Talk:Biological psychiatry

blatantly POV

Someone added a paragraph to the article that's blatantly POV. I'm reverting the article back to its last form until I can organize a response. I apologize for the lack of citations in what follows, but I'm throwing this out in a hurry. Once I have those I'll get to work on the cleaning up the article itself. Whoever added it (anonymously, at that [and yes, I'm anonymous too, but I will remedy that ASAP and come back here to reveal myself]) seems to be of the opinion that any criticism of biological psychiatry constitutes an attack against the scientific method and the concept of science in general. There's a difference between a critique of the assumptions behind the biologically deterministic school of psychiatry that's been in vogue for a while and that of the more radical anti-psychiatrists who use "biological psychiatry" as an all-purpose epithet MyNameisfor those that don't agree with them that psychic anguish is only the result of the conflict between the free-spirited individual and a repressive society. If only the layers of societal repression could be removed, and people could learn to expand their idea of "normal behavior" then mental illness would cease to exist. In a sense, this use of "biological psychiatry" is the diametric opposite of the beliefs of the ones who posit its existence in the first place. The anti-psychiatrists (in this author's opinion, amongst others) romanticize the plight of people who are seriously suffering as a means of speaking truth to power.

There's another, less radical definition of "biological psychiatry". That there's a journal out there that goes by that moniker indicates (to me, at least) that the term is more than just the creation of anti-psychiatry activists. I've personally known people who consider themselves "biological psychiatrists". I would define "biological psychiatry" in this sense as the theory that depression/schizophrenia/anxiety/etc (what are commonly known as "mental illnesses") that are illnesses and as such are the result of pathological differences in the way their brains work compared to other people, in a manner analogous to other, physical diseases. To this critic at least (one heavily influenced by Stanton Peele, among others), conceptualizing differences in mood and/or perception as purely the result of a disease process denies the role of individual agency and experience in determining how they feel. In particular, the idea that "mental illnesses" are inexorably lifelong, chronic, and relapsing, isn't necessarily borne out by the data (cites to follow), and that conceiving them as such can make it harder for people to get better by encouraging them to view their thoughts and emotions as ipso facto evidence of pathology. You can be anti-"biological psychiatry" without denying a role for biology in psychiatry.

That there are differences in brain activity between "normal" and "mentally ill" individuals does not necessarily imply that the "mentally ill" brain state is pathological. To the extent that the brain is the seat of the mind it follows that there is a physiological correlate to every mental state, associated with different levels of neurotransmitters or receptors, gene expression, etc. It's easy to simply pick two groups of people labled "normal" and "mentally ill" and then proceed to pick them apart in search of differences between the two groups. You'd find plenty. A lot of them might even show strong correlations. But, as they say, correlation does not equal causation. There is dramatic overlap between "normal" brain activity and "mentally ill" brain activity, enough so that it's impossible to look at HVAA or DMT levels in spinal fluid or urine, or glucose or oxygen utilization and make a diagnosis with any reliability. False-color MRIs or other imaging techniques can be manipulated to make minor, possibly inconsequential differences in brain activity seem more dramatic than they are.

Contrast this to diabetes or hypothyroidism. In the former case, insufficient insulin production or a reduced cellular response to insulin is diagnostic. In the latter, low circulating thyroid hormone levels and abnormally high TSH levels are. There are some borderline cases, but if you've got a TSH of 10, something's wrong with your thyroid, or else your pituitary gland. In the case of Parkinson's Disease or Alzheimer's Disease (both of which the author compares to mental illnesses), specific, identifiable neurodegenerative changes are clearly present. The specific causes might not be known at this time, but when you cut open the brain of someone with Alzheimer's disease, it becomes very clear very quick that they have it. It's the same with Parkinson's. In the case of bipolar disorder and schizophrenia, no such clear healthy/ill dichotomy can be found. Every so often it seems that someone comes along with a discovery that a gene (or genes) is the cause of alcoholism or drug abuse or bipolar disorder or schizophrenia or depression or... the list is endless. The "discovery" inevitably garners great media attention as an example of the way that modern medicine is conquering all ills, but the retraction a few weeks, months, or years later showing that the correlation isn't the slam-dunk it originally seemed to be usually doesn't. Despite that, these "great discoveries" keep getting trotted out in textbooks and further media reports as examples of the "overwhelming evidence" that mental illness is the result of a dysfunctional brain, with a little lip service paid to the role of the environment.

I'm stopping here before I get too carried away on that. Here are some ideas for expanding the article:

-A better definition of biolgical psychiatry. If there's a journal that goes by the name, there's people actually devoting themselves to its study.

-More examples of the evidence for biological psychiatry, as defined above, without being presented as simply "overwhelming". The biopsychiatric interpretation of the evidence is the most popular right now, but the data lend themselves to other reasonable (and scientific, unlike the relationship between evolution and "intelligent design", say) interpretations.

eg: The higher depressive relapse rates for people who have been on antidepressants and go off of them versus people who stay on them has been commonly accepted as evidence that the drugs work, but as a result of the way antidepressant studies are structured (more on that later) the difference could be interpreted as the result of some kind of biological change making people more liable to depression after taking antidepressants.

-More about the differences between anti-biological psychiatry critiques. Link the radical one to anti-psychiatry and let people who want to learn about it read up on it there. Maybe some examples of psychatric excesses so as to give some perspective on why people might be skeptical of it, without transforming it into a psychatrists-as-amoral-butchers freakshow.

-More balanced coverage about weaknesses in or excesses of the biological psychiatric model, without smearing all critics as being anti-science or the "everyone's ok, it's society that's the problem" model.

One example that comes to mind is the study that came out recently that referred to conservatism as a mental disorder. —The preceding unsigned comment was added by 68.47.87.12 (talk • contribs) . 07:04, 24 November 2005

Article as written is highly POV, inappropriate for an encyclopedia, and based on a misconception

This article is extremely biased, and inappropriate for an encyclopedia. The main purpose of an encyclopedia article is to describe the topic, not take positions on it. Simply describing it does not equate to a "pro" position. Furthermore this article as written is based on a misconception: that because the term "biological psychiatry" is frequently used by detractors of the concept, that justifies writing a highly POV disparaging article on the topic.

Examples: abortion is very controversial, but that article mainly describes the topic. Describing abortion in detail does not constitute taking a "pro" position on that. Within the article there's a link to a separate article on Abortion debate. Likewise evolution is very controversial, but that article primarily covers that topic not the controversy. Describing evolution in detail does not constitute taking a pro position on that. There's a link within the article to Creation-evolution controversy.

Similarly this article should primarily cover the topic: biological psychiatry and the basis for that concept. If anybody feels strongly against the associated controversy, they are welcome to write a separate article on that and place a link to it in this article. If you further want to advocate your opinions, there are plenty of opportunities on Usenet and various other discussion forums. However this is an encyclopedia article on a specific topic and not the place for those opinions.

Re "biological psychiatry" being primarily used by detractors, that is not necessarily correct. Of course a Google search will show many such hits, but that is NOT representative of how the term is generally used. You can go to any library, use their search tools and you'll see most of the references are factual descriptions of biological psychiatry or related matters.

To better understand this, consider the term "Yankee". It is often used in a disparaging way, but the Wikipedia article on Yankee doesn't emphasize that. Rather it describes the origin and basis for the term. Likewise this article (like any other encyclopedia article) should focus primarily on describing the topic. Joema 18:54, 25 January 2006 (UTC)

The prime directive of an encyclopedia article is to describe the topic. This is not a Usenet discussion, nor a high school debate. The article should emphasize the topic description, basis for existence, and history. If great controversy is associated with the topic, it should be placed in a separate article.

