when she first tried to make sense of psychiatry in her training. Such an experience of trying to make sense of psychiatry in the wake of the so-called anti-psychiatry of the time was common for our generation of psychiatrists (see eg. my

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Critical Psychiatry

DECEMBER 13, 2024

Owen Jones is a succesful Guardian journalist. He was central to the Jeremy Corbyn movement. He feels as though he has been held back by his ADHD, and obtained this diagnosis over a year ago (see his YouTube video ). The charity ADHD UK was founded in 2020. It aims to help people like Owen Jones navigate their life with ADHD, and wants to reduce the stigma that some people attach to those with ADHD, build awareness, and undertake or fund research that will have a meaningful positive impact on th

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Critical Psychiatry

DECEMBER 18, 2024

I talked about Jan Foudraine in the first chapter of my edited Critical Psychiatry book. As I said, he became the personal ambassador' in Holland of Bhagwan Shree Rajneesh or Osho, as he later came to be called. Osho was an Indian spiritual leader who preached an eclectic doctrine of Eastern mysticism, individual devotion, and sexual freedom while amassing vast personal wealth (see Foudraines obituary on the Osho website).

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Critical Psychiatry

JANUARY 12, 2025

The Sunday Times magazine has an article about Joanna Moncrieff promoting the publication this week of her new book , Chemically imbalanced: The making and unmaking of the serotonin myth. This follows the 2022 umbrella review, of which she was the first author, which concluded that there is no consistent evidence of an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations (see previous post ).

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Critical Psychiatry

JANUARY 13, 2025

I mentioned the Sunday Times magazine article about Joanna Moncrieff in my last post , where I focused on the issue of whether antidepressants work. I also wanted to pick up what the article says in its introductory rubric about Jo daring to argue that depression is not a physical disease. At face value, saying that depression is not a physical disease may not appear to be so much of a challenge to psychiatry.

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Critical Psychiatry

JANUARY 14, 2025

Awais Aftab has responded (see his blog post ) to the Sunday Times magazine article about Joanna Moncrieff (see eg. previous post ). He raises various useful questions about Jo's position but tends to be very critical of her perspective. It's possible some of the questions he raises may be answered in Jo's new book, due to be published this week. Nonetheless, Awais accepts that the "chemical imbalance story as it existed in the public imagination has little scientific legitimacy".

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Critical Psychiatry

JANUARY 18, 2025

Jo Moncrieff in her new book Chemically imbalanced (see eg. previous post ) discusses Peter Kramers 1993 book Listening to Prozac (see Wikipedia entry ), which I mentioned in a previous post. As the New York Times said at the time (see article ) Kramers best seller described how Prozac transformed his patients, making them calm, confident, cheerful and somehow better than well.

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Critical Psychiatry

JANUARY 21, 2025

Ive mentioned before my concerns about the notion that antidepressants work through being emotional suppressants (see eg. previous post ). In fact, Im more inclined to think antidepressants dont work any better than placebo (see eg. last post ), so theres no need to explain how antidepressants work, as such. Although the emotional numbness theory has been promoted by Joanna Moncrieff, in her recent book she does qualify this hypothesis by saying she thinks we should be cautious about assuming em

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Critical Psychiatry

JANUARY 21, 2025

Im not sure who advised the king about the appointment of Ed Bullmore as Regius Professor of Psychiatry at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at Kings College London (see announcement ). I wrote a satirical, even rude, review of Bullmores book The inflamed mind a few years ago (see previous post ). As Ive always said, psychiatry has been too dominated by biomedical psychiatrists, like Bullmore (see eg. previous post ).

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Critical Psychiatry

JANUARY 23, 2025

As Ive said before (see eg. previous post ), Im inclined to believe that antidepressants are no better than placebo. I cant prove this but it is possible that the statistical difference between antidepressant and placebo in short-term clinical trials is an artefact because of methodological problems, such as unblinding (see eg. another previous post ).

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Critical Psychiatry

JANUARY 30, 2025

Functional mental illness is an abstract not concrete concept. It differs from organic mental illness where there is brain dysfunction. Illnesses tend to be seen as things which people have (see eg. previous post ). Since the nineteenth century with the elucidation of pathological mechanisms, our positive understanding has become that the thing that people have is a diseased organ or bodily system.

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Critical Psychiatry

FEBRUARY 4, 2025

People are being misled about the nature of mental illness. Of course brain abnormalities can cause organic mental illness, such as delirium or dementia. But most presentations of mental health problems are not caused by brain abnormalities. Using depression as an example, people have been encouraged to see depression as a chemical imbalance in the brain.

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Critical Psychiatry

FEBRUARY 12, 2025

I worry that the clash between Joanna Moncrieff and Awais Aftab about her new book Chemically imbalanced has become too personal (see eg. last post ). For example, Awais recent blog post criticises Jo for her methods rather than necessarily actually what she says. In many ways, how Jo expresses her critique is irrelevant. What matters is the content of what she says.

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Critical Psychiatry

FEBRUARY 22, 2025

Doctors have always exaggerated the advantages of medication. But medication, including recreational drugs, cant just be eliminated. There are plenty of people that say that psychiatric medication has helped, despite its disadvantages (see eg. previous post ). This experience cannot be denied, even if it is due to the placebo effect. Mainstream psychiatry will never accept that psychiatric medication is not effective.

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Critical Psychiatry

MARCH 1, 2025

Psychological problems are common. People don't always adjust to difficulties in life and relationships very well. They don't always meet their own or others' expectations of how they should function socially. Solutions on offer to psychological problems from mental health services, such as psychotropic medication and talking therapy, may, therefore, seem attractive.

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