Why Psychiatry Should Be Abolished

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Why Psychiatry Should Be Abolished

as a Medical Specialty

by Lawrence Stevens, J.D.

 

 

Psychiatry should be abolished as a medical specialty because medical school

education is not needed nor even helpful for doing counselling or so-called

psychotherapy, because the perception of mental illness as a biological entity

is mistaken, because psychiatry's " treatments " other than counselling or

psychotherapy (primarily drugs and electroshock) hurt rather than help people,

because nonpsychiatric physicians are better able than psychiatrists to treat

real brain disease, and because nonpsychiatric physicians' acceptance of

psychiatry as a medical specialty is a poor reflection on the medical profession

as a whole.

 

 

In the words of Sigmund Freud in his book The Question of Lay Analysis: " The

first consideration is that in his medical school a doctor receives a training

which is more or less the opposite of what he would need as a preparation for

psycho-analysis [Freud's method of psychotherapy]. ... Neurotics, indeed, are

an undesired complication, an embarrassment as much to therapeutics as to

jurisprudence and to military service. But they exist and are a particular

concern of medicine. Medical education, however, does nothing, literally

nothing, towards their understanding and treatment. ... It would be tolerable

if medical education merely failed to give doctors any orientation in the field

of the neuroses. But it does more: it given them a false and detrimental

attitude. ...analytic instruction would include branches of knowledge which are

remote from medicine and which the doctor does not come across in his practice:

the history of civilization, mythology, the psychology of religion and the

science of literature. Unless he is well at home in these subjects, an analyst

can make nothing of a large amount of his material. By way of compensation, the

great mass of what is taught in medical schools is of no use to him for his

purposes. A knowledge of the anatomy of the tarsal bones, of the constitution

of the carbohydrates, of the course of the cranial nerves, a grasp of all that

medicine has brought to light on bacillary exciting causes of disease and the

means of combating them, on serum reactions and on neoplasms - all of this

knowledge, which is undoubtedly of the highest value in itself, is nevertheless

of no consequence to him; it does not concern him; it neither helps him directly

to understand a neurosis and to cure it nor does it contribute to a sharpening

of those intellectual capacities on which his occupation makes the greatest

demands. ... It is unjust and inexpedient to try to compel a person who wants

to set someone else free from the torment of a phobia or an obsession to take

the roundabout road of the medical curriculum. Nor will such an endeavor have

any success... " (W.W. Norton & Co, Inc., pp. 62, 63, 81, 82). In a postscript

to this book Dr. Freud wrote: " Some time ago I analyzed [psychoanalyzed] a

colleague who had developed a particularly strong dislike of the idea of anyone

being allowed to engage in a medical activity who was not himself a medical man.

I was in a position to say to him: 'We have now been working for more than three

months. At what point in our analysis have I had occasion to make use of my

medical knowledge?' He admitted that I had had no such occasion " (pp. 92-93).

While Dr. Freud made these remarks about his own method of psychotherapy,

psychoanalysis, it is hard to see why it would be different for any other type

of " psychotherapy " or counselling. In their book about how to shop for a

psychotherapist, Mandy Aftel, M.A., and Robin Lakoff, Ph.D., make this

observation: " Historically, all forms of 'talking' psychotherapy are derived

from psychoanalysis, as developed by Sigmund Freud and his disciples ... More

recent models diverge from psychoanalysis to a greater or lesser degree, but

they all reflect that origin. Hence, they are all more alike than different "

(When Talk Is Not Cheap, Or How To Find the Right Therapist When You Don't Know

Where To Begin, Warner Books, 1985, p. 27).

 

 

If you think the existence of psychiatry as a medical specialty is justified by

the existence of biological causes of so-called mental or emotional illness,

you've been misled. In 1988 in The New Harvard Guide to Psychiatry Seymour S.

Kety, M.D., Professor Emeritus of Neuroscience in Psychiatry, and Steven

Matthysse, Ph.D., Associate Professor of Psychobiology, both of Harvard Medical

School, said " an impartial reading of the recent literature does not provide the

hoped-for clarification of the catecholamine hypotheses, nor does compelling

evidence emerge for other biological differences that may characterize the

brains of patients with mental disease " (Harvard Univ. Press, p. 148).

