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Damned Lies and Statistics: Untangling Numbers from the Media, Politicians and Activists
Damned Lies and Statistics: Untangling Numbers from the Media, Politicians and Activists
by Joel Best
Edition: Hardcover

1 of 1 people found the following review helpful
5.0 out of 5 stars Awe-struck by big numbers, 7 Aug. 2011
The indelicate title of this book is taken from the well-known aphorism "There are lies, damned lies, and statistics" attributed to either Mark Twain or Benjamin Disraeli. It nearly caused me to not read it, unjustly, because the language between the covers is perfectly gentlemanly.

Most people, Best tells us, are innumerate. This means that they don't readily spot implausible numbers, and all big numbers are more or less the same to them, whether a million or a billion. Not only the people who hear statistics are often innumerate, but also the people who report them, and not infrequently even the people who generate them.

Statistics can be wildly off course for many reasons. They may originate in a guess. But even when they originate in research, there are many factors that can influence their accuracy. The researcher may have interviewed people using leading questions. The subject of the research may be poorly defined. The method of measuring it may be flawed. The sample on which the research is based may not be representative. Or perhaps a comparison was made between two entities that aren't comparable. Numbers may have been mangled by someone who quoted them, such as a reporter. Or the condition described mutates into something else during the retelling. The finesses of complex statistics may be overlooked. Basing new statistics on older ones may result in a chain of bad statistics. And, unavoidably, they are influenced by the interests of the party who compiles them.

The author does not mention the statistics used in modern medical mega-trials, but everything he says about statistics in general applies to those as well.

He warns us not to be naïve or awestruck by statistics, but not to be cynical either. Statistics, he says, are a valid and useful tool. Not all statistics are bad statistics. So we shouldn't reject all statistics off the bat, just be critical. Of course we should always be critical about everything anyway, he concedes, not just about statistics. I'm afraid I'm not going to take Best's advice. He provides fine questions to ask when examining statistics, but who will answer them? So I am going to join his cynical group, and remain suspicious of all statistics.

Best's writing style is refreshingly uncomplicated. This little gem of a book is suitable for a broad audience, including the less sophisticated reader, readers for whom English is a second language, and people who, like me, are innumerate.

Best has since (2004) published a sequel to this book, called More Damned Lies and Statistics.

Copyright © MeTZelf

The Tyranny of Health: Doctors and the Regulation of Lifestyle
The Tyranny of Health: Doctors and the Regulation of Lifestyle
by Michael Fitzpatrick
Edition: Hardcover
Price: £105.00

2 of 4 people found the following review helpful
4.0 out of 5 stars A physician's rebellion against received medical wisdom, 7 Aug. 2011
Fitzpatrick wins me over right away with nail-on-the-head statements like:
The government's public health policy is really a programme of social control packaged as health promotion.

Medicine has become a quasi-religious crusade against the old sins of the flesh.

While resources are poured into projects that use health to enhance social control, real health needs - especially those of the elderly - are neglected.

Only an epidemiologist could believe that data based on 'selfreported' levels of alcohol consumption can provide a useful basis for quantitative studies.

Such is the degradation of medical ethics that it is now considered virtuous for doctors to take on the role and responsibilities of the police and to subordinate the best interests of their patients to the dictates of government drug policy.

The invention of new disease labels - such as 'attention deficit hyperactivity disorder' in children or diverse forms of addiction in adults - reflects the trend to define a wider range of experience in psychiatric terms.

The propaganda of addiction finds a ready resonance in a society in which people are all too ready to accept a medical label for their difficulties.

There is ... a marked tendency for vulnerable people to develop an ongoing dependence on therapy, which is as likely to confirm their inadequacy as it is to enable them to overcome it.

Parenting projects are likely to weaken parental authority still further.
He asserts that the government (he never mentions the industries that pull the government's strings) peddles health and longevity. But, he posits, if you eat right and moderately, take plenty of exercise, and don't smoke, you are likely to prolong your life only marginally, maybe by a few months. Who wants to live long, anyway? Most of the elderly people Fitzpatrick sees in his medical practice in an underprivileged borough of London live in poverty and loneliness. "[I]t may well be the case that an old person's enjoyment of a cigarette, a cream bun and a bottle of Guinness is more important to them than the extra few weeks they might spend in a life of miserable abstinence."