This article is currently worthless

First of all, biopsychiatry is not a term used entirely by detractors. It's just that one of them (a detractor, that is) wrote this article. Second of all, medicine has its basis in the natural sciences (e.g. biology, chemistry) and it is a widely, if not universally, accepted fact that medical (and by extension, psychiatric) problems arise from some tangible source. In other words, medicine attempts to look for the cause of the problem. Psychological counseling neither diagnoses nor specifically treats any underlying physical (whether it be anatomical or phsyiological) illnesses. See the article called "chemical imbalance theory" for an explanation of why this [flawed] conception of biopsychiatry exists.

"...which they believe places undue emphasis upon biological theories and psychiatric drug treatment, rather than objective diagnosis of medical pathologies and psychological counseling."

First of all, who are these critics? Scientologists, no doubt. Second of all, what is "objective diagnosis" in the context of psychological counseling? The answer is, it doesn't exist. Psychological counseling and diagnosis of medical pathologies are diametrically opposed. Psychology is not (currently) a science, nor is it objective, by any means.

Lastly, let me point out that without "biological theories" medicine would cease to exist. Without these theories, we simply wouldn't have the sort of advanced technology that we do. Let me end this by saying: All medical problems have a biological basis, whether we know what it is or not. With conditions of an unknown etiology, remember that: Absence of evidence is not evidence of abscence.

- Fuzzform (not logged in, using school computer) Mar. 3rd, 12:31 EST.

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I've removed the following paragraph, as it is highly misleading and totally against all notions of NPOV. I think it should, at most, be used in a "Criticism" section, definitely not as a main description of this field. More partisan stuff will show up in this section.

"...used mainly by critics of mainstream mental health practice to describe what opponents of psychiatry believe are unproven and subjective diagnostic and treatment practices in modern psychiatry. References to biological psychiatry are used specifically by critics to denote the biological model of mental health, which they believe places undue emphasis upon biological theories and psychiatric drug treatment, rather than objective diagnosis of medical pathologies and psychological counseling."

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This entire article is pretty much worthless right now. I moved the criticism out of the initial description and into the "Criticism" section. The entire article is criticism. No neutral references to the discipline whatsoever. And certainly no rebuttals to or reasons for any of the criticism. The article starts denigrating biopsychiatry before the reader even knows what it is. One neutral sentence isn't quite enough. I'll keep working on it, and if it changes drastically, please leave any comments on this page (especially relating to edits). Fuzzform 00:10, 4 March 2006 (UTC)

Only one tag removed

The article is indeed POV. However, I removed the “disputed” tag since I cannot see factual inaccuracy in the article.

The article can be saved introducing in the first paragraphs biological psychiatry as the psychiatric profession views it. Only after that the controversy could be presented (there is no need for another article; the recently re-written Anti-psychiatry article is enough).

On the other hand, there are errors of logic in the “Rebuttals to criticism” section. The sort of reasoning “If it responds to medication it must be biological” has been refuted by psychiatrist Colin Ross in his article “Errors of logic in biological psychiatry”. I read Ross’ article in a book he co-edited with Alvin Pam. When I bought “Pseudoscience in Biological Psychiatry” ten years ago I only paid $50. It now costs $165 in Amazon Books! [1]. However, it is worth reading Ross and Pam’s critique of biopsych. (Of course, you can see for free Ross’ web page [2].)

Though the initial paragraphs in the Wikipedia article are anti-psychiatry POV, the last paragraphs are pro-psychiatry POV. This makes the article no less POV but more POV! Consider the last paragraph:

It is also worth noting that all medical conditions are caused by biological factors, whether those factors are anatomical or physiological. A disorder with unknown etiology is still rooted in biology (despite the fact that the origin is unknown - absence of evidence is not evidence of absence), whether the problem is a product of somatic of neural malfunctioning.

I have written a whole article about this sort of tricky argument. Though it has not been published (I live in Mexico and don’t have editorial connections with other countries), an English version of it can be read in my own web page. Please take a look at it [3]. Cesar Tort 17:43, 28 March 2006 (UTC)

Dualism?

Just reverted the dualist epithet. Thomas Szasz is perhaps the best known critic of bio-psychiatry. He is not a dualist. Like me and many other critics of biopsych, Szasz is totally agnostic. We don’t even believe in post-mortem survival. —Cesar Tort 23:40, 2 April 2006 (UTC)

Without some sort of dualism, what is there to influence that is not biological, and accessible to drugs? Would you describe it as a non-cartesian dualism or in some other way? Midgley 03:22, 4 April 2006 (UTC)

Thanks for your presence in this page and for your edits. You are very welcomed here! This page needs more people like you.

It is not a matter of Cartesian vs. non- Cartesian dualism. It is possible to be a materialist and to fight against involuntary psychiatry as well. I myself am a fan of CSICOP and the secular humanists. There is even a CSICOP fellow, Robert Baker, who recently passed away, who wrote a book stating that bio-psych is a pseudoscience [4]. In a nutshell, neurology is true science and a genuine branch of medicine; biological psychiatry is not, as can be seen in the arguments in the Anti-psychiatry article. Biopsych is similar to phrenology or Lysenkoism. As to your specific question, please take a look at neurologist Elliot Valenstein’s “Blaming the brain: the truth about drugs and mental health” [5]. —Cesar Tort 06:50, 4 April 2006 (UTC)

Thank you. Is the phrase being used a good one? "Biology" seems to me to be orthogonal to "involuntary". I mean one may have involuntary talking treatment, and voluntary biological - drug surely - treatment. In the UK also under the Mental health Act it is entirely possible for people to not accept any drug treatment even if their medical attendants think it is very clear that it would be beneficial to them.

There is a distinction between "not entirely understood" and "know nothing about" and some of this article seems to have been based on ignoring or eliding that difference. The mind is more complex than the hardware it runs on, but that doesn't stop some things being known about it well enough to improve. There is an evidence-based psychiatry movement. Midgley 08:34, 4 April 2006 (UTC)

The word “biopsych” is a code word used to oppose involuntary psychiatric drugging, electroshock or lobotomy. In 1998-1999 I took a mental health course in Manchester’s Open University. If I remember correctly, the 1983 Mental Health Act does not warrant at all the liberties you mention to users. As to your last paragraph, I believe that neurologists, psychologists (on the science side) and biographers and autobiographers (on the humanities side) can handle the mind problem. But psychiatry has absolutely nothing to do with hard sciences. You can also take a look at the book “Pseudoscience in Biological Psychiatry” [6]. —Cesar Tort 09:21, 4 April 2006 (UTC)

You make good points in your informative postings. I was perhaps lazy in pointing at our MHA - I meant it defines the rather limited times and scope of compulsory treatment, and outwith that (and common law and so on) treatment can be resisted, and is. Doctors in general, and nurses and otehr professions allied to medicine (PAMs) as much so, are not only content with that, but don't want extensions of it such as the mental health bill rattling around Parliament currently. The general population may though. Midgley 09:55, 4 April 2006 (UTC)

Codeword is what i was getting at. There are perfectly good words for all those concepts, and they are more clear and specific, and without etymological problems than the codeword. (Part of the definition of a code vis a vis a cipher is that the words in a code are arbitrary. here a word which appears to have a meaning is being used for something not quite the same. There has been some over-categorisation in the general area of activity and discussion. It would be better in many ways to use "JKLIV" than "Biological" because the definition would then be from scratch.)Midgley 09:55, 4 April 2006 (UTC)