So-called mental or emotional " illnesses " are caused by unfortunate life

experience - not biology. There is no biological basis for the concept of

mental or emotional illness, despite speculative theories you may hear. The

brain is an organ of the body, and no doubt it can have a disease, but nothing

we think of today as mental illness has been traced to a brain disease. There

is no valid biological test that tests for the presence of any so-called mental

illness. What we think of today as mental illness is psychological, not

biological. Much of the treatment that goes on in psychiatry today is

biological, but other than listening and offering advice, modern day psychiatric

treatment is as senseless as trying to solve a computer software problem by

working on the hardware. As psychiatry professor Thomas Szasz, M.D., has said:

Trying to eliminate a so-called mental illness by having a psychiatrist work on

your brain is like trying to eliminate cigarette commercials from television by

having a TV repairman work on your TV set (The Second Sin, Anchor Press, 1973,

p. 99). Since lack of health is not the cause of the problem, health care is

not a solution.

 

 

There has been increasing recognition of the uselessness of psychiatric

" therapy " by physicians outside psychiatry, by young physicians graduating from

medical school, by informed lay people, and by psychiatrists themselves. This

increasing recognition is described by a psychiatrist, Mark S. Gold, M.D., in a

book he published in 1986 titled The Good News About Depression. He says

" Psychiatry is sick and dying, " that in 1980 " Less than half of all hospital

psychiatric positions [could] be filled by graduates of U.S. medical schools. "

He says that in addition to there being too few physicians interested in

becoming psychiatrists, " the talent has sunk to a new low. " He calls it " The

wholesale abandonment of psychiatry " . He says recent medical school graduates

" see that psychiatry is out of sync with the rest of medicine, that it has no

credibility " , and he says they accuse of psychiatry of being " unscientific " . He

says " Psychiatrists have sunk bottomward on the earnings totem pole in medicine.

They can expect to make some 30 percent less than the average physician " . He

says his medical school professors thought he was throwing away his career when

he chose to become a psychiatrist (Bantam Books, pp. 15, 16, 19, 26). In

another book published in 1989, Dr. Gold describes " how psychiatry got into the

state it is today: in low regard, ignored by the best medical talent, often

ineffective. " He also calls it " the sad state in which psychiatry finds itself

today " (The Good News About Panic, Anxiety, & Phobias, Villard Books, pp. 24 &

48). In the November/December 1993 Psychology Today magazine, psychiatrist M.

Scott Peck, M.D., is quoted as saying psychiatry has experienced " five broad

areas of failure " including " inadequate research and theory " and " an

increasingly poor reputation " (p. 11). Similarly, a Wall Street Journal

editorial in 1985 says " psychiatry remains the most threatened of all present

medical specialties " , citing the fact that " psychiatrists are among the

poorest-paid American doctors " , that " relatively few American medical-school

graduates are going into psychiatric residencies " , and psychiatry's " loss of

public esteem " (Harry Schwartz, " A Comeback for Psychiatrists? " , The Wall Street

Journal, July 15, 1985, p. 18).

 

 

The low esteem of psychiatry in the eyes of physicians who practice bona-fide

health care (that is, physicians in medical specialties other than psychiatry)

is illustrated in The Making of a Psychiatrist, Dr. David Viscott's

autobiographical book published in 1972 about what it was like to be a

psychiatric resident (i.e., a physician in training to become a psychiatrist):

" I found that no matter how friendly I got with the other residents, they tended

to look on being a psychiatrist as a little like being a charlatan or magician. "

He quotes a physician doing a surgical residency saying " You guys [you

psychiatrists] are really a poor excuse for the profession. They should take

psychiatry out of medical school and put it in the department of archeology or

anthropology with the other witchcraft.' 'I feel the same way,' said George

Maslow, the obstetrical resident... " (pp. 84-87).