It is a fallacy that we can stay healthy until we die. Old age unavoidably brings infirmity. Ironically, today most people would rather drop dead suddenly while still in the best of health than first have to go through a period of illness. In former times such a death would have been considered a terrible scourge, depriving the person of advanced warning that it's time to wrap up affairs and take leave of loved ones.

Citizens are bullied by the government into fearing cancer, heart disease, cot (crib) death, aids, and melanoma from sunbathing. In reality we have no proof that behavior (other than refraining from smoking, which is already well-known) can reduce our chances of being stricken with cancer or heart disease, or prevent crib death. AIDS, contrary to the hype, is rather rare in England, and one's chance of contracting it remote. Most melanomas appear on unexposed areas, such as the inside of the thighs.

So far so good, but reading on, my enthusiasm for Fitzpatrick's position is tempered. I agree with Fitzpatrick's ridicule of fear mongering up to a point. Inflating the risks of various diseases and the efficacy of measures to reduce the risks only serves the wrong parties, those who benefit financially and socially from our fears.

But then Fitzpatrick goes a step too far. He also ridicules fear of BSE, the 3rd generation contraceptive pill, and the measles vaccine. He misses the point that the public has been deceived by industries and the government that purports to regulate them by exposing us to risks we have not chosen, nor even known about, such as: feeding cows an inappropriate diet, withholding information about the harmful side effects of drugs, and adding poisonous mercury as a preservative to baby vaccines in order to save refrigeration costs. He claims that pregnancy and abortion are far more dangerous than the pill, and that not vaccinating children could cause a "return of measles" (a childhood illness that was usually almost trivial in otherwise healthy and well-nourished children). Now Fitzpatrick is doing the fear mongering. He also denies the risks of passive smoking, as though we should all stop whining and breathe whatever anybody blows our way.

Then follows a long diatribe disparaging British and other politicians, as though these developments would not have occurred if the rival candidate or opposing party had been elected. Fitzpatrick is pretty clear on medicine, but he is totally confused about political dynamics. He blames government interference in health care on -- capitalism and free markets! He even becomes lyrical, mentioning "The unchallenged ascendancy of the capitalist system." He doesn't seem to grasp what the terms capitalism and free markets mean. They are about absence of government interference, exactly the policy he endorses regarding medicine. Perhaps when it comes to diagnoses, he should stick to his stethoscope.

Towards the end of the book, the author begins to somewhat regain my confidence. He acknowledges that physicians have always welcomed state licensing because it strengthens their position of dominance, while at the same time they resent it for interfering with their professional autonomy. They want it both ways.

Then there's another strange statement: "Traditional physicians ... were forced to compete with diverse unscrupulous practitioners." Why would competent and conscientious physicians have to worry about competition, particularly from frauds? A well-regarded doctor is likely to be plagued by more demand for his services than he can provide.

Fitzpatrick further defines: "a quack is a practitioner who tries to please his customers rather than his colleagues." If that is true, then please give me a quack.

The Tyranny of Health is available in paperback and as an e-book.

Copyright © MeTZelf
Comment Comment (1) | Permalink | Most recent comment: Aug 15, 2011 2:41 PM BST

The Constant Gardener
The Constant Gardener
by John Le Carré
Edition: Hardcover

2 of 5 people found the following review helpful
3.0 out of 5 stars A fictionalized version of unethical drug company practices, 7 Aug. 2011
This review is from: The Constant Gardener (Hardcover)
Fiction is not my cup of tea. I simply don't care what a person looked like, what he thought or felt, and whom he loved, least of all when that person never really existed. John le Carré is no doubt an excellent novelist, but his talents are as wasted on me as a symphony on someone who is hard of hearing. I wouldn't have borrowed this book from the library had not another MeTZelf member recommended it, on grounds that in spite of its tame name, it deals with the corrupt practices of the pharmaceutical industry in Africa. As becomes novels, the moral theme is but a backdrop to the plot.