My impression is that psychiatrists come in many flavours, and that they start off as medical students and junior doctors and get a grounding in the scientific basis of medicine as we all do. I think it exaggerates to say they and their specialty have nothing to do with hard sciences. On one model this would be slightly similar to condemning computer programmers for having nothing to do with the soldering of the hardware their programs run on. Midgley 09:55, 4 April 2006 (UTC)

Biopsych has really nothing to do with hard sciences: just as Soviet psychiatry in communist times had nothing to do with real science, but only imitated the scientific method. Another book I may recommend on this very subject is Szasz’s “Pharmacracy” [7], though for the moment you can take a look at my own article [8]. Only neurology is a true hard science. —Cesar Tort 11:29, 4 April 2006 (UTC)

I suspect that despite, or alongside, the excesses of a police state mediated through the cover of psychiatric institutions and language, there were people trying to improve the quality of life of other people with mental illness. Many things go on at the same time, some of them better than others, and some of them more firmly rooted than others. Midgley 11:45, 4 April 2006 (UTC)

Vague, uncited, POV. Parked here

"Criticisms of mental health marketing practices and pharmaceutical treatments have seemingly had little impact on the growing solidarity between the pharmaceutical industry and the mental health professions. Instead, the influence of 'biological psychiatry' appears to actually be strengthening, as evidenced by the growing political and economic clout of the industry."

Needs work, or abandoning. Midgley 03:26, 4 April 2006 (UTC)

I vote for abandoning. —Cesar Tort 06:53, 4 April 2006 (UTC)

Alzheimer’s disease? Biological psychiatry?

I have great problems with the phrase: “Much of the criticism attributed to biological psychiatry centers on the fact objectively defined pathological conditions have been found for only a select few mental illnesses, such as Alzheimer...”

Historically, if a psychiatric condition is found to be biological, it is withdrawn from the psychiatric field and studied by neurologists. And there’s the rub with all of this neurology vs. psychiatry, hard- or pseudo-science issue. Alzheimer is absolutely unique: it’s exactly in the border of neurology and psychiatry. But it’s not a paradigmatic psychiatric disorder. These are schizophrenia (dopamine pseudoscientific theory); depression (serotonine pseudoscientific theory); ADHD (ibid.), and many more. It is therefore unwise to mention Alzheimer: it may be misleading for the Wikipedia readership.

As to the article’s opening paragraphs, I have been in psychiatry libraries and have seen mainstream psychiatry manuals with the title BIOLOGICAL PSYCHIATRY. So it’s not used only by critics...

I am curious if you have read the main Anti-psychiatry article, Midgley? —Cesar Tort 18:50, 4 April 2006 (UTC)

I expect I swung the meaning of the opening too far - crisp, clear, but incomplete. Its next iteration will be better, I expect. I read anti-psychiatry (and I'd met it) but I know the article has been edited since, and IIRC it was described as major edits... The psycho-geriatricians are an increasing specialty who deal with general medicine ("internal medicine" for Americans I think), neurology obviously, and psychiatry. There is a risk of ending up characterising a doctor as nothing to do with science in their psychiatry practice, and all to do with it in their neurology practice, when they are actually dealing (holistically even) with patients running minds on damaged and degenerating hardware. Same doctors, same patients... As Humpty Dumpty might say, given that "Biological psychiatry" is a code for (see earlier) and means what those using it (WP: Owning the words perhaps) decide it means, perhaps someone writing a textbook or journal with the same words on the cover is not writing about the same thing? Relative, essential, or confusing. Midgley 21:17, 4 April 2006 (UTC)

The Anti-psychiatry article was re-written by me and others last month. It is precisely the re-written article, not the original article (very bad written by the way), which you might find interesting.

If you read the re-written article you will see that only neurologists deal with damaged hardware; never psychiatrists. And yes, I agree with you: since it is used by both sides, the “Biological Psychiatry” term is indeed confusing! —Cesar Tort 21:36, 4 April 2006 (UTC)

I'll make time for that. Possibly tomorrow. I'm unsure how many topics there are here, and where to slice them up - certainly there is something worth having around these articles. Midgley 23:00, 4 April 2006 (UTC)

Shaky clause

..."rather than objective diagnosis of medical pathologies and psychological counseling."

However one spells counselling, I suspect this clause has deeper troubles, starting off from a POV forumulation, and continuing through an absence of the demonstration of objective diagnoses of _psychiatric_ medical diagnoses where the question is begged. In short, I doubt that this represents the polar opposite of the first clause in the sentence in which it lies, still. Midgley 21:22, 4 April 2006 (UTC)

Cull

If no objections, with the help of other editors I will unmercifully cull and re-write this article as I did with the Anti-psychiatry article. —Cesar Tort 10:44, 5 April 2006 (UTC)

Breggin

Yes Midgley, please correct my English when you feel it necessary. Spanish is my native language so my phrases need syntactic correction and clarification. (BTW, Breggin studied psychiatry in Harvard; has written a dozen of psychiatry books; founded the International Center for the Study of Psychiatry and Psychology; founded the only peer-reviewed journal I know devoted exclusively to criticize biopsych, and has been called to Congress to talk about the dangers of Ritalin.) As I said above, to make the article NPOV we could first present biological psychiatry as mainstream psychiatry perceives the field. A paragraph may be needed above the “Critics” section. —Cesar Tort 13:43, 5 April 2006 (UTC)

Caesar's English is very good. Ratehr than correcting anything I might strip some redundancy out of sentences, something I do to any writing, except my own. Midgley 14:38, 5 April 2006 (UTC)

Ombudsman's edit

"rv: cursory examination of Midgley's edits indicates insertion of pov, spin, or worse; even the copy edit re: reference vs references, after consideration of context, is dubious at best" I am displeased by this unWP:CIVIL [[WP:NPA|personal attack. I am unsurprised that a large reversion by User:Ombudsman comes with no discussion or justification on this talk page because it is his common practice. What can be done to restrain this? Midgley 22:02, 5 April 2006 (UTC)

NPOV tag removal?

The article may still need changes, additions or modifications. As I said above, English is not my native language.

However the re-written article looks NPOV to me. Any objections to remove the NPOV tag? —Cesar Tort 15:35, 6 April 2006 (UTC)

Much better. I've made an edit to the opening paragraph that is seeking precision rather than a change of meaning. Midgley 17:04, 6 April 2006 (UTC)

Add further info?

I see the article has been significantly improved from the earlier state, which is great. I have a fair amount of additional info (definitions, history, etc) I'd like to add. Is that OK? Wikipedia says "be bold", but I didn't want to surprise everybody if I add a bunch of stuff. Joema 23:12, 7 April 2006 (UTC)

Of course you can contribute! The only rule is that the edition should be NPOV. —Cesar Tort 23:37, 7 April 2006 (UTC)

Discuss changes

As previously discussed, I've integrated a lot of new material. It's essentially a total re-write. I hope it's obvious it was an ambitious, laborious project.

My goal was to produce an article worthy of an encyclopedia (that's what Wikipedia is, after all): scholarly, neutral, informative, and well-referenced.

I'm not a healthcare professional, and am completely agnostic about biological vs behavioral determinants to mental health. However an encyclopedia should prioritize describing the topic, not debating it, critiquing it, or editorializing on it. This descriptive-oriented approach is standard practice at of other encyclopedias, and for good reason. To do otherwise damages the scholarly impartiality, usefulness and ultimately the very legitimacy of the encyclopedia.