 

 

It would be good if the reason for the decline in psychiatry that Dr. Gold and

others describe was increasing recognition by ever larger numbers of people that

the problems that bring people to psychiatrists have nothing to do with

biological health and therefore cannot be helped by biological health care. But

regrettably, belief in biological theories of so-called mental illness is as

prevalent as ever. Probably, the biggest reason for psychiatry's decline is

realization by ever increasing numbers of people that those who consult mental

health professionals seldom benefit from doing so.

 

 

E. Fuller Torrey, M.D., a psychiatrist, realized this and pointed it out in his

book The Death of Psychiatry (Chilton Book Co., 1974). In that book, Dr. Torrey

with unusual clarity of perception and expression, as well as courage, pointed

out " why psychiatry in its present form is destructive and why it must die. "

(This quote comes from the synopsis on the book's dust cover.) Dr. Torrey

indicates that many psychiatrists have begun to realize this, that " Many

psychiatrists have had, at least to some degree, the unsettling and bewildering

feeling that what they have been doing has been largely worthless and that the

premises on which they have based their professional lives were partly

fraudulent " (p. 199, emphasis added). Presumably, most physicians want to do

something that is constructive, but psychiatry isn't a field in which they can

do that, at least, not in their capacity as physicians - for the same reason TV

repairmen who want to improve the quality of television programming cannot do so

in their capacity as TV repairmen. In The Death of Psychiatry, Dr. Torrey

argued that " The death of psychiatry, then, is not a negative event " (p. 200),

because the death of psychiatry will bring to an end a misguided, stupid, and

counterproductive approach to trying to solve people's problems. Dr. Torrey

argues that psychiatrists have only two scientifically legitimate and

constructive choices: Either limit their practices to diagnosis and treatment of

known brain diseases (which he says are " no more than 5 percent of the people we

refer to as mentally 'ill' " (p. 176), thereby abandoning the practice of

psychiatry in favor of bona-fide medical and surgical practice that treats real

rather than presumed but unproven and probably nonexistent brain disease - or

become what Dr. Torrey calls " tutors " (what I call counselors) in the art of

living, thereby abandoning their role as physicians. Of course, psychiatrists,

being physicians, can also return to real health care practice by becoming

family physicians or qualifying in other specialties.

 

 

In an American Health magazine article in 1991 about Dr. Torrey, he is quoted

saying he continues to believe psychiatry should be abolished as a medical

specialty: " He calls psychiatrists witch doctors and Sigmund Freud a fraud. For

almost 20 years Dr. E. (Edwin) Fuller Torrey has also called for the 'death' of

psychiatry. ...No wonder Torrey, 53, has been expelled from the American

Psychiatric Association (APA) and twice removed from positions funded by the

National Institute of Mental Health ... In The Death of Psychiatry, Torrey

advanced the idea that most psychiatric and psychotherapeutic patients don't

have medical problems. '...most of the people seen by psychotherapists are the

'worried well.' They have interpersonal and intrapersonal problems and they

need counseling, but that isn't medicine - that's education. Now, if you give

the people with brain diseases to neurology and the rest to education, there's

really no need for psychiatry' " (American Health magazine, October 1991, p. 26).

 

 

The disadvantage to the whole of the medical profession of recognizing

psychiatry as a legitimate medical specialty occurred to me when I consulted a

dermatologist for diagnosis of a mole I thought looked suspiciously like a

malignant melanoma. The dermatologist told me my mole did indeed look

suspicious and should be removed, and he told me almost no risk was involved.

This occurred during a time I was doing research on electroshock, which I have

summarized in a pamphlet titled " Psychiatry's Electroconvulsive Shock Treatment

- A Crime Against Humanity " . I found overwhelming evidence that psychiatry's

electric shock treatment causes brain damage, memory loss, and diminished

intelligence and doesn't reduce unhappiness or so-called depression as is

claimed. About the same time I did some reading about psychiatric drugs that

reinforced my impression that most if not all are ineffective for their intended

purposes, and I learned many of the most widely used psychiatric drugs are

neurologically and psychologically harmful, causing permanent brain damage if

used at supposedly therapeutic levels long enough, as they often are not only

with the approval but the insistence of psychiatrists. I have explained my

reasons for these conclusions in another pamphlet titled " Psychiatric Drugs -

Cure or Quackery? " Part of me tended to assume the dermatologist was an expert,

be trusting, and let him do the minor skin surgery right then and there as he

suggested. But then, an imaginary scene flashed through my mind: A person walks

into the office of another type of recognized, board-certified medical

specialist: a psychiatrist. The patient tells the psychiatrist he has been

feeling depressed. The psychiatrist, who specializes in giving outpatient

electroshock, responds saying: " No problem. We can take care of that. We'll

have you out of here within an hour or so feeling much better. Just lie down on

this electroshock table while I use this head strap and some electrode jelly to

attach these electrodes to your head... " In fact, there is no reason such a

scene couldn't actually take place in a psychiatrist's office today. Some

psychiatrists do give electroshock in their offices on an outpatient basis.

Realizing that physicians in the other, the bona-fide, medical and surgical

specialties accept biological psychiatry and all the quackery it represents as

legitimate made (and makes) me wonder if physicians in the other specialties are

undeserving of trust also. I left the dermatologist's office without having the

mole removed, although I returned and had him remove it later after I'd gotten

opinions from other physicians and had done some reading on the subject.

Physicians in the other specialties accepting biological psychiatry as

legitimate calls into question the reasonableness and rationality not only of

psychiatrists but of all physicians.

 

 

On November 30, 1990, the Geraldo television talk show featured a panel of

former electroshock victims who told how they were harmed by electroshock and by

psychiatric drugs. Also appearing on the show was psychoanalyst Jeffrey Masson,

Ph.D., who said this: " Now we know that there's no other medical specialty which

has patients complaining bitterly about the treatment they're getting. You

don't find diabetic patients on this kind of show saying 'You're torturing us.

You're harming us. You're hurting us. Stop it!' And the psychiatrists don't

want to hear that. " Harvard University law professor Alan M. Dershowitz has said

psychiatry " is not a scientific discipline " ( " Clash of Testimony in Hinckley

Trial Has Psychiatrists Worried Over Image " , The New York Times, May 24, 1982,

p. 11). Such a supposed health care specialty should not be tolerated within

the medical profession.

 

 

There is no need for a supposed medical specialty such as psychiatry. When real

brain diseases or other biological problems exit, physicians in real health care

specialties such as neurology, internal medicine, endocrinology, and surgery are

best equipped to treat them. People who have experience with similar kinds of

personal problems are best equipped to give counselling about dealing with those

problems.

 

 

Despite the assertion by Dr. Torrey that psychiatrists can choose to practice

real health care by limiting themselves to the 5% or less of psychiatric

patients he says do have real brain disease, as even Dr. Torrey himself points

out, any time a physical cause is found for any condition that was previously

thought to be psychiatric, the condition is taken away from psychiatry and

treated instead by physicians in one of the real health care specialties: " In

fact, there are many known diseases of the brain, with changes in both structure

and function. Tumors, multiple sclerosis, meningitis, and neurosyphilis are

some examples. But these diseases are considered to be in the province of

neurology rather than psychiatry. And the demarcation between the two is sharp.

.... one of the hallmarks of psychiatry has been that each time causes were

found for mental 'diseases,' the conditions were taken away from psychiatry and

reassigned to other specialties. As the mental 'diseases' were show to be true

diseases, mongolism and phenylketonuria were assigned to pediatrics; epilepsy

and neurosyphilis became the concerns of neurology; and delirium due to

infectious diseases was handled by internists. ... One is left with the

impression that psychiatry is the repository for all suspected brain 'diseases'

for which there is no known cause. And this is indeed the case. None of the

conditions that we now call mental 'diseases' have any known structural or

functional changes in the brain which have been verified as causal. ... This

is, to say the least, a peculiar specialty of medicine " (The Death of

Psychiatry, p. 38-39). Neurosurgeon Vernon H. Mark, M.D., made a related

observation in his book Brain Power, published in 1989: " Around the turn of the

century, two common diseases caused many patients to be committed to mental

hospitals: pellagra and syphilis of the brain. ... Now both of these diseases

are completely treatable, and they are no longer in the province of psychiatry

but are included in the category of general medicine " (Houghton Mifflin Co., p.

130).

 

 

The point is that if psychiatrists want to treat bona-fide brain disease, they

must do so as neurologists, internists, endocrinologists, surgeons, or as

specialists in one of the other, the real, health care specialties - not as

psychiatrists. Treatment of real brain disease falls within the scope of the

other specialties. Historically, treatment of real brain disease has not fallen

within the scope of psychiatry. It's time to stop the pretense that psychiatry

is a type of health care. The American Board of Psychiatry and Neurology should

be renamed the American Board of Neurology, and there should be no more

specialty certifications in psychiatry. Organizations that formally represent

physicians such as the American Medical Association and American Osteopathic

Association and similar organizations in other countries should cease to

recognize psychiatry as a bona-fide branch of the medical profession.

 

 

THE AUTHOR, Lawrence Stevens, is a lawyer whose practice has included

representing psychiatric " patients " . His pamphlets are not copyrighted. You

are invited to make copies for distribution to those who you think will benefit.

1998 UPDATE

" I view with no surprise that psychiatric training is being systemically

disavowed by American medical school graduates. This must give us cause for

concern about the state of today's psychiatry. It must mean, at least in part,

that they view psychiatry as being very limited and unchallenging. ...there are

no external validating criteria for psychiatric diagnoses. There is neither a

blood test nor specific anatomic lesions for any major psychiatric disorder.

So, where are we? ... Is psychiatry a hoax, as practiced today? " From a letter

dated December 4, 1998 by Loren R. Mosher, M.D., a psychiatrist, resigning from

the American Psychiatric Association.

1999 UPDATE

According to an article in the September 1999 American Journal of Psychiatry

titled Attitudes Toward Psychiatry as a Prospective Career Among Students

Entering Medical School, by David Feifel, M.D., Ph.D., Christine Yu Moutier,

M.D. and Neal R. Swerdlow, M.D., Ph.D.: " The number of U.S. medical graduates

choosing careers in psychiatry is in decline. In order to determine whether

this disinclination toward psychiatry occurs before versus during medical

school, this study surveyed medical students at the start of their freshman

year. ... these students begin their medical training viewing a career in

psychiatry as distinctly and consistently less attractive than other specialties

surveyed. More than one-quarter of the new medical students had already

definitively ruled out a career in psychiatry. New medical students rated

psychiatry significantly lower than each of the other specialties in regard to

the degree to which it was a satisfying job, financially rewarding, enjoyable

work, prestigious, helpful to patients, dealing with an interesting subject

matter, intellectually challenging, drawing on all aspects of medical training,

based on a reliable scientific foundation, expected to have a bright and

interesting future, and a rapidly advancing field of understanding and

treatment. ... Contrasting these results with previous studies suggests that

an erosion has occurred over the past two decades in the attitudes that new

medical students hold toward psychiatry. " [underline added]

2000 UPDATE

" Psychiatric disorders are vastly different from physical disorders, however,

because our understanding of how the normal brain works is incomplete. ... We

know very little, however, about the neurological processes of learning, memory,

thoughts, reasoning, and consciousness, and the production of emotions. ...

The treatment you receive depends on the orientation of your psychiatrist, not

on a solid foundation of knowledge about the etiology and pathogenesis of the

disorder itself. " Edward Drummond, M.D., Associate Medical Director at Seacoast

Mental Health Center in Portsmouth, New Hampshire, in his book The Complete

Guide to Psychiatric Drugs (John Wiley & Sons, Inc., New York, 2000), pages 8-9.

Dr. Drummond graduated from Tufts University School of Medicine and was trained

in psychiatry at Harvard University.

 

 

 

 

 

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