Talk:Psychiatry

About my remove

too influenced by ideas from medicine causing it to misunderstand the nature of mental distress

@Talpedia It is a speciality of medicine, you meant by other specialities? Most critics I've read are the opposite: that it lacks what all other specialities of medicine have: diagnoses are subjective, biochemical explications for mental disorders lacks replicability and that diagnosis criterias are mostly empirical and arbitrary, in short that is not EBM; (or that it is justification for social control). I think this goes against most critics (I also did not find something similar from my glance at your cite but you may have reformulate).

its use of drugs is in part due to lobbying by drug companies resulting in distortion of research

Your quote from the source does not says that it distorts research.Hploter (talk) 21:38, 31 July 2022 (UTC)

Your quote from the source does not says this may well be a bad summary. I'm open to a suggestion of better wording - and would look into making one now, but am doing other things. In general this sort of distortion works by changing *what* is researched rather than the outcomes, so for example people might be more inclined to look for drug based interventions than social ones. To be clear, I have not seen good evidence that proves or disproves this, rather the source asserts that people make these criticisms.

lacks what all other specialities of medicine have my thoughts on this are it *wants* well-defined diagnoses with biological causes that can be addressed with general interventions. It doesn't necessarily want complicated psychological models that are difficult to test with multiple specific interventions. In trying to fit its interventions into this framing it at time fails (e.g. misdiagnoses, people moving between diagnoses, receiving multiple medications. But... I think the source sort of says "ignores psychological and social explanations bececause they don't find into the model". Basically if it didn't pretend that it had diagnosis and treatments all the time it might have better interventions.

BTW the source is open access so would could look at the some context for the quotes for different summaries and better wording. Also I found this paper as a reasonable good secondary source summarizing critiques from psychiatrists, but there may well be better sources out there: we should uses WP:BESTSOURCES. The author is potentially a bit biased being critical of some psychiatric ideas herself, but that doesn't necessarily undermine the scholarly standard. There are also potential WP:DUE arguments if we found some other sources that had different focuses

Talpedia (talk) 22:18, 31 July 2022 (UTC)

The dominant view, even among its critics, is that the nature of psychiatric disorders is in fine biochemical (see Type physicalism), and that we can study them with neurology and neuropsychiatry (medicine). They're misunderstood, because of the difficulty and lack of medical study, not because of its influence. Hploter (talk) 11:26, 1 August 2022 (UTC)

I'm not sure that above is really in conflict with a physicalist viewpoint. Critics viewpoint would be that speech influences "thought" which in turns influences the biochemical function of the brain. The assertion would be that the best way to understand the brain's function might be through social and psychological constructs (and potentially those of the patient) rather than neurological ones. The analogy would be between particle physics and thermodynamics. No physicist really disagrees with partical physics, and yet they might still argue that the concept of temperature and thermometers are useful tools.

I don't really disagree that massive advances in Neusopsychology could be useful for treating a range of psychiatric and psychological disorders. But I don't think that's at odds with the idea that the underlying assumptions and practices of medicine are at times an ill-fit for addressing people's thoughts and behaviours.

Of course, here we are only saying that some notable people have made these criticisms and that it is WP:DUE. I might dig up some sources describing this sort of thought a little later but for now both Anti-psychiatry and Controversies about psychiatry will cover some of it. Talpedia (talk) 12:55, 1 August 2022 (UTC)

The assertion would be that the best way to understand the brain's function might be through social and psychological constructs (and potentially those of the patient) rather than neurological ones

That's better said. A reductionist / medical approach ignores its external causes, so social environnement approach is needed. But Psychiatry already do that so I think it is a minor view and doesn't belong at first or even in a summary. Hploter (talk) 15:29, 1 August 2022 (UTC)

But Psychiatry already do that I agree that there has been some acceptance of psychosocial interventions within psychiatry, especially with the rise of multidisciplinary teams. I still suspect more psychologists would view psychiatry as "overly biomedical" and for certain diagnoses (e.g. psychosis) the diagnosis is still entirely biomedical (though psychology doesn't really have any tested interventions...). Perhaps some of this critique is out of date. I know that psychiatry differs between countries in terms of how much psychology gets pulled into psychiatry.

I've added some material that discusses how psychiatry has embraced anti-reductionism itself from a paper. Talpedia (talk) 18:19, 1 August 2022 (UTC)

It has been argued that psychiatry confuses disorders of the mind with disorders of the brain that can be treated with drugs

Double argues that most critical psychiatry is anti-reductionist

We should put valid criticism instead of dualist pseudo-scientific view that one guy said.

The section should be overhauled. IMO we should summarise the controversies article (which is good content IMO) with the structure of this draft (french): https://fr.wikipedia.org/wiki/Discussion:Psychiatrie#Critiques_2 and some scholars.

(a critic section was once removed, maybe this was good content and we should look at the archive) Hploter (talk) 08:49, 2 August 2022 (UTC)

pseudo-scientific I mean... it's a contextualised quote from the british journal of psychiatry that is anti-critical-psychiatry and adds your argument that psychiatry has already internalised the critiques of critical psychiatry. We are getting a little niche here... so I wouldn't necessarily expect systematic reviews. I don't think it's pseudo-scientific or dualist, arguing that social constructs exists is not so say that mind exists separately from the brain. Do you like the second sentence, and do you think we should include response to the critiques of psychiatry?

I mean everything always needs "an overhaul". The french version looks like a very short version of the longer controversies article. I have no issues with starting to expand this section out here in a similar way... but also don't see much wrong with the summary as it stands with a link to the full article. Talpedia (talk) 09:19, 2 August 2022 (UTC)

It's in the paper which is an argument for WP:DUE. But I guess would agree that there should be additionally information on psychiatry's adoption of psychosocial models along with this content.

If we could find other sources that talk about controversy surrounding psychiatry (and perhaps give defences) it might be easier to assess WP:DUE... Talpedia (talk) 16:40, 1 August 2022 (UTC)

for certain diagnoses (e.g. psychosis) the diagnosis is still entirely biomedical

It's not, it's behaviour assement. Hploter (talk) 17:18, 1 August 2022 (UTC)

Sure the diagnosis is behavioural but the hypothetical theoretical causes are mostly biological as are the treatment modalities. Talpedia (talk) 17:33, 1 August 2022 (UTC)

Throwing in some other sources. This looks interestin for contextualization / defence from within psychiatry (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684769/)

The collection of essays "Philosophical issues in psychiatry" probably lets us go deep into these issues.

Here is a course offered by the royal college of psychiatry (uk's professional body for psychiatrists) teaching a course by one of the author of the paper on the same topic. Talpedia (talk) 17:08, 1 August 2022 (UTC)

doesn't belong at first I've reordered the clauses in the sentence so that it appears last. I have no particular preferene for the order. My take is that if it's in a section on controversies and the end of the article and people are still arguing it at the moment then it probably belongs - but I've added contextualization to anti-reductionist critiques to the section. Talpedia (talk) 18:34, 1 August 2022 (UTC)

Psychiatry as a religion

I think in this article psychiatry is coming off far too much like a religion. The way it is presented almost makes it sound as medicine has taken advantage of modern dismissiveness towards religion to institute its own religion clothed as science. It also makes it sound as though medicine has been introducing a new, self-serving morality (don't be selfish, don't be suspicious, don't be a contrarian, etc.) and using thought-policing and its exclusive control over the drug supply to grow increasingly more powerful and wealthy.

I would like to echo some of the earlier comments on this article, namely:

(1) people should not be provided accurate information merely because it may prevent them from being exploited when it comes to medicine,

(2) information alone can be dangerous, because people may accept information uncritically which is a bad thing unless the information is coming from government-sanctioned sources,

(3) what information people receive should be decided upon by government-sanctioned individuals, who should have the right to decide what harm is and is not likely to occur in the future.

To illustrate the point, the article talks about mental diseases that across Wikipedia are described as typically having no objective criteria. Meanwhile, psychiatric therapies are known to have very real, objective negative consequences. This would seem to insinuate that the only actual reliable/objective finding of most psychiatric experiments is how much damage the therapeutic is causing, and whether it is quick and painful or slow and painful. In turn, this suggests that doctors practicing involuntary psychiatry are simply modern-day torture-masters who have grown increasingly adept at using expensive procedures to subdue and exploit vulnerable individuals for their personal and collective gain.

However, I'm sure that most psychiatrists would agree that the fact that most of psychiatry's modern and historic treatments resemble torture is purely coincidental (the fact that the UN has labelled them as such obviously notwithstanding). To suggest that surgically removing or using medications that shrink a person's brain matter, restraining a person's movement, isolating them from friends and family and restricting their access to nature, exercise, sunlight, healthy produce and sex is as bad for a person's health who has been involuntarily diagnosed with a mental disease as it would be for someone who hasn't is pure fancy.

I do like the fact that this article doesn't make mention of the sexual assault that has been documented to run rampant throughout psychiatric medicine, particularly by the psychiatrists themselves, as that may dissuade people from relying on them. Similarly, it's also probably best that there continues to be no reference of the recent and publicly published studies of patients that had metal electroshock wires inserted into their brains, some of whom were sexually stimulated in this fashion, while being studied, as many of these subjects are involuntary (under the doctrine of third-party consent as opposed to consent in the older sense).

However, besides that, it seems like the article could do with a lot of work. I'm not quite sure how to start fixing it but maybe it could be opened it by emphasizing that involuntary medicine is real and that a medical education gives a psychiatrist the power to see into people's minds with sufficient accuracy to diagnose the person with a permanent illness. I've personally benefited greatly from the powers of psychiatry but perhaps some more of the psychiatric fraternity could chime in as I'm sure they will give us their even-handed, professional opinion. 91.129.101.175 (talk) 15:42, 27 November 2021 (UTC)

@91.129.101.175 Seeing as no-one else has weighed in on this yet, I'll take a stab. Because the goal of involuntary treatment is to establish within a person health that is ongoing but is not actually of the person's own volition (and so can have no relation to the person's virtue per sé), it may be important to take special care to pre-empt any inferences that the unsophisticated reader is wont to draw between this and Satanism ("attempting to summon the Devil"):

It almost goes without saying that even if, by coincidence, modern psychiatric illnesses correlate with historical negative Jewish stereotypes - sociopathy with being selfish, anxiety disorder with being neurotic, schizophrenia with putting one's faith in myths, etc. - the Bible is not factual and so is to be disregarded: the allusions to it are meaningless. Mental illnesses may not have any objective criteria and there may not be any empirical proof that the mind outright exists *per sé* but psychiatry is nevertheless a real and legitimate science.

While the objective of treatment is to make a patient less neurotic and less fraught with delusions, without suffering from side effects of the therapeutics - with the hope that the person may be assistive in turn of how such a state of ongoing health may be achieved by others - involuntarily producing in a societal outcast such a charismatic, obsequious, physically-supreme "symbol" is a far cry from ritual sacrifice as psychiatrists are good people - who are simply following what the science dictates.

Simply put, psychiatry works. Yes, Buddhism may have recorded the world's happiest people. However, it is not practical to simply let Buddhist philosophy guide how society treats aberrant behavior or for how people with unsettled minds may gain control. For one thing, Buddhism precludes the ingestion of mind-altering substances (never mind their forcible administration), and such a level of tolerance for idiosyncratic behavior would likely leave the law alone to be responsible for deciding who may or may not grace our streets.

Whatever religion it is one considers (including a worship for ICCPR Articles 18 & 19, "everyone shall have the right to freedom of thought, "no one shall be subject to coercion which would impair his freedom to ... adopt a ... belief of his choice" and so on), the church must be kept separate from the state and academia's scientific evidence has consistently shown that psychiatry - psychoactive chemicals, electroshock and psychosurgery along with therapy sessions and/or the restriction of freedoms - is effective.

Perhaps we could add a note somewhere like this:

The goal of psychiatric medicine, and involuntary medicine in particular, is to address the symptoms of mental illness such as to provide a subject with persistent and stable health. However, while force may be involved (and at such times death may even occur), this should not be considered a blood ritual, to which it is distinct. 46.131.38.206 (talk) 08:47, 20 April 2022 (UTC)

Scientologists

I agree that the discussion of scientologists in anti-psychiatry can often be a little distracting. They do appear to have been *historically* relevant to the movement. See for example: https://en.wikipedia.org/wiki/Thomas_Szasz#Relationship_to_Citizens_Commission_on_Human_Rights, but I guess history isn't so relevant in this article. Also I don't know how much work the Citizens Commission on Human Rights does... Talpedia (talk) 08:39, 1 August 2022 (UTC)

High incidence of psychiatric patients being raped

I like that we've now got a consensus going on the "Psychiatry as a religion" discussion but honing in on one point mentioned there, namely: how psychiatric inpatients are raped at an extremely high incidence - and if I recall correctly there was also a UK study where a large percentage of psychiatrists admitted to raping patients explicitly for the patients' perceived benefit. By rape, I'm specifically referring to genital rape as opposed to brain rape (i.e. invasively stimulating the nerves higher up in the nerve pathway, or attempting to invasively exert coercive another person's brain generally), which the UK study I believe did not bother enquiring about.

While I know we're dodging a bullet by avoiding including it in the article, is there a way to make the omission less striking? We haven't gone into conservateeship here in the Criticism section either but maybe we can give it a mention instead without explicitly going into the thirteenth amendment implications.

Again, I'm not saying we upset the careful line we're treading but if we want to keep not mentioning (a) gender dysphoria, gender affirming care, detrans & the separation of children from anti-trans parents, (b) progressively increasing rates of suicide amongst those being subjected to modern psychiatric treatments, (c) schools which taze special needs students, (d) failures of drug studies to be conducted on the same timeframe to which they are recommended to be prescribed (i.e. lack of follow-up studies) and various other "hallmarks of pseudoscience" (failure to provide controls using spurious reasoning, gathering results that are inherently subjective but are in this case subjective explicitly on the part of the person who is supposed to be impartially running the study), (e) the insane and selfish geopolitical critiques about psychiatry as being a parallel hegemonic one-world government that gave the Marxist East a foothold in each country in the otherwise democratic West which was then leveraged as "wokeness" to bring the West to heel in the space of a few short years, (f) the so-called "addictive" nature of pharmaceuticals and they're "common failure" to produce any result other than symptoms of mental disease (leading to that old fallacy that mental illness doesn't actually have a biological root in hormone imbalances), (g) the failure of psychiatry after many decades and billions of dollars invested to "find any objective markers of most mental diseases whatsoever" (i.e. diagnoses continuing to be unfalsifiable by those subjected to them despite, as the article rightly points out, psychiatry trying very hard to make their diagnoses falsifiable - even if they haven't necessarily made any visible progress in the last half-century or whatever), (h) the incompatibility of psychiatry with almost every other major religion (and involuntary psychiatry especially), (i) the (probably coincidental) ideological similarities and common motifs shared between modern psychiatry and what a Jew would explicitly describe as Satanism, (j) involuntary deaths frequently caused by forced psychiatric therapies and professional liability insurance and laws protecting from recourse against it amounting to a "license to kill," (k) the difficulty of a person generally to seek legal recourse once they have been targeted by it, getting put on treatment before an appeal, having one's body controlled by the people one is suing, indefinite limits on incarceration, bla bla (l) the use of "This person is encouraging others not to take their meds!" as a dog-whistle and quirky silencing tactic illegalizing so-called legitimate concerns raised about psychiatry, especially on harms experienced by people taking their meds, (etc.) including in the Criticism article itself, we should probably throw a bone to the critics, just making sure it's not a big one IMO.

In short, I don't think we're doing a good enough job drawing away from framing psychiatry in constitutional, human rights, political, criminal, religious or (conventional) health grounds, and so my thought is if we're going to include the Criticism section at all we throw in another sentence or two that keeps the same tone but really paints one or two standard objections in the proper light.176.46.113.248 (talk) 07:57, 9 August 2022 (UTC)