Please discuss any questions, issues or problems here. (remark by Joema) (Please sign with 4 tildes Midgley 19:25, 11 April 2006 (UTC))

I've cleaned up the references quite a bit. Some names of authors and journals need further editing, as they are incomplete. Access dates are also needed for all web-based sources. Also, I've added a few "citation needed" tags to uncited pieces of information. Fuzzform 20:14, 12 April 2006 (UTC)

Thanks, I'll work on that. Joema 21:13, 12 April 2006 (UTC)

NPOV tag

Biological psychiatry is a pseudoscience like phrenology and Lysenkoism, as can be demonstrated in the writings of several non biological psychiatrists and mental health professionals: [9], [10], [11], [12], [13], [14], [15], [16]. There is even an entire peer-reviewed journal devoted exclusively to debunk bio-psychiatry [17]. The totally re-written article is pro-psychiatry propaganda. —Cesar Tort 04:15, 13 April 2006 (UTC)

What do you think the article should say? --WikiCats 11:10, 13 April 2006 (UTC)

A problem here is that the term is being used for different things by different people. I suspect that while articles could be written about each use, any of those, or an article about all uses is unlikely to satisfy any group. A lot of it looks like alternative doctor-knocking rubbish, but that may just be the view you'd expect from a doctor. Midgley 12:04, 13 April 2006 (UTC)

I propose that the short NPOV article edited by Midgley and me replace the existing long POV article and then try to work together on a NPOV basis if the article edited by Midgley and me is going to be extended. —Cesar Tort 16:30, 13 April 2006 (UTC)

Incidentally, I agree with you Midgley that alternative medicine is rubbish. As stated above, I am a fan of CSICOP and the skeptics (I even contributed with a note in Skeptical Inquirer to debunk the “wall face” appearances of Belmez, Spain). However, criticism of phrenology, Lysenkoism or biopsych is not “alternative medicine”. —Cesar Tort 17:31, 13 April 2006 (UTC)

The article is NOT pro-biological psychiatry, any more than the article on abortion is pro-abortion or the article on evolution is pro-evolution. The main purpose of an encyclopedia article is to describe the topic. Think of it as an elaborate dictionary. Describing the topic and the underlying basis DOES NOT equate to a pro position on the subject. The NPOV tag is entirely unwarranted. Joema 23:24, 13 April 2006 (UTC)

I am not alone in this opinion. In his 17:59, 13 April 2006 contribution to the article, Ombudsman wrote: “this article has become a poster child for extreme ivory tower pov pushing”. —Cesar Tort 23:53, 13 April 2006 (UTC)

Incidentally, evolution is real science; biopsych is not. —Cesar Tort 23:57, 13 April 2006 (UTC)

Just like you have very strong feelings against this topic, and claim it's not real science, millions have strong feelings against evolution and claim IT is not real science. From an encyclopedia standpoint, that makes no difference. The purpose of an encyclopedia is describe and explain the topic. Doing so does not equate to taking a position on it. I understand you may want to convince others of your position, and that's fine -- but not in an encyclopedia article. I sincerely entreat you, please do not continue this. You have many avenues to persuade others of your position. Please don't use an encyclopedia article for this. If necessary this can be escalated, but I beg you -- please save everybody the time. Put anything you want in the anti-psychiatry article. Or create your own specific anti-biological psychiatry article. But please, please don't continue putting that into this article. Joema 00:10, 14 April 2006 (UTC)

I could say exactly the same about the article Midgley and I edited and you took over: please, don't continue putting that into this article. —Cesar Tort 00:17, 14 April 2006 (UTC)

I'm going to have to side with Joema on this one. The critics of biopsychiatry are criticizing certain aspects of it yes, but I have yet to see any claims that it is a pseudoscience. Perhaps you came to this conclusion abrubtly due to some unpercieved bias - I surely hope you are not another Scientologist seeking to smear the notion that perhaps there is a biological basis for all medical conditions. After all, we are just a gigantic complex of molecules, organized into cells, tissues, and in the end, the organism - humans. So if you would like to debunk something, try psychology. After all, that wasn't considered a science until fairly recently, and it still incorporates incorrect and non-empirical conclusions in varying degrees. If you would like to include a "Criticism" of biopsych, feel free to add a section toward the end. But please don't change the intro to say "biopsych is a pseudoscience" or anything of that nature, because it is no more a pseudoscience than psychology. (P.S. you do realize the article already incorporates criticism of biopsychiatric theories?) Fuzzform 04:10, 14 April 2006 (UTC)

Citation number 17: all of the contributors to this journal are in the fields of "divinity", "psychology", "psychoanalysis", "spirituality", "author", "survivor" (those last two greatly puzzle me), "mind-body medicine", "phenomenological psychology". All of these draw conclusions through deductive reasoning. None of them use empirical, or inductive reasoning to come to conclusions. Biopsychiatry does use empiricism as its basis; using MRI, EKG and many, many other quantitative methods, the physical/biological nature of mental illness can be investigated. Ergo, psychology is a pseudoscience, biopsychiatry is not. But still, feel free to add criticism, if you can find specific examples. Fuzzform 04:18, 14 April 2006 (UTC)

Write out what you want to say here so the other editors can have a look at it. --WikiCats 04:23, 14 April 2006 (UTC)

Why psychiatry is a pseudo-science

No: I am not a scientologist. I am not a psychologist either.

Didn’t Fuzzform misrepresent citation number 17 (Ethical Human Psychology and Psychiatry: An International Journal of Critical Inquiry)? The journal’s founding editor that debunks biological psychiatry is a psychiatrist himself: Peter R. Breggin, MD. The editors are Jonathan Leo, PhD, and Laurence Simon, PhD; the associate editors are David Cohen, PhD; David Jacobs, PhD; Jay Joseph, PsyD; Stephen E. Wong, PhD, and Michael McCubbin, PhD.

Also, the editor of Pseudoscience in Biological Psychiatry is a psychiatrist [18].

In a nutshell, as a Popperian philosopher of science would easily notice, the way bio-psychiatrists present their hypotheses on the diverse neuroses and psychoses —biological diseases “of unknown etiologies”— makes them non-falsifiable or irrefutable biological hypotheses. “Thus, an irrefutable hypothesis is a sure-fire sign of a pseudoscience” (Terence Hines). —Cesar Tort 05:02, 14 April 2006 (UTC)

Cesar, I appreciate you think psychiatry is a pseudo-science. People have strong opposing feelings about many subjects: evolution, abortion, The Holocaust, etc. However encyclopedia articles on those subjects should prioritize documenting the topic, not being a forum for dissenting opinion.

There's no shortage of venues to express your feelings and persuade others. But this encyclopedia article is not that place. I beg you, please, please, use those other avenues. Feel free to write a Wikiepdia article on anti-biological psychiatry. Start your own discussion forum. But I earnestly entreat you, please don't continue this. I beg you with all my heart -- please. Joema 05:31, 14 April 2006 (UTC)

I could also beg you, Joema, not to delete the article I edited with Midgley: but you nuked it.

Also, Holocaust deniers and creationists are crackpots. I hate Holocaust deniers and despise creationists. On the other hand, psychiatrist Peter Breggin, the founding editor of the journal that criticizes biopsych, and the other mental health professionals, are sane people. Why don’t you better address my Popperian argument? After all, biopsychs, not their critics, say that they study biomedical entities “of unknown etiology”. —Cesar Tort 05:49, 14 April 2006 (UTC)

Hi guys (and perhaps, gals). I was referred to this page to offer an opinion. I've read through the article and talk and, as its stands, i think it isn't too bad, but there are still a few problems about neutral tone. For example we cannot say: a central theory of biological psychiatry (monoamine hypothesis, popularly known as the "chemical imbalance theory") is deeply flawed in its original form. or Since the monoamine theory is certainly wrong in its initial formulation, and likely incomplete even in the current form, it would appear that much of biological psychiatry is based on a shaky foundation. Both are highly POV and thus it must be attributed if they are to remain.

I also happen to think that the article loses focus, it should be more factually descriptive of what biopsych is (from both the majority (pro) and minority (anti) POV) and less a critique of its flaws. I agree that much of the content would much better linked to another article on the controversy of chemical imbalance. However, the argument that it is a pseudoscience is easily cleared up in policy, WP:NPOV says:

If we're going to represent the sum total of human knowledge, then we must concede that we will be describing views repugnant to us without asserting that they are false. Things are not, however, as bad as that sounds. The task before us is not to describe disputes as though, for example, pseudoscience were on a par with science; rather, the task is to represent the majority (scientific) view as the majority view and the minority (sometimes pseudoscientific) view as the minority view ''

In terms of this article, I interpret that as follows. Whether something is psuedoscientific or not is not relevent in regards to how it is presented in an encyclopedia (after all we adopt a neutral point of view, not a scientific point of view). Therefore we describe biopsych according to what the majority view is (and i'm pretty sure that majority view is that biosych is not pseudoscience) AND we state what the minority view is (i.e. that anti-psychiatrists, some religious groups and assorted others believe that it is a pseudoscience). From my discussions with Cesar, i think he believes that the "majority scientific view" on this subject does somehow infringe what defines pseudoscience (i appreciate that is an oxymoron, but i hope you can see what i mean). That may be the case, but its got good enough for Wikipedia to call it a pseudoscience. For our purposes, "scientific" is what current mainstream science accepts and "pseudoscientific" is what the current mainstream calls a pseudoscience. So as long as we state what the majority and minority beliefs are, we should have no problem, as both should be explained neutrally. Thus the question is not whether biopsych can fulfil the criteria of a pseudoscience, but does anyone dispute that the scientific mainstream currently treats it as a science and those that call it a pseudoscience are in a minority? Rockpocket 06:52, 14 April 2006 (UTC)

I have no objections with your comments Rockpocket but I wonder if you read the article I edited with Midgley (who is quite a skeptic of alternative medicine). Anyway, that article was nuked. But I agree that the minority view deserves a space in the article even if it is just 25%. Take a look at the flaming debate about the Mother Teresa article (MT for short). Almost the entire world is convinced that MT was a saint. However, a tiny minority believes she was an evil and selfish old woman. I wrote at the end of the current debate in Talk:Mother_Teresa: “A single individual may be right and the rest of the society wrong. That’s what I learnt in John Stuart Mill’s On Liberty and Orwell’s 1984. Hitchens is no Wonkum. All I am asking is some space for people like him in the MT article”. In other words, the majority view about biopsych doesn’t mean that it’s real science. That’s the ad populum fallacy. Like the MT article, 25% of space should be conceded to critics. —Cesar Tort 08:44, 14 April 2006 (UTC)

"Almost the entire world is convinced that MT was a saint." I would just like to point out that this is a baseless claim. Perhaps the religious believe this, the Christians, but they are not "Almost the entire world". Fuzzform 23:54, 14 April 2006 (UTC)

Of course! I was using hyperbole. —Cesar Tort 00:54, 15 April 2006 (UTC)

I haven't read past versions of the article (yet) - i was simply commenting on the most current version. I'm afraid your comment "the majority view about biopsych doesn’t mean that it’s real science" may indeed be true, but as i explained, is completely irrelevent for our purposes as Wikipedia editors. Billions of people believe in a God, yet religions are not primarily represented in Wikipedia as ad populum fallacy. Neither are you correct that 25% of the article must be conceded to critics. As Ande B argues below, the importance of the criticism in the article is is judged by how influential the opposing view is in reality. Thus in some articles critism may cover as much as 50% of the article (see animal testing, for example, where animal rights is a very high profile and culturally influenctial viewpoint) and others a simple sentence saying there are critics who oppose this. As it happens there is an entire article that describes the anti-psychiatry movement. Thus here, i would suggest a short section summerising the critical viewpoint and a link to that page. Al also agree that standard policy is to not include criticism in the intro. Rockpocket 17:29, 14 April 2006 (UTC)

I've got to agree with Rockpocket, above, only more strongly: this article reeks of POV and original research. I don't know how Cesar Tort has arrived at the notion that the ad populum fallacy applies in this instance and I'm concerned that the article, as envisioned by Cesar Tort, would have the same problems that would arise if a creationist wrote an article about evolution and promptly labeled it "pseudoscience." And I can't agree that 25% of any article should be "conceded to critics." In some articles, the mere mention that there are critics may suffice. This page seems to be a candidate for a "Needs Expert Attention" template. Ande B 09:13, 14 April 2006 (UTC)

The article that Midgley and I wrote was NPOV. I really don’t understand what you are talking about. In the MT article 25% is, in fact, conceded to critics, even if they are a tiny minority compared to the billions of Christians. I think that Rockpocket’s evaluation of the article is fairer that yours. —Cesar Tort 09:21, 14 April 2006 (UTC)

I have not looked at the MT article and have no interest in doing so. What is appropriate to that article is not related to this one. Particularly since MT's actions and reputation are matters of social, cultural, and religious opinions. Religious and political based articles are likely to have good reason to include serious or even lengthy discussions of criticisms. This article is not of that type.

I have attempted to remove the strong POV in the introductory paragraphs. I was apalled when I clicked on the link to a reference that supposedly supported the statement that a biological psychiatry theory was "deeply flawed" when the referenced article did not say that. Beyond that, the article was from Psychology Today, a widely circulated magazine but a popular magazine, not one that is properly cited for such an evidentiary claim. Now it may be that the reference was footnoted in error, but those types of problems need to be fixed.

Moreover, it is not good form to include an argumentative attack on the subject matter of an article within the introduction. Criticisms belong later in the article, after an adequate explanation of the topic has been given. Ande B 10:09, 14 April 2006 (UTC)

I wrote the "deeply flawed" statement and I agree it may be poorly worded. I agree criticisms (if any) belong later in the article. However the Psychology Today article was based on several peer reviewed papers which I cited later in the article. One of those researchers was quote in the Psychology Today article saying: "It is not possible to explain either the disease or its treatment based solely on levels of neurotransmitters". Yet the original monoamine hypothesis does just that. That is a clear example of a deeply flawed theory, and there's very little disagreement on that among neurobiological researchers today. I can provide more references if needed. However the first section as now re-written looks fine to me. Thanks Joema 13:19, 14 April 2006 (UTC)

More on why "deeply flawed" is not judgmental but accurately summarizes the facts in language approachable to the broad Wikipedia readership.

"some, if not all, depressions are associated with an absolute or relative deficiency of catecholamines" (Schildkraut JJ, 1965). That's the catecholamine ("chemical imbalance") hypothesis as originally stated. By contrast:

"It would appear that the primary pathophysiology of depression is neither a NE[56] nor serotonin deficiency." http://www.medscape.com/viewarticle/412866_4

Again, I agree the "deeply flawed" wording might be improved, also that it fits better later in the article. However I wanted to be clear it wasn't made up or without credible corroboration. Joema 13:47, 14 April 2006 (UTC)

Hi Joema, thanks for your clarification of your cites and the peer review articles, which I'm always happy to see. But the overall message of the Psychology Today article did not present the information in the manner so strongly suggested in the prior phrasing. My primary concern with the intro was not simply that there was criticism of the earlier hypotheses of MAOI action but that the statement causes an uninformed reader to conclude that flaws in understanding the basis of MAOIs are the equivalent of a total repudiation of the value of any pharmacological agent in the treatment of psychiatric disorders. I got the message you posted & I'll finish this chat on your talk page. Ande B 14:24, 14 April 2006 (UTC)

This doesn't look like the right article to explain why psychiatry might or might not be a pseudoscience. The anti-psychiatry article already does that. Neurodivergent 14:58, 16 April 2006 (UTC)

There is a partial quote above ... here is the next line from that article:-

"However, NE and serotonin circuit dysfunction together may mediate many of the symptom clusters of depression, such as:
   * NE -- poor attention and memory, decreased concentration, reduced socialization, and altered states of arousal; and
   * Serotonin -- poor impulse control, low sex drive, decreased appetite, and irritability (Figure 3)."

Whatever is going on is complicated, our measurements lack precision, and that which allevites a condition is neither thereby shown to have its absence cause that condition, nor is an absence of showing that any inication that the empirical treatments have not in fact worked. Modern science is to a large extent empiricism, and the demonstration that theories are at an early stage does not indicate that the empirical work is less of a science.

Psychiatry has a scientific basis, in the soft sciences of sociology and psychology as well as in harder ones such as pharmacology and biology. Simplifying the target of the argument is erecting a straw man, and not helping produce an encyclopaedic article to inform the putative reader. Midgley 21:39, 16 April 2006 (UTC)

Major reorganization is needed

I realize that a lot of work has been done on this article during the last month or so. Still, it has organizational problems that we should be able to remedy by doing a bit of re-shuffling. Right now, the article is organized to reflect its "historic" development. I think this is a mistake. Most readers don't want to know the history from Hippocrates forward, they want to learn the current scope and understanding of the field. So I suggest that we move the historical information toward the end of the article so that we don't lose readers before they get to the real substance.

There are two other concerns I have about the organization. The first is that the lead-in starts with a bulleted list. These types of lists are helpful but they pose a barrier to understanding when placed up front. That first section would benefit from a slight re-orientation of the paragraphs.

The other, perhaps more difficult to resolve issue is the amount of space devoted to some sort of back and forth argument about the physiological basis for the effects of MAOIs when used to treat depression. Treatment of depression is a considerable issue by itself. In this article, it sort of ambushes the reader, making it appear that, because we do not yet fully understand the mechanisms by which MAOIs work, treatment with MAOI is suspect, regardless of its clinical efficacy. And it fails to acknowledge any of the many other treatment modalities for that condition or any other condition. I suspect that some of this material was written in response to prior versions of this article which were, for lack of a better word, total bunk.

I suggest that the MAOI material be reduced or merged into a more appropriate article, such as Monoamine oxidase inhibitor, depression or anti-depressants, where it could get the attention of readers trying to understand that class of drug.

For this article, it might work better if there was an overview section(s) titled something along the lines of "specific psychiatric problems and their treatments." Then provide a quick summary of each major diagnosis alnog with a synopsis of the types of treatment modalities currently employed. I think that Joema has been working on much of this and might be the best person to streamline the material.

These are just my thoughts after wading through a couple comparative versions of this article. Ande B 16:24, 14 April 2006 (UTC)

I think they are all very sensible proposals and i support them. I think it also helps to point out that length does not equal quality. Since much of the information here is covered in article like Monoamine oxidase inhibitor and anti-psychiatry, there is a strong argument for placing a link saying 'Main article: Anti-psychiatry' then just a brief overview of that POV here. Rockpocket 17:34, 14 April 2006 (UTC)

I agree with all of the above proposals. Your assessment is correct and the suggestions for improvement right on target. I'll start on that. Joema 17:59, 14 April 2006 (UTC)

“I suspect that some of this material was written in response to prior versions of this article which were, for lack of a better word, total bunk” (Ande B). This article has been re-written three times, including the present one. Is Ande B talking about the first or the second article? If s/he refers to the article I edited with Midgley, is this comment fair? Midgley earned Wikipedia’s Ruben Pseudoscience Barnstar “for heroic defense of reality against those who would impose the pseudoscience of their belief system”. And once we re-wrote the biased article Midgley, not me, removed the NPOV tag of that article that Joema nuked a few days ago. —Cesar Tort 23:37, 14 April 2006 (UTC)

Hello, Cesar. I appreciate that you tried to put togethor an article on this topic. I also appreciate that there seems to be some type of on-going edit dispute about both the content and form of the piece that was going on long before I got here. I actually have a hard time comparing your edit with the latest ones since they both have serious, though quite disparate, difficulties. The earliest versions (which seem to be your work product) were quite clearly written and, although neutral in tone, had a misplaced emphasis on criticsim of the topic rather than elucidation of it. The discussions on this talk page suggest that you have a misunderstanding of what consitutes evidence for purposes of establishing the scientific legitimacy of this field of medicine. This is what leads me to believe that the current condition of the article relects the efforts of someone(s) trying to answer the arguments put forth on this talk page but, unfortunately, having the opposite effect of what may have been intended. The current article's problems stem largely from unfortunate word choices, a style that gives the impression of being original research, and a misguided effort to providedetailed covereage of issues that side-track the article. And Cesar, I apologize for mistaking some of the later edits for being your work rather than someone else's Ironic, isn't it? Ande B 01:20, 15 April 2006 (UTC)

Cesar, I must beg you to stop opposing the simple fact that the article is, in its current form, of more encyclopedic value than it would be if it began by saying that biopsych is a pseudoscience. Rocketpocket describe the exact reasons for this description, and I pointed out why biopsych is not a pseudoscience in the above section. If you want to criticize biopsych, then add a "Criticism" section and stop trying to hijack the article. This is a group effort, and compromises must be made, yes, but Wikipedia has guidelines which must be followed in order to make this as encyclopedic as possible. Fuzzform 00:01, 15 April 2006 (UTC)

Your reply is a total non sequitur. I was merely referring to Ande B’s comment. —Cesar Tort 00:50, 15 April 2006 (UTC)

Yes, Cesar, I see that some of the dynamics here have not been very productive to the cooperative spirit. I hope I don't end up making things worse. No-one is well served by the current state of affairs and if we don't get past some of these talk page arguments, we'll never get this project to resemble a professional article. Ande B 01:20, 15 April 2006 (UTC)

Well: I think I can agree with that :) Cesar Tort 01:30, 15 April 2006 (UTC)

Progress reports

• Joema, I hope you don't mind that I broke of your progress report into a fresh section. I'm hoping it will make it easier for everyone to folow along and track contributions. You certainly seem to be hard at work! Ande B 18:58, 15 April 2006 (UTC)

Ande, sorry about the delay. Hopefully I can work on this more today. However a few comments on your previous suggestions: "amount of space devoted to some sort of back and forth argument about the physiological basis for the effects of MAOIs". More accurately, physiological basis for monoamine cause of and remedy for depression. MAOIs are just one class of drug that achieves that. But I agree there's maybe too much space on back-and-forth issues about basis for monoamine theory. OTOH this is one of the key underlying issues of biological psychiatry, plus one that's most familiar to the general audience as the "chemical imbalance" theory. To not spend a fair amt of space on this is like discussing the American Civil War without discussing slavery as a key theme. You're right it should be structured differently, plus maybe reduced in size a bit.

However there's already a separate article on Chemical imbalance theory. Normally you'd want to avoid duplication of material between this one and that, but that article is not in great shape. E.g, it has more material on controvery/criticism than on describing the basis for the topic, an all-too-frequent Wikipedia problem these days.

You're right the main purpose of any article is document and describe, not analyze and critique. This article probably needs some improvement there, although a lot of that came from the Braslow article, which was a professional-level article from the Harvard Mental Health Letter. So actually there wasn't much analysis and critique, but a historical treatment that could have given that impression. You're right about the history being moved further down the article.

BTW because of the ample references, it maybe gave the evidence of original research, but there was none. Almost every statement was taken from or paraphrased from a credible source, most of them peer-reviewed literature.

Some other issues that need handling: clarify Depression vs other conditions. Article spends much space on depression, but that's only one condition. To a degree that's appropriate since the monoamine theory was based on depression and a good % of current work (plus drugs familiar to the audience) is on depression. But it's only one condition so other coverage is needed.

Another matter is research vs clinical work. While the average reader considers biological psychiatry exclusively in the clinical context, the other side is research. Much biological psychiatry research takes place, a lot of it published in the journal Biological Psychiatry.

The point about removing the bulletized list at the beginning is good.

So several things need addressing. I'll make a first pass at it today, then everybody can take a look. Joema 13:38, 15 April 2006 (UTC)

• Joema, I'm not one of your professors demanding an immediate re-write! Especially during what is a much needed spring break for many of us. But I think we all appreciate your level of commitment. As to the "appearance of original research," after you and I chatted, I realized what you were trying to do with the cites. Part of this is simply stylistic and part is probably no more than editorial stages along the way to a final product. I've been teaching research and writing classes since the early 80s and I just recognize some of the common stumbling blocks that trip people when they attempt to write in an unfamiliar style or form. My guess is that you could put together a great paper for a class literature search assignment. Those same skills can be used for other types of projects. Ande B 18:58, 15 April 2006 (UTC)

OK, I just put up a rough cut based on your suggestions. Take a look and please comment. Joema 02:06, 16 April 2006 (UTC)

How the heck did you do all that editing in a single day? Joema, I think this is looking good. I hope you have not dumped your previous drafts because they did contain a lot of good info that can be adapted for other uses. Are you going to move some of the MAOI material into another article? It was pretty detailed and I think those interested in that medication would be interested in reading about it. Ande B 02:20, 16 April 2006 (UTC)

The Wikipedia software maintains all previous versions in non-deletable form. Just by pressing the article "history" tab, then clicking on the date/time, those can be examined. You're right some of the removed information could probably be used in the "chemical imbalance" article. After we're done here, I'll examine that. Let me know your thoughts on the current version. Joema 08:41, 16 April 2006 (UTC)

Hi Joema, yeah, I know that wiki saves our work, so I really don't know why I said that! It was just a way of saying that your previous material should not be tossed aside never to be used again, there was alot of good work there that can be put to good use. Hope you have a good Easter break. Ande B 18:38, 16 April 2006 (UTC)

Tag-pushing

In the above discussion it remains unclear why there is a {{NPOV}} tag on the article. Disagreement with the premises of biological psychiatry or with its adherents is not a valid use for the tag. The only reason for it would be that the portrayal of biological psychiatry is biased.

I note that the editor who placed the tag, namely Cesar Tort (talk · contribs), has not made any attempt to "restore balance". This is a form of POV-pushing by tag placement. I'm removing it now and await constructive comments on the talk page, as well as constructive edits to the article. JFW | T@lk 19:31, 16 April 2006 (UTC)

You might notice that this article has been undergoing considerable edititng efforts during the last week. Several people have been worknig through certain problemed issues on this talk page but Joema has been doing most of the work on the article itself. If you can contribute more, that would be great. If you have major changes in mind, I think it might help to post your suggestions on the talk page first. Right now, we are trying to avoid an edit war by coordinating our efforts. I agree with your removal of the POV tag. Ande B 20:06, 16 April 2006 (UTC)

Ombudsman reverted the POV tag that JFW removed. I agree with Ombudsman. Please wait a few hours while I write a critique of Joema’s article. —Cesar Tort 20:43, 16 April 2006 (UTC)

• Cesar, by all means write your critique. But the current article, although not comprehensive, is definitely not POV. There is an article on Anti-psychiatry where your disputes with BioPsy belong. This article is only trying to explain what BioPsy is as understood by the scientific / medical community. Ande B 21:22, 16 April 2006 (UTC)

This is a good article. I can see why Ombudsman regards it as POV, but it is a very good piece of NPOV writing. The only adverse thing that I woudl say about it is that it is an article about one use of a term used by at least two populations to mean quite different things. Ombudsman tends to the other meaning. I'm not sure it is a very useful term in either direction, myself, but it probably needs a cunningly constructed opening paragraph or note making this clear, and/or a different article titled provisionally Biological psychiatry as a dismissive synonym for all conventional psychiatry. — Preceding unsigned comment added by midgley (talk • contribs)

Good point, and that's why the opening sentence that defines Biological Psychiatry is taken straight from Webster's Dictionary. That is the official definition. People use many terms in pejorative ways, but you won't see every such encyclopedia article elaborating on these, or even including those usages. Where needed, simply mentioning that usage is sufficient and this article does that.

Yet another problem is the other usages are non standard, so there's no unified consensus on the meaning. E.g, is the pejorative Biological Psychiatry dismissive for ALL conventional psychiatry, or just the biological variant? Does that mean there should be three definitions? Or is it pejorative for just over-use of pharmacology, but accepting of some biological psychiatric methods? Does that mean there should be four definitions? Who decides that, and by what authority? I agree writing a separate anti-biological psychiatry article is probably the best way to handle this. That's how the Evolution and Abortion articles were handled. Joema 22:04, 16 April 2006 (UTC)

Joema’s article: a critique

Biological psychiatry, or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics and physiology to form theories about the biological bases of behaviour and psychopathology.

This is totally inaccurate and misleading. Nancy Andreasen, the editor of the American Journal of Psychiatry, the most financed and influential journal of psychiatry, recognizes in Brave New Brain, a book published in 2001, that (1) there has not been found any physiological pathology behind mental disorders; (2) nor chemical imbalances have been found in those diagnosed with a mental illness; (3) nor genes responsible for a mental illness have been found; (4) there is no laboratory test that determines who is mentally ill and who is not; (5) some mental disorders may have a psychosocial origin. A better proof of the inaccuracy of Joema’s opening statement can hardly be found. It is worth saying that Andreasen’s book has been tagged as “the most important psychiatry book in the last twenty years” by a book reviewer.

While there is some overlap between biological psychiatry and neurology, in general neurology focuses on disorders where gross or visible pathology of the nervous system is apparent, such as epilepsy, cerebral palsy, encephalitis, neuritis, Parkinson's disease and multiple sclerosis, among others. There is some overlap with neuropsychiatry, which typically deals with behavioural disturbance in the context of apparent brain disorder.

Again, for the reasons expressed above this is totally inaccurate and misleading. Neurology is a real science based on biological markers. Ironically, in “biological” psychiatry there are no such markers, as Andreasen made it all too clear. The following illustration shows why neurology is science and “bio” psychiatry is not.

Presently, diverse concepts of disease are compelled to coexist by authorities in medicine, the pharmaceutical companies, the media and even politics and the law —in a word the status quo: what Thomas Szasz has called “Pharmacracy”. The suggestion that, say, AIDS and ADHD (attention deficit hyperactivity disorder) are radically different kinds of disease —or more precisely, that the later is not a disease at all— is so politically incorrect in today’s pharmacratic society that it is dismissed out of hand. But due to the lack of biological markers in biopsych we may conclude that, while AIDS is genuine disease, ADHD is merely a diagnosis. And there is the rub of this controversy.

Biological psychiatry and other approaches to mental illness are not mutually exclusive, but may simply attempt to explain the phenomena at different levels of explanation. Because of the focus on the biological function of the nervous system, however, biological psychiatry has been particularly important in developing drug-based treatments for mental disorder.

As can be inferred from Andreasen’s book and many other standard psychiatric textbooks, there is no lab test in the profession for mental disorders. Therefore, the above statement is, once more, grossly misleading.

Biological psychiatry is a broader field than commonly-mentioned disorders (e.g, depression, schizophrenia) and associated drug treatments. On a research level, it includes all possible biological bases of behavior.

“...all possible biological bases of behavior”. Wow. Can biopsych explain my behavior: for example why I fight in Mexico against the psychiatric drugging of children and even toddlers? “All possible biological bases of behavior” is psychiatric megalomania, also called God complex in the profession. I would be dumfounded if an article with such a sentence finds its place in a serious encyclopedia.

Although the "chemical imbalance" hypothesis has been significantly revised since 1965, many newer medications (such as fluoxetine and other SSRIs) were developed based on the underlying theories of the hypothesis. More recent research points to deeper underlying biological mechansisms as the possible basis for several mental health disorders.

While it is true that these drugs produce changes in the activity of a neurotransmitter, “it has not been possible to demonstrate that any biochemical abnormality is associated with any of the subgroups of depression”. These are words of Elliot Valenstein in his book “Blaming the Brain: The Truth About Drugs and Mental Health”, page 102. Valenstein, a neurology professor, devotes several technical chapters of his book to support his argument. His views are widely shared and quoted among the mental health practitioners that oppose biopsych.

Also missing in the article is any mention of adverse effects of SSRI drugs. Serious criticism of these drugs have been published. Over 40,000 reports of adverse effects from Prozac alone have been submitted to FDA since it was first marketed. No other drug comes close.

Modern brain imaging techniques allow noninvasive examination of neural function in patients with mental health disorders. With some disorders it appears the proper imaging equipment can reliably detect neurobiological problems which correlate with a specific disorder.

The specific imaging techniques, magnetic resonance imaging studies or other, ought to be mentioned in the text. For the moment suffice it to say that, for instance, the blood perfusion that can be seen with the imaging techniques is not considered a biological marker in the medical profession. “Biological marker” is physiopathology, histopathology or the presence of pathogen microorganisms in the patient. Andreasen and the psychiatrists recognize that they cannot demonstrate any of these true biological markers that they postulate in the 374 human behaviors classified in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-IV. If they could do it, psychiatry as a specialty would have disappeared and its body of knowledge would have merged in neurological science.

Another source of data indicating a significant biological aspect of some mental health disorders is twin studies. Identical twins have the same DNA, so a carefully constructed study can determine the degree to which genetics influences the development of a particular mental health disorder.

When co-twin stdies have been examined by critics, it appears that schizophrenia is a folie a deux, or some variation of shared paranoia where each twin plays a central part in the other’s delusional system, as pointed out by D. Jackson and others since the 1960s. The entire genetic studies in biopsych are a muddle. Critics contend that most of these studies are not solid and that there is sophistry in the way inferences are drawn from data (the reason is that bio-shrinks are aprioristically convinced that there must be a genetic cause for unwanted behaviors). Biopsych claims, based mainly in family studies, cannot disentangle the potential influences of genes and insulting environment. The claims are also based in small methodologically-flawed twin studies whose results can be explained by non-genetic factors. “Not surprisingly, then, years of efforts to find genes for mental disorders have come up empty”. These are words that appear in a book released this January [19].

Biologic treatments of mental health disorders is not limited to drugs. Non-drug biologic treatment diet and exercise modifications, or in some severe cases transcranial magnetic stimulation or electroconvulsive therapy.

This is truly amazing. Please read the section about electroshock in the Anti-psychiatry article. In my clinical experience I personally know people who have lost vital memories after the so-called electroconvulsive therapy.

Before treatment can begin for any mental health disorder, correct diagnosis is crucial. This is because treatments that are effective for one condition might make a different condition worse. In other cases apparent mental health disorders could be a side effect of a serious biological problem (e.g, concussion, brain tumor, hormone abnormality) requiring medical or surgical intervention.

Once again this is extremely misleading: it is confusing neurology with biopsych. I reiterate: there are no known biological markers in the profession. In September 2003 the American Psychiatry Association itself acknowledged that “brain science has not advanced to the point where scientists or clinicians can point to readily discernible pathologic lesions or genetic abnormalities that in and of themselves serve as reliable or predictive biomarkers of a given mental disorder or mental disorders as a group […]. Mental disorders will likely be proven [my emphasis] to represent disorders of intracellular communication; or of disrupted neural circuitry.”

In other words, there is no evidence that mental disorders are biological.

SSRIs, Lithium salt, Haldol, Prolixin, Trilafon, Risperidone, Seroquel [...]. An important point in modern history of biological psychiatry was discovery of modern antipsychotic and antidepressant drugs. Thorazine, an antipsychotic, was first synthesized in 1950, and [...]

Lithium and the neuroleptics produce even more serious adverse effects than antidepressants. Users develop Tardive dyskinesia and Akathisia after taking such dangerous drugs. This must be mentioned in the article.

Recent research indicates a biological "final common path" may exist which both electroconvulsive therapy and most current antidepressant drugs have in common. These investigations show recurrent depression may be a neurodegenerative disorder, disrupting the structure and function of brain cells, destroying nerve cell connections, even killing certain brain cells, and precipitating a decline in overall cognitive function.

Another unsupported claim, already addressed above. Patients with purely psychological problems falling into the hands of bio-shrinks will not be helped: they will merely be tranquilized. The psychiatric drugs or ECT will suppress and cover-up the symptoms but will not affect the underlying, existential disorder.

Increasing evidence points to various mental health disorders as a neurophysiologic problem which inhibits neuronal plasticity.

Once more, misleading the reader. That DSM disorders are neurological is not even claimed in the DSM-IV itself!

Lastly, by identifying the neurobiologic "final common path" into which most antidepressants funnel, it may allow rational design of new medications which target only that final common path. This could yield drugs which have fewer side affects, are more effective and have quicker therapeutic onset.

This looks like a futuristic statement (and as such violates Wikipedia’s policies). —Cesar Tort 00:06, 17 April 2006 (UTC)

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I respect that you have strong feelings against the article Cesar, but it seems you have not listened to the above statements made by JFW, Joema, Ande B, or myself. Furthermore, it seems you have searched the Wikipedia policy pages for random policies (taken out context) to support the pushing of your own agenda. You have not been able to contribute anything constructive to the article by tearing it apart in the above spiel. It seems that arbitration will inevitably be needed. For the time being, I am going to remove the neutrality tag. If you wish it to be reinstated, make your reasons clear, and furthermore, please start a vote to find a consensus for whether or not it should even be there at all. 24.147.141.127 00:48, 17 April 2006 (UTC)