A different book on this subject, which thankfully says a lot more in a lot fewer pages, is Ivan Wolffers' Drops Against Poverty, subtitled, Organon in the Third World. Organon is a pharmaceutical company in the south of The Netherlands. Unlike most pharmaceutical companies, which sprang up as side-kicks to the dye industry, Organon rose out of the efforts to make marketable products from slaughterhouse waste. Hormones are Organon's specialty, although that didn't prevent it from trying to cash in on the lucrative antidepressant market with its Johnny-come-lately tricyclic Remeron, audaciously marketed as "not an SSRI". (See my report on the Triptych convention.*) Remeron received bad press in the Dutch Medical Bulletin because Organon was caught misrepresenting it, hushing up unfavorable test results. Nonetheless, it continues to be sold, so much, even, that Organon now faces a class-action settlement in the USA, not for all the harm Remeron does to people who take it, but, of all things, for hogging the market.

In Drops Against Poverty, published in 1983, Wolffers describes how Organon marketed useless and dangerous hormones in poverty-stricken Third World countries as an antidote to malnourishment in children. This is no fiction. Wolffers backs up his claims with photographs of advertisements and documents. Unfortunately, Wolffers wrote this as well as all of his best books in Dutch, a language most of the world cannot read. So I am left returning you to Le Carré's novel.

Hiring thugs to murder opponents is going a bit far, but many of the pharmaceutical practices Le Carré weaves into the plot do really exist. They are not conjured up from the author's imagination, but whispered into his ear by friends in the know. What Organon is accused of doing with Remeron, Le Carré has the fictional manufacturer ThreeBees doing with the fictional drug Dypraxa (inspired by Zyprexa?) for the treatment of tuberculosis. As this disease is making a comeback in wealthy first-world countries, a new (the author could have added, still patented) drug for it would be a huge money-earner. However, it is not yet approved for First World markets. In effect, starving people in Africa are used as guinea pigs. They lose their eyesight and even die from it, but the company insists it's just a matter of adjusting the dose. The drug's inventors turned whistleblowers are silenced with fine print in contracts and professional slur campaigns. No, they aren't murdered. That honor is reserved for the beautiful heroine.

* For report location, see my comment, below.

Copyright © MeTZelf
Comment Comment (1) | Permalink | Most recent comment: Aug 7, 2011 8:48 PM BST

Creating Mental Illness
Creating Mental Illness
by Allan V Horwitz
Edition: Paperback
Price: £17.50

3 of 5 people found the following review helpful
3.0 out of 5 stars Right arguments, wrong conclusions, 7 Aug. 2011
Horwitz is one of those tantalizing authors (see also: Blok, Blom, Boyle, Caplan, Thomas, Walker) in the field who exposes the folly and fraudulence of psychiatric diagnoses, yet fails to follow his own views to their logical conclusion. Below are some of his own persuasive arguments questioning the validity of the foundation of psychiatry and psychotherapy:

* "Contrary to its definition of mental disorder, a basic principle in the DSM definitions of particular disorders is to avoid inferences about the causes of symptoms."
* "The reasons for the proliferation of mental illnesses lie in the historical development of the psychiatric profession over the course of the twentieth century."
* "[T]he grounds for inclusion of the conditions found in the DSM-III, and perpetuated in the DSM-II-R and DSM-IV, did not stem from either theory or research but from the need to maintain the existing clientele of mental health professionals."
* "Through discarding etiology as a means of classification, the DSM could encompass the conditions treated by all competing schools of psychotherapy."
* "If a professional wants to argue, for example, that there is an entity called 'compulsive television watching' she can easily come up with specific criteria ... and train observers to measure the disorder in a consistent way."
* "Insurance forms, not the nature of symptoms, demand precise diagnoses."
* "[O]nce a drug was developed, a specific illness would have to be found that the drug would treat."
* "Once a diagnosis has been created, it enters professional curricula, specialists emerge to treat it, conferences are organized about it, research and publications deal with it, careers are built around it, and patients formulate their symptoms to correspond to it."
* "Diagnostic categories emerged in order to raise the prestige of psychiatry, to guarantee reimbursement from third parties, to allow medications to be marketed, and to protect the interests of mental health researchers and professionals."
* "'Frightening mental illnesses' ... help justify large research budgets for the NIMH."
* "[T]he most direct benefits of high prevalence estimates of depression accrue to pharmaceutical companies."
* "Their dependence on professionals can lead [people] to produce the kinds of symptoms their therapists expect them to have... [the symptoms] vary as professional fashions in diagnosis change."
* "Diagnostic psychiatry recognizes the presence of 'culture-bound' disorders only in other cultures."
* "[T]he best predictor of MPD is having a therapist who believes in the diagnoses."
* "[L]inkage analysis [linking psychotic disorders to particular locations on chromosomes] has to date been the source of more embarrassment than accomplishment in biological psychiatry."
* "[M]ethods of assessing brain structure and function... [and] the discovery of neurotransmitters ...despite rhetoric to the contrary...have not led to significant advances in knowledge about the causes of mental disorders."
* "It does not follow from the fact that drugs produce changes in the brain that the original brain state that is changed constitutes a mental disorder."
* "[P]rofessionals are not more effective clinicians than nonprofessionals... No amount of coursework, training, or experience can create the qualities that lead to successful psychotherapy."

But now comes the big surprise. In spite of all of the above, Horwitz fully believes in "the three major disorders that Kraepelin distinguished one hundred years ago: schizophrenia, bipolar disorder, and endogenous depression." How these "real" disorders can be reliably identified, or how Kraepelin identified them, he doesn't say. On the contrary, he admits that "the distinction between people who can't function appropriately and those who won't function appropriately is far more a moral value judgment than a judgment based on psychiatric knowledge." Nor does he postulate as to the causes of these supposedly real diseases. He only mumbles that there is a "strong possibility that these are brain-based disorders."

The drug companies that conspire with NIMH and the APA to convince us all that we need their poiso- I mean medications, suddenly turn into heroes when it comes to what he considers Kraepelinian diagnoses. "[T]he greatest accomplishment of modern psychiatry [is] the development of efficacious psychotropic medications," and "Schizophrenia ... responds to the phenothiazines and clozapine. Overall, there is little doubt that these medications are 'antischizophrenic' agents, not general tranquilizers." Likewise, he goes on to claim that lithium is an effective treatment for "bipolar patients." Yet when someone with a diagnosis that Horwitz pooh-poohs feels helped by a drug, this "could stem from cultural expectations for success, rather than from the biological impact of the drug itself." He doesn't say whether he means the patient's expectations or the physician's. Though Horwitz acknowledges a study which indicated that "patients [on a] placebo pill had the lowest rates of relapse," he never entertains the idea that the drugs he lauds may be precisely the cause of a great deal of what he considers real mental illness.

Just as Horwitz fails to present evidence for the presence of somatic lesion in his three pet mental illnesses, so he fails to point out that somatic lesion can never be conclusively ruled out. He ascribes the "sensations of pain, fatigue, or distress" of "fibromyalgia in the contemporary United states" to "sociocultural processes" and "the nature of hysteria... [that] represent culturally produced symbolic entities rather than direct indicators of underlying diseases." The unsustainability of this position is given away by the fact that he makes the same claim about Lyme disease (spread by ticks and curable by antibiotics).

Why not just admit that ALL of psychiatry and psychotherapy is bunkum, and mental health workers don't know what they are doing?

Copyright © MeTZelf
Comment Comments (5) | Permalink | Most recent comment: Oct 4, 2013 10:40 AM BST

The Creation of Psychopharmacology
The Creation of Psychopharmacology
by D Healy
Edition: Hardcover

2 of 3 people found the following review helpful
4.0 out of 5 stars A critique of the antidepressant industry, 7 Aug. 2011
You may remember David Healy's rise to headlines when a Canadian University fired him on his first day. He had committed the academic error of biting the hand that fed him by criticizing the pharmaceutical industry that funded his chair.
This book is a critique of that industry regarding psychotropic drugs, and in particular the role of marketing and government regulations in that industry. Fascinating to read, though the chemical details were often a bit above my head, was the description of how copy-cat drugs are developed, and why claims for specificity are laughable hoaxes. The choice for calling some of these drugs antipsychotics and others antidepressants he calls a matter of historical accident. In fact, he says, in Japan, depression is treated with atypical antipsychotics, not SSRIs.

Healy isn't coy about the horrific damage these drugs do, and the fact that doctors knew, or could have known, about it all along. It seems that doctors today are less, not more, aware of this harmfulness.

The book includes interesting historical notes, though I was occasionally dismayed by Healy's naive acceptance of unlikely case scenarios recorded by early psychiatrists. For instance, he uncritically quotes that people were cured by chlorpromazine after having been in catatonic states, "frozen into several positions" for years. How is it likely, in the days before medical heroics, that someone survived such a condition? Healy does not question it. What caused catatonia, how did chlorpromazine relieve it, and why is the condition unknown today? Healy does not say. Yet he acknowledges the fraud of psychiatric diagnoses in more recent times, as well as the deception in drug company testing.

Buried among the otherwise highly informative material is the odd statement that totally contradicts the rest of the book. For instance, Healy says about insulin coma therapy, "It... was used for twenty years... A therapy that did not produce some good would surely have faded away, given... the risk of fatalities." You would expect Healy to realize that medicine does not follow such logic, much less psychiatry. Furthermore, it *did* fade away, unlike the drugs which he criticizes. Equally baffling is his terse and unexplained claim for the efficacy of ECT. And though he himself coins the term "biobabble," he doesn't shirk from a bit of biobabble himself, such as "Brain imaging will make it clear that our brains are as social as they are biological and that being biological means having social arrangements stamped into our neuroendocrine systems."

Among the implied advice that Healy includes in his book is the abolition of regulations, yet he comments that they cannot be abolished. Why not? He also endorses the free availability of SSRIs, so without a doctor's prescription. But why not free availability of all drugs, as he himself states (though he is not the first to do so), "The 'good' drugs are now difficult to access because they are available only by prescription, while the 'bad' drugs, which prescription-only status was introduced to control, are widely available."

In short, Healy wrote an excellent book, though it contains the occasional slip which probably reflects a lack of critical editing.

Copyright © MeTZelf

Schizophrenia: A Scientific Delusion?
Schizophrenia: A Scientific Delusion?
by Mary Boyle
Edition: Paperback
Price: £30.99

8 of 8 people found the following review helpful
4.0 out of 5 stars It's all in the definition, 7 Aug. 2011
Among the professionals who raise their voices against psychiatry, the general consensus is that psychiatric disorders by their various names do not exist. The most prolific author on this subject is Dr. Thomas Szasz. His best known book, published in 1961, is called The Myth of Mental Illness. Szasz asserts that mental illness by definition cannot exist, as disease means demonstrable physical lesion. Only the body can be ill, not the mind. Dr. Fred Baughman agrees. On his website, named ADHD fraud he states: "Twenty five years of research ... has failed to validate ADD/ADHD as a disease." Dr. Peter Breggin asserts in his classic book Toxic Psychiatry that any lesion found is not the cause of purported mental illness, but rather the result of (mis)treatment for it.

Supporters of biopsychiatry, on the other hand, insist that psychiatric disorders do involve physical lesions which are yet to be discovered. They support their claim by pointing out that broken bones were real enough before x-ray photographs were invented, syphilis was a real disease before the spirochete was discovered, and Creutzfeldt-Jakob Disease was killing people before anyone had heard of prions. This is true, of course. The presence of physical lesion cannot be ruled out just because it hasn't been demonstrated to exist. So to deny that "psychiatric disorders" are diseases, disease will have to be defined some other way than dependent on physical lesion.

This is precisely what Mary Boyle, Professor of Clinical Psychology, does. She begins by explaining that illness and disease are not scientific terms at all. They are lay terms. Illness is identified by the person himself (or if he is incompetent, by the person responsible for him) before the services of a physician are sought. He does this because he has complaints, which in medicine are called symptoms. Symptoms are the subjective complaints reported by the patient to the physician.

The physician's job is to identify which symptoms are relevant and which aren't, and to look for a pattern in them. Identifying patterns is what science is all about.

Once a pattern in the patient's complaints has been found to match a familiar pattern, the physician looks for signs that fit in with the symptoms. A sign in medicine is something related to symptoms that the physician can observe and measure, possibly using special tools.

When the symptoms and signs together form a pattern which matches patterns familiar to the physician from his training, professional literature, or clinical experience, this is called a syndrome. The syndrome itself, however, is not a fact, but an idea, a construct. To be valid, it has to refer to symptoms and signs that are unlikely to be clustered together by chance. It also has to be usable to predict what is going to happen next to the patient.

Syndromes are given names which may or may not include the word syndrome. Down's Syndrome includes it. Diabetes doesn't but is nonetheless a syndrome. Confusingly, some syndromes are given names which have the word disease in it such as Creutzfeldt-Jakob Disease (my example, not Boyle's.)

So let's say a patient goes to his doctor and complains of thirst, weight loss, and fatigue. Individually, each of these complaints are frequent, and can have a variety of causes. Clustered together, these complaints form a pattern of complaints that occur when people have high levels of sugar (glucose) in their blood. However, the doctor will not decide that this is the case until he has tested for high glucose levels in the patient's urine (before modern laboratory tests, done by tasting!) or blood. Only when the tests indeed verify high glucose levels, does the doctor "diagnose" diabetes. The doctor can then, on the basis of previous experience with this syndrome, reliably predict what will happen next, and possibly propose a course of treatment which will change the prediction. If, however, no unusual level of glucose was detected by the tests, the doctor will probably tell the patient that his complaints are unrelated, and that he (the doctor) doesn't know what, if anything, is wrong with him.

The DSM claims that schizophrenia (and other "disorders") is a syndrome. But this cannot be, because there is no pattern in the symptoms. It is perfectly possible, and in fact constantly happens, that various people are labeled "schizophrenic" according to the DSM even though they don't have a single "symptom" in common.

The supposed symptoms themselves are often not complaints by the patient at all, but complaints by others, or accusations, or attributes assigned by the psychiatrist. None are supported by signs, which, it must be remembered, are observable and measurable by the physician. Take, for example, the classic "symptom" of hearing voices. These voices cannot be heard by anyone else. There is no way to verify that the person is actually hearing voices. And of course, as has been demonstrated over and over again by research, the label of "schizophrenia" (or others in the DSM) has no predictive power whatsoever.

No amount of revisions and claims for scientific basis will ever be able to correct the underlying flaw in the DSM, namely, that it assumes the existence of syndromes, patterns of symptoms and signs with reliable predictive value, which don't exist.

Boyle is not saying that none of the people brought to the attention of psychiatrists have anything wrong with their brain. She is saying that nobody can know what if anything is wrong with the person, because the symptoms and signs (of which there usually are none) don't match any pattern. Kraepelin himself, considered the discoverer of "schizophrenia," was not able to establish such a pattern, even though in retrospect, it is likely that most of his patients were victims of the epidemic of encephalitis lethargica which swept through Europe in his day. That disease was caused by a virus, and like so many epidemics, has since died out. Kraepelin's belief that the disease was hereditary was undoubtedly influenced by the popularity of eugenics among psychiatrists of his day, which led to unspeakable crimes and genocide. Tellingly, psychiatrists still insist today that "schizophrenia," the non-existent syndrome, is hereditary, or as they call it now, genetic.

No doubt Boyle was repeatedly asked, "If schizophrenia doesn't exist, then what is wrong with these people?" That may be why in the final chapter she makes a stab at answering this question. Focusing on the two classic features of "schizophrenia," namely hearing voices and delusions, she suggests seeing them not as part of a pattern or syndrome, but, for instance, as coping mechanisms. Although her suggestions are interesting and compelling, they obviously suffer from the same flaws she so brilliantly exposes regarding the concept of schizophrenia: no pattern, no proof, no predictive value, no usefulness. She seems to be proposing dealing with these phenomena outside of the medical profession, but inside the psychological profession. Like so many other professionals in the field, she fails to take that last little step, and recognize that no profession is equipped to deal with these phenomena, and that what people affected by them need is non-professional, practical assistance.

Boyle's explanation why "schizophrenia" (and by extension, all other psychiatric disorders) doesn't exist, is the clearest and most thorough I have ever read. Yet I hesitate to recommend this book to you. The sophisticated language and challenging argumentation are not for everybody. If you can borrow it from the library (make sure you get the second edition), do it. If you have to buy it, and you are uncomfortable with complicated texts or you are not a native English speaker, I recommend Mad in America instead. However, do keep Boyle's message in mind. Nobody else has explained it as well as she has.

Copyright © MeTZelf

Mad in America
Mad in America
by Robert Whitaker
Edition: Hardcover

3 of 3 people found the following review helpful
5.0 out of 5 stars The Painful Truth, 7 Aug. 2011
This review is from: Mad in America (Hardcover)
Mad in America describes psychiatry not only in America but in all wealthy countries.

The author, an investigative medical journalist, has written a well-researched book exposing the truth behind psychiatric practice and its modern sponsor, the pharmaceutical industry. Wisely, he does not dabble in the debate about the existence of mental illness, but rather, demonstrates that whether or not it truly exists, psychiatric treatments are catastrophic for their victims.

Whitaker's straightforward writing style makes this excellent book suitable also for readers for whom English is a second language.

I'm not going to go into detail, because I want you to read it yourself. If you prefer to read more about this book anyway, check out other reviews of it on the Amazon web site and elsewhere on the web.

Copyright © MeTZelf

Autism: Explaining the Enigma (Cognitive Development)
Autism: Explaining the Enigma (Cognitive Development)
by Uta Frith
Edition: Paperback
Price: £25.99

10 of 23 people found the following review helpful
2.0 out of 5 stars Pretending to understand, 7 Aug. 2011
This is a major overhaul of a book by the same name published in 1989 that established Frith as an authority on autism. Frith, who is a professor and senior scientist at University College in London, seems to be identified by a variety of professions, among them psychology, neuropsychology, and cognitive development.

Frith charms the reader with her warm and colorful writing. She draws on a rich mix of sources, including anecdotes from history, the cinema, and computer programming. Her book contains delightful, cartoon-like drawings. The cover is embellished by a painting by the 17th century French artist Georges de la Tour: The Cheater with the Ace of Diamonds.

In the first edition, Frith popularized her term Theory of Mind (ToM), replacing the word empathy, for the concept of the innate ability to gauge other people's thoughts and feelings. She considers the absence of ToM the core disability of autism. In this edition she changes the term to mentalizing and its absence to mind blindness.

People who identify themselves as autistic, while accepting that they are different from most people in a major way, tend to deride Frith's theory by whatever name. They point out that non-autistics (whom they call neurotypicals or NTs) equally fail to attribute the right thoughts and feelings to autistics, and sometimes even to their fellow NTs. Other people who identify themselves as autistic reject the concept of mind in general, or question Frith's way of assessing it.

She apologizes for not always using the in her opinion politically correct term *person with autism* which nevertheless occurs frequently throughout her book. Worse, she speaks about sufferers of autism. One suffers from illness, yet Frith denies that autism is a (mental) illness. This is not because she questions the concept of mental illness, but because she considers autism a permanent, irremediable disability, whereas apparently she thinks that "mental illness" is real illness, from which one either becomes cured or dies. Autistic people understandably perceive attributions of suffering and disability as attaching a negative value judgment to autism.

Frith briefly claims that autism is a syndrome, correctly identifying the criterion a syndrome must meet, namely having a pattern of symptoms and signs that always occur together and are unlikely to do so by chance. She then claims that autism meets this criterion due to the presence of a triad of symptoms, which she lists only 147 pages later. The first of the triad is mind-blindness, her core thesis. The next is special talents, but, according to Frith, they are present in only about 10% of autistics, thus hardly qualifying as a symptom that fits into a pattern. The third is the absence of top-down control, a concept so complex that calling it a sign or symptom is unreasonable. Nobody comes to the physician complaining, "Doctor, I (or: my child) lacks top-down control." We are thus left with only one symptom, mind-blindness. So the definition becomes circular: someone who is called autistic is presumed to be mind-blind, and someone who seems mind-blind is labeled autistic. Compounding the confusion, Frith compares autism to schizophrenia, apparently either oblivious to or uninterested in the controversy over this concept.

In speculating about the causes of autism Frith treats only heredity seriously. This is in keeping with psychiatric tradition which in spite of the atrocities to which it has led continues to see genes as the cause of whatever is perceived by psychiatrists to be wrong with a person. Although she gives lip service to parents' concerns about the MMR vaccine, she clearly does not take them seriously. She heads the section in which she discusses it The Great Vaccine Scare but she does NOT head the section on genetic factors The Great Gene Scare. She warns about the terrible things that might happen to children who don't receive the MMR vaccine, whereas in reality the childhood illnesses against which it vaccinates are usually trivial, certainly compared to a lifetime of autism. Likewise, infants born premature, ill, or after difficult labor are at vastly increased risk for autism, yet Frith only slightly touches on illness in infancy as a factor, and totally neglects medical interference before, during, and after birth.

Whatever made someone autistic is probably different from person to person. To this much Frith reluctantly agrees. Genes may well have a lot to do with it in some people, but the stubbornness with which Frith and other professionals prefer this theory is appalling. It precludes other causes, which are more given to preventive efforts than genes, from being properly investigated. Naturally the professional world totally lacks the ability to introspect about its own contribution to causing autism. By defining it as a disability present at birth, professionals overlook the vast populace who turn autistic in adulthood after psychiatric treