Debunking Denialism

Defending science against the forces of irrationality.

Category Archives: Anti-psychiatry

The Anti-Psychiatry Propaganda of Nathan Shachar

The Anti-psychiatry propaganda by Nathan Shachar

Dagens Nyheter (the largest morning newspaper in Sweden) continues to promote pseudoscience. Last month, the newspaper decided to publish a full-page anti-immigration ad with flawed equivocations, ignorance of confounders and the deceptive framing of published statistics. Out of the ashes into the fire, Dagens Nyheter decided to publish a column filled with anti-psychiatry propaganda by Nathan Shachar. He has previously come under fire for his ignorant ADHD denialism, where he fear mongered about the side-effects of ADHD medications, butchered the complex etiology of ADHD and misrepresented scientific reports on ADHD rating scales.

In his latest pseudoscientific screed, Shachar continues to recycle common anti-psychiatry myths. He claims that the FDA and the Swedish counterpart (Medical Products Agency) is bought by pharmaceutical companies, but the FDA charges pharmaceutical companies to ensure fast and high-quality drug review process. He asserts that modern psychiatry holds that all psychiatric conditions are caused by “chemical imbalance”, when the scientific consensus position is that they result from a complex interaction between biological, psychological and social factors. Shachar makes a false comparison between “pure amphetamine” and ADHD medication, completely without insight that it differs in chemical nature, dosage and release rate. He bases his case against modern psychiatry on the writings of Janne Larsson, a member of the Scientology-based organization Citizens Commission on Human Rights (CCHR). Counter to the myths promoted by Shachar, several large-scale meta-analysis has found that antidepressants are more effective than placebo even when you take publication bias into account. He continues by showing that pharmaceutical companies sometimes behave unethical, but that is an issue of corporate ethics, not the science of psychiatry or the efficacy of psychiatric medication. Finally, he dismisses ADHD as merely a “maturity” issue, despite the well-known biological underpinnings of the condition. Read more of this post

Being Transgender is Nothing Like Having a Psychotic Napoleon Delusion

Transgender and Napoleon

There are some assertions about reality that are so wildly out of touch with scientific evidence and rational thinking that is extraordinarily difficult to grasp why some people consider them even remotely sound. Presumably, the maelstrom of blind ignorance, breathtaking stupidity and ingrained ideology engulf them and force a complete disconnect from any sensible view of the world. Despite considerable efforts, these individuals are typically highly resistant to correction.

One such assertion that keeps getting resurrected and regurgitated no matter how hard it has been bombarded to shreds is the flawed notion that being accepting towards transgender individuals or providing hormone-replacement therapy and gender reassignment surgery is akin to supporting the psychotic delusion of someone who believes himself to be Napoleon. Here are just a few recent examples of this problematic trope:

Pretending that a man who thinks he’s a woman really is one is like giving a man who thinks he’s Napoleon an army with which to invade Russia.

To make the claim that everyone in society has to take part in their hallucination is akin to opening the doors of the mental hospitals and having to recognize that everyone that thinks they are Napoleon are actually Napoleon. They are mentally dysfunctional – treat THAT.

GID patients have a mental illness and society should be looking into ways to eradicate that mental illness through some form of treatment that isn’t the equivalent of giving a paranoid schizophrenic who thinks he’s Napoleon a bicorn hat and a saber.

Treating a man as a woman would be like catering to the delusion of a paranoid schizophrenic. Their hallucinations aren’t real, and pretending they are doesn’t actually help the person.

…and so on ad nauseam.

However, even a cursory understanding of the relevant scientific background makes it painfully obvious that being transgender is nothing like having a psychotic Napoleon delusion. Read more of this post

Scientific Reality Versus Anti-Psychiatry: Once More Unto the Breach

Related: Entertaining the Denialism of Yet Another Anti-Psychiatry Troll.

anti-psychiatry

Why should scientific skeptics care about refuting anti-psychiatry? Compared with other forms of pseudoscience, such as creationism or climate change denialism, anti-psychiatry has received considerably less skeptical attention. Yet anti-psychiatry is a dangerous pseudoscience that causes real harm. Like alternative medicine quacks, anti-psychiatry exploits vulnerable people and by denying the existence of psychiatric conditions or dismissing them as harmless, proponents of anti-psychiatry deny the suffering of human beings.

After debunking the claims made by the anti-psychiatry proponent Tin, this person continued to make a long list of assertions about psychiatry. When your opponent blasts you with multiple, long texts, it is very difficult to ensure that you responded to every single assertion (I am sure I accidentally missed some in this post, and I’m sure I will be hearing about it too). To a certain extent, that is the goal of this kind of shotgun approach (sometimes called the Gish Gallop in honor of the young earth creationist Duane Gish who frequently used this technique): make as many flawed and unsupported assertions as possible in an attempt to overwhelm the opposition. If any claim is forgotten or not decisively refuted due to time or space, declare victory. This is also related to what is known as the asymmetry of pseudoscience: it takes a few seconds to make a pseudoscientific claim, but anywhere from ten minutes to several hours to research and refute one of the claims in detail. In that sense, scientific skepticism is always an uphill battle. However, once the refutation is out there online, anyone who comes across a similar claim can find it with a search engine and review the material in the references. So although I have little hope that the arguments and evidence I present will convince a ingrained anti-psychiatry proponent, it is still worth doing. Read more of this post

Entertaining the Denialism of Yet Another Anti-Psychiatry Troll

anti-psychiatry category

Out of all the pseudoscience that are criticized on this website — from creationism and the anti-vaccine movement to anti-GM sentiments and alternative medicine — no subject has attracted more malicious attention from denialists trolls than the articles refuting anti-psychiatry. I often respond and end up in never-ending debates where they simply repeat the same arguments over and over again despite having had their errors explain to them in great detail with references to the scientific literature. When they fail their misguided war of attrition, they resort to verbal abuse by calling me fascist, pig, dickhead, Führer etc. and claim that I must consider individuals with mental conditions who receive evidence-based treatment to be “roadkill” (I do not). After a while this comes very tiresome, so those individuals have their comment privileges removed for violating the comment guidelines. However, they do not let this stop them from spouting their nonsense. They simply use proxies, new names and email addresses to continue with their behavior (while keeping the assertions exactly the same). Some even try to impersonate me. I ban the new identities or turn off comments. This makes things calm down for a while, but it starts back up again the next time I publish a post debunking anti-psychiatry.

Recently, a previously banned user now going by the name of Tin attempted to post an anti-psychiatry diatribe on an argument describing some common anti-psychiatry archetypes that scientific skeptics are likely to come across when they take on anti-psychiatry proponents online. Although using a new name and IP, he still used the same email address as he did when he was banned the first time, thereby giving it away and so the comment got caught by the spam filter. Usually I would not bother to write anything about it and just empty the spam queue, but some of the claims he made in that comment was absurdly wrong on so many different levels that it could be useful for other scientific skeptics to have access to a detail refutation of those assertions.

In his comment, Tin confuses a debate about the scientific details with a debate on the validity of the entire field and tosses in appeals to false balance. He also makes a number of other flawed arguments, such as calling Psychology Today an academic journal, when it is really just a magazine and blog website. He also asserts that antidepressants are not better than placebo despite the fact that meta-analyses taking publication bias into account show that they do outperform placebo in a clinically significant way. Tin even fails to understand that ICD-10 also has an ADHD diagnosis and that ADHD is diagnosed outside the U.S. Finally, the five papers that allegedly show that anti-psychiatry is based on evidence either do not support his position, directly contradicts his position or is irrelevant to the discussion. The rest of this article examines those anti-psychiatry claims in additional detail. Read more of this post

Nathan Shachar and ADHD Denialism

Nathan Shachar and ADHD Denialism

Nathan Shachar is a Swedish author and editorial columnist at a large Swedish newspaper called Dagens Nyheter. For his essay writings on South America, he was awarded the Gerard Bonnier’s prize in 1998. He is also a long-time proponent of anti-psychiatry, claiming that the entire category of breathing-related sleep disorders is nothing more than an attempt to pathologize snoring. In reality, it includes conditions ranging from chronic snoring to obstructive sleep apnea. On top of this, he states that opposing structural sexism and racism in society is akin to “living in a temple of orthodoxy” and “bullying dissidents”. Needless to say, he has a history of playing fast and loose with empirical evidence and rational thinking.

His recent opinion piece promoting ADHD denialism in the Swedish newspaper Östgöta Correspondenten is no exception. He regurgitates many of the classic anti-psychiatry conspiracy theories about psychiatrists being shills for evil pharmaceutical companies and claims that the media and the school system have been “seduced by the siren song of the medicine men”. His choice of phrasing betrays a deep mistrust and contempt for psychiatry. Throughout his article, he presents six different false and/or misleading statements. He claims that the mainstream scientific model for ADHD is “circular” and “contradicts all scientific logic” because it attempts to go from symptoms to causal processes. He apparently does not understanding that this is the general case with any medical condition, whether psychiatric condition, autoimmune or infectious disease. He grossly misrepresents a report from the Swedish Council on Health Technology Assessment (SBU), spreads fear mongering about the side-effects of ADHD medications, ignores research on executive function in ADHD and references a medical doctor who has never published anything on ADHD in the scientific literature. Read more of this post

More Creationist Anti-Psychiatry at Answers in Genesis

Related: Some Common Anti-Psychiatry Archetypes, Creationist Anti-Psychiatry: The Worst of Two Worlds.

Creationist anti-psychiatry

Creationist anti-psychiatry is a grotesque chimera that combines the unrelenting presuppositional dogmatism of biblical creationism with the rejection of the mainstream scientific account of the risk factors, nature and evidence-based treatments of psychiatric conditions. These individuals are typically substance dualists and subscribe to contra-causal free will, so they cannot accept that brain processes have any profound relevance to the mind. Also, since mainstream evidence-based treatments do not focus on original sin, proponents of creationist anti-psychiatry consider them to be flawed and misleading. This results in the nearly complete dismissal of psychiatry and even clinical neuroscience in general. Debating tactics deployed by anti-psychiatry creationists includes confusing mental health professionals (such as licensed psychiatrists, licensed psychotherapists and licensed clinical psychologists) with quack treatments by “therapists” (a title anyone can use) and misrepresenting psychotherapy as the wholesale rejection of personal responsibility.

The irrational and anti-scientific approach of anti-psychiatry creationism can be found in a post written by Steve Ham that was recently posted on the Answers in Genesis website. Ham rejects the mainstream scientific account of psychiatric conditions, labels them as “spiritual issues”, claims that many psychiatric diagnoses do not correspond to an actual condition (mental illness denial) and asserts that ten cases studies show that biblical scripture is sufficient to treat psychiatric conditions. He promotes the evidence-free notion of biblical presuppositionalism and claims that the efficacy of psychiatric treatments is a “worldview” issue and not a clinical issue. He also supports giving false scientific information to clients so they can summarily dismiss anything their mental health practitioner tells them. In addition, Ham trouts out the classic anti-psychiatry straw man that psychiatric conditions are only related to “chemical imbalance” and he also misrepresents a number of psychiatric diagnoses such as intermittent explosive disorder and oppositional defiant disorder and claims that sinful thoughts are risk factors for psychiatric conditions. He even takes a shot at science-friendly Christian counselors who attempt to bring in real science into their sessions. Read more of this post

Some Common Anti-Psychiatry Archetypes

Debunking anti-psychiatry

The anti-psychiatry movement resembles the anti-vaccine movement and HIV/AIDS denialism in many ways. Whereas anti-vaccine cranks claim that vaccine-preventable diseases are not that bad and HIV/AIDS denialists often deny the causal link between HIV and AIDS, anti-psychiatry cranks typically deny the existence of mental conditions outright (claiming they are made up or that they are “natural” states) or blame the individuals for “attracting” the illness into their lives with “too much negative thinking”. All three groups attack the underlying scientific models (e. g. mechanisms for vaccine-induced immunity and herd immunity, that HIV cause a reduction in CD4+ T helper cells, the biological basis and neurological mechanisms of mental conditions), the efficacy of the medical product, pharmaceutical companies, the government and the scientific community.

This post is an attempt to summarize seven of the most common clusters of characteristics, beliefs and approaches taken by various types of anti-psychiatry cranks: the creationist, the alt med zealot, the new age ignoramus, the “sophisticated” mysterian, the selective “skeptic”, the conspiracy lunatic and the scientologist. These archetypes are not based on published scientific studies, but rather on experience with debating anti-psychiatry cranks. Some of them overlap and not all features of a given archetype always occur. An interesting observation is that anti-psychiatry can be found across political, religious and philosophical spectra and divides. Even though a lot of the assertions made and rhetoric deployed is consistent across archetypes, different archetypes have different motivations and a slightly different focus.

The Creationist: the anti-psychiatry creationist represents the worst of two worlds: both a rejection of modern cosmology, geology and biology as well as a rejection of modern neuroscience, psychology and psychiatry. These individuals reject psychiatry and related fields because (1) neuroscience considers the mind to be a function of the brain, which is incompatible with the anti-psychiatry creationist’s faith that an immaterial soul is the entity responsible for the mind and (2) treatments of mental conditions does not involve a consideration of original sin, but focuses on medication and therapy. Although not all creationists are anti-psychiatry, those that are reject additional fields of science in order to keep their religious beliefs afloat. Depending on the individual anti-psychiatry creationist, he or she may reject the existence of mental conditions as medical conditions or go so far as to provide a religious description of mental conditions as demonic possessions or gifts from a deity.

The Alt Med Zealot: the alt med zealot embraces anti-psychiatry because he or she wrongly believes in the efficacy and safety of so-called “alternative” treatments for mental conditions. In reality, these alleged “treatments” are quackery and almost never gives any practically significant benefit above placebo. Most of the time, these individuals accepts the medical reality of mental conditions. However, they tend to shuns positions supported mainstream science, usually by ignorantly dismissing it all by shouting about “evil, multinational pharmaceutical corporations” (apparently without realizing the irony that a lot of “alternative medicine” is being produced and sold by large corporations) and accusing all critics of their beliefs of being pharma shills. Read more of this post

David Brooks: Not Beyond Neuroscience Denial

Related: The Failure of Mysterian Complaints about Neuroesthetics, Naive Philosophical “Criticism” of Reductionism in Science

David Brooks and Neuroscience

Through the shining light of rational science, most reasonable people have stopped attributing epidemics of infectious diseases and natural disasters to deities or demons. Instead, they have come to accept the scientific reality of disease-causing microorganisms and natural processes such as earthquakes and tropical cyclogenesis. Again and again, scientific explanations have replaced alleged mystical or religious claims in fields as diverse as cosmology, astronomy, geology and biology. Although mysterian beliefs about the world has largely cracked under the evidence and retreated from the natural sciences, some people still cling to the misguided notion that the human mind exists independent of and above-and-beyond the brain. These individuals, called mysterians, often come in one of two flavors. The religious flavors rejects mind-brain physicalism because if it was true, that would mean the end of both souls and deities (as they are considered brainless minds). The secular, non-religious flavor rejects mind-brain physicalism because if it was true, they (falsely) believe that it would mean end of moral responsibility, human appreciation of art and beauty, freedom and equality.

Although careful not to go into details about neuroscientific research, journalist and social commentator David Brooks made a similarly unpersuasive case against mind-brain physicalism in his op-ed column called Beyond the Brain. It starts with a straw man of neuroscientific research, claiming that neuroscientists consider it a theory of everything and that humans are viewed as nothing but neurons. It continues to list some important limitations and current neuroscientific research. It finishes off by drawing the unjustified and preposterous inference that these limitations imply that the mind is not the brain.

Scattered through the article are a couple classic anti-psychiatry and neuroscience denialist talking-points, such as the rejection of mind-brain physicalism and the claim that addiction is not a brain disease. Read more of this post

Fraud Psychic Sylvia Browne Promotes Anti-Psychiatry

This blog post continues the skeptical investigation of the unscientific and wildly inaccurate claims that the alleged psychic Sylvia Browne makes on her Facebook page. Previous installments include her denial of the germ theory of disease, her public failure regarding the prediction that Amanda Berry was dead and an analysis of some of the tactics Browne and her true believers use in their promotion and support.

This time, Browne blindly charges into the field of psychiatry and makes the following ignorant claims about the origin of specific phobias (and another case of germ theory denialism as an added bonus):

Sylvia Browne talk nonsense on specific phobias

The number of scientific errors and unsubstantiated claims in these three sentences is gigantic.

The existence of supernatural entities

Throughout her facebook post, Sylvia Browne asserts the existence of a number of supernatural entities such as a creator deity, a holy spirit, a soul. She also makes implicit claims that reincarnation occurs, that deities respond to human prayer and that prayer is an effective treatment of many illnesses and specific phobias.

She provides no evidence whatsoever for any of these and there is therefore no reason to take any of those claims seriously.

Continued germ theory denialism

Brown repeats her germ theory denialism that was refuted in a previous post. Before, she asserted that most illnesses starts in the mind of the individual, but now she apparently thinks that illnesses are the result of cellular memories or subconscious memories from a past life. These two positions are deeply contradictory: do illnesses start in the mind of individuals in this life, or the result of cellular memories from a past life?

Rejection of the mainstream scientific view on specific phobias

Mainstream psychology indicate that factors that influence specific phobias and other anxiety conditions include evolutionary preparedness, genetic risk factors, highly reactive autonomic nervous system, conditioning (both classical and operant), learning by observation and so on (Passer et. al. 2009).

Instead of accepting the science behind phobias, Browne asserts that phobias are the result of subconscious or cellular memories from a past life. However, she provides no evidence that past lives exists in the first place. Read more of this post

Mailbag: More Nonsensical Ravings from an Anti-Psychiatry Troll

email icon

I rarely get email via the contact form, but when I do I like responding to them in the mailbag series. This time, a troll by the curious name of You are a moron (I will henceforth refer to this individual as “Moron” for short) sent me an angry email. I previously declined to publish a comment written by Moron on How Skepchick Rebecca Watson Misuses Statistics that containing anti-psychiatry nonsense and I suspect that Moron is one of the resident anti-psychiatry trolls that has been posting comments for many months through many different proxies to evade bans. Moron tends to use emails such as “dsm@dsmisascam.com” and similar.

For those who wonder if Moron has anything intellectually productive to say, I must be upfront and say that you will be greatly disappointed. The general aim of this post is to (1) demonstrate the breathtaking inanity of some trolls and (2) to expose the specific fallacies and errors in the assertions made by this particular troll.

Kamil, I have been following very intermittently your blog.

Apparently not often enough to get my name right. This is a common tactic used by trolls in order to depersonalize the individual.

You are the prime example of why self proclaimed “skeptics” are perceived as jackasses -whose most likely problem in fact might be a lack of an interesting sexual life.

Notice how Moron decides not to engage any arguments I have made against anti-psychiatry but rather make the assertion that self-proclaimed skeptics are jackasses. However, it does not logically follow that an argument is wrong just because it is presented by a person who is perceived as a jackass. This is the genetic fallacy, where an argument is dismissed because of its origin and not its intellectual merits.

It is also interesting that this troll attempts to condescendingly dismiss scientific skepticism by attempting to associate it with “lack of an interesting sexual life”. This is based on the stereotype of skeptics as humorless and boring men who cannot get laid. In addition, it is a pathetic attempt by Moron to introduce an irrelevant personal aspect (sex life) as a way to rationalize why Moron’s nonsensical ravings are not being taken seriously. Finally, Moron does not present any scientific evidence for the notion that a “lack of interesting sex life” (how should “interesting” be operationalized in this context?) is associated with being perceived as a jackass. Read more of this post

Responding to Incoherent Anti-Psychiatry Drivel

crank comment

A person going by the name of Alan David Anderson decided to post a few comments loaded with anti-psychiatry drivel on an older blog post I wrote. It is a garbled mix of assertions, such as that I am stupid and an ignorant fool, that psychiatrists have worthless educations, that anti-psychotics and anti-depressants are used to euthanize elderly that lack a balanced diet and that people with mental conditions are just obese.

Normally, I would have responded in the comment section of that blog post or just deleted his crap. However, it is the holiday season, I am feeling particularly charitable. Not that I think this will change his mind, but hopefully will give my readers something informative and perhaps something to chuckle at. Also, it is free blogging material for me at a time when I have more important things to do. Therefore, I will give his assertions a fair hearing in a new blog post. As we will see, they do not fare well.

The first comment

Mr. Anderson started his objections to psychiatry by posting the following:

wonderful sight thanks for leting me clear up the fact that you have no education that is legit it in this subject. psychiatrists have worthless educations. psychiatrists drugs are not needed under any circumstances. they give synthetic drugs that resemble things that are naturally produced. why would we need them? you simply do not need them at all. you ignorant fool. you cannot win an argment with me. you HAVE NO EDUCATION ON THE SUBJECT.

Mr. Anderson is correct in that I am not a psychologist, psychiatrist or psychotherapist. I have no formal training in any of these subjects. However, that says nothing about the credibility of the arguments I put forward. Arguments stand on their own evidential and logical merit and their truth does not depend on who puts them forward.

Throughout his three comments, Mr. Anderson makes no effort to engage in the arguments I actually do put forward. This shows an unwillingness to have an honest discussion about the reasonableness of those arguments. Mr. Anderson does not appear interested in a reasoned debate, but rather to spread his bare assertions. Nowhere in his comments does he provide any empirical evidence for his assertions or links to any sources.

Contrary to what Mr. Anderson claims, psychiatrists do not have a worthless education. In the United States, a psychiatrist must first complete an M. D. and then spend four years as a psychiatric resident (American Psychiatric Association, 2012). Thus, psychiatry is like any other medical specialty in terms of educational requirements. This is hardly a “worthless education”.

While mental conditions are not quite as simple as “chemical imbalance”, treatments that modify neurochemistry in individuals with some mental conditions has shown to be very effective. I have written at length about this in other blog posts, such as here and here.

Mr. Anderson calls me an ignorant fool, yet provides no evidence to why we should believe him. He repeats his claim that I have no education on the subject and triumphantly claim that I cannot win an argument with him. Actually trying to convince someone who has sunken so deep into pseudoscience as Mr. Anderson has is very difficult and largely a waste of time. However, my goal here is not to convince him that he is wrong, but to convince fence sitters of the rationality of scientific skepticism and science-based medicine as well as giving supporters of these two concepts useful things to read. Read more of this post

Creationist Anti-Psychiatry: The Worst of Two Worlds

creationist anti-psychiatry

Crank magnetism refers to the discovery that people often believe different forms of pseudoscience at the same time. The classical examples are social right-wing conservatives who are creationist and reject the science of climate change, alternative medicine proponents who promote homeopathy and reject vaccines, creationists who are HIV/AIDS denialists and so on. Maybe the different forms of pseudoscience reinforce each other or maybe they are united in their opposition to the mainstream scientific establishment.

One such form of crank magnetism is creationist anti-psychiatry. It is a strange chimera, as proponents of anti-psychiatry often are secular liberals or social libertarians, who have very little in common with socially conservative creationism. Answers in Genesis published an article on the topic of mental conditions and treatment for mental conditions called Psychology Without Sin by Ernie Baker, a “certified biblical counselor”. The post contains an astounding level of ignorance of psychology and psychiatry and the proposed solution is laughable. Read more of this post

Anti-Psychiatry in the Atheism+ Forum?

balance scale

I find my self slightly unsettled to watch the slow infiltration of anti-psychiatry into the various skeptical movements. This is probably facilitated by political ideology. Some left-leaning liberals have a suspicion of psychiatric medication because they are provided by large multinational corporations. Some libertarians are susceptible to anti-psychiatry because the government helps to finance psychiatric care. This is the kind of situation that made me have careful qualifications about new aspiring social movements in my post Crossing the Chasm. Even though there is a broad agreement on social values, there can be a strong disagreement on what empirical methods are best used to fulfill these values. I am carefully optimistic about Atheism+ and I support many of its values, but I first want to see where the movement is going in practice.

Recently, a thread appeared on the Atheism+ forum discussing mental health issues. Right now, it is just one thread and we should not overestimate the size of the problem. We should also not approach the ideas of a few as if they were a majority position. I am not saying that any particular forum poster is necessarily anti-psychiatry and I am also not saying that Atheism+ has been corrupted by anti-psychiatry. After all, anti-psychiatry proponents can probably be found in every movement. I am also not telling marginalized people to stop telling their stories. With those qualifiers out of the way, I do note that arguments commonly put forward by anti-psychiatry proponents has started to appear on the Atheism+ forum. I do not want to make accusations against any individual poster, but I feel it is important and worthwhile to address the claims being put forward. I could have done it the forum thread itself, but as anti-psychiatry is a topic that this blog covers, I thought I might as well make a blog post about it.

The thread is called Mental Illness Support. It starts out completely reasonable where the opening poster is inviting others for discussing things like how mental conditions affect group participating in the atheist movements and what can be done to help those coping with mental conditions become more involved in the movements. I think these questions are highly relevant. In passing, the opening poster apfergus mentioned that a new medication had been beneficial for him or her. For those of you experienced with debating anti-psychiatry proponents, you know what happens next. Read more of this post

Sisyphean Arguments with Anti-psychiatry Proponents…

In response to the previous article discussing OCD and Involuntary Psychiatric Care, S. P. has decided to post a reply on his blog. He also used different proxies to comment on this blog, despite the fact that his comment privileges were removed several weeks ago because of his constant abusive behavior and unwillingness to address arguments. Unsurprisingly, S. P. engages in multiple personal attacks (calling me a zealot, claiming that I must be mentally retarded, a fascist and a pathetic useful idiot) and rehashing of the same old assertions that have been debunked before. Unlike S. P. I am going to be the bigger person and just address the arguments.

Details are not irrelevant!

It is clear that the personal story of S.P. was an important influence for the origin of his animosity towards psychiatry. In my previous post, I made a provisional conclusion that the story lacked crucial details. The major details S. P. gives us is that he has an exaggerated fear of contracting HIV through usual contact, that he was diagnosed with OCD and that he underwent involuntary psychiatric care in an unnamed European country. However, to investigate whether the decision to commit S. P. for involuntary psychiatric care was justified (an by extension the emotional underpinnings of his position), one needs to know the precise details of the conditions, such as severity and the level of functional impairment, as well as the identity of the European country (to be able to check the laws regulating it).

My general argument was that it seemed implausible that he was subjected to involuntary psychiatric care just because an exaggerated fear. I assume most people have more or less irrational fears: wasps, dogs, clowns, heights, spiders, snakes, lightning and thunder, flying and of course germs. But obviously the majority of people with irrational fears are not subjected to involuntary psychiatric care. The conclusion I drew was that there is more to the story that S. P. has shared. Now, I certainly realize that anxiety issues (as well as other issues related to mental health) are sensitive things and I obviously cannot force S. P. to share if S. P. does not want to. However, this does not change the fact that these questions are very relevant. How severe is the condition? How much functional impairment was there? What are the laws regulating involuntary psychiatric care in the unnamed European country?

Individual freedoms and laws regarding involuntary psychiatric care (Sweden v.s. the U. S.)

S. P. dislikes the Swedish laws that regulates involuntary psychiatric care. To summarize, Sweden require that the patient has a severe psychiatric condition, refuses voluntary care and cannot be taken care of in any other way that around-the-cloak psychiatric care. According to S. P., the U. S. requires that the life of the patient or a third person needs to be threatened. What S. P. fails to grasp is that the third condition in the Swedish law is related to whether or not the life of the patient is threatened, but is more specific and focuses on not being able to take care of him or her self, or by other people. This highlights an important difference between Sweden and the U. S. Sweden has a generous welfare system, but the U. S. generally does not. It boils down to how much do we think that the government should have to care about people.

I find it peculiar that S. P. considers the U. S. to value freedom. Is S. P. aware that the FBI regularly abuses the Patriot Act?

Accuracy of medical testing

I confronted S. P. on his belief that medical tests are generally 100% accurate. S. P. then says that he clearly did not mean 100%, but used a metaphor. I find this hard to believe because the argument is often used by opponents of science-based medicine and metaphor is really a form of analogy, so S. P. is using the term incorrectly. The general message of my argument was that medical tests that are not 100% accurate does not undermine the existence of the condition, or the biological basis of the condition. Read more of this post

Explaining OCD and Involuntary Psychiatric Care to a Denialist

There is a certain anonymous anti-psychiatry commentator who imaginatively goes by the name of Stop.Psychiatry (henceforth S.P.). He has been IP banned twice on this blog because of engaging in irresponsible character assassination, spamming, and repeating same old canards over and over without addressing counterarguments. Predictably, this person has started his own blog, from which he spews his pseudoscience on anti-psychiatry by compiling personal anecdotes, emotional manipulation and arguments that have been refuted thousands of times before. He has made a couple of posts, but most of them are just linking to videos on other websites without much original content. Two posts contain more written text; one of them called “My story” and the other called “Anti-psychiatry is not denialism”.

Let’s critically examine these blog entries and see if they have any merit.

1. The uniting feature of OCD: obsessions and compulsions

The first interesting section of the first entry comes when S.P. talks about his own mental condition:

During most of my adult life I have struggled with a condition that was diagnosed as Obsessive Compulsive Disorder, OCD. The funny thing is that psychiatry dumps into this disorder all kinds of different types of mental distress. In my case it’s an exaggerated fear of contracting HIV through usual contact. However, psychiatry dumps under the same umbrella thinks [sic] such as repeated task checking or number counting. How is that these things are related escapes my understanding.

I empathize with S.P’s situation. Having a mental condition is a serious matter and should not be ignored, mocked or stigmatized. He is brave to talk about his situation. Furthermore, HIV is a virus with potent capabilities for harm, so it makes sense to be fearful of contracting HIV. It makes sense to use protection during sex and screen blood donations for HIV. However, as I have understood the situation, S.P. had or has an exaggerated fear of contracting the virus through usual contact. He does not specify what usual contact he was concerned about or what steps he took to avoid those forms of contact. These details are vital for an accurate understanding of the situation and I wish that he did not leave them out. Perhaps he will discuss them in a later blog post when he feels more comfortable talking about his condition in public.

So what is the connection between repeated task checking, number counting and an exaggerated fear of getting HIV? An OCD condition generally consists of two components (although it is possible for either to occur alone): obsessions (cognitive component) and compulsion (behavioral component). Here is how the Mayo Clinic describes the condition (Mayo Clinic, 2010):

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). With obsessive-compulsive disorder, you may realize that your obsessions aren’t reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your stressful feelings.

Obsessive-compulsive disorder often centers around themes, such as a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped. Despite your efforts, thoughts of obsessive-compulsive behavior keep coming back. This leads to more ritualistic behavior — and a vicious cycle that’s characteristic of obsessive-compulsive disorder.

On the symptom page, they describe it like this:

OCD obsessions are repeated, persistent and unwanted ideas, thoughts, images or impulses that you have involuntarily and that seem to make no sense. These obsessions typically intrude when you’re trying to think of or do other things. [...] OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety related to your obsessions.

Now we can see how these different things tie together: they share in common a pattern of obsessions and compulsions. Read more of this post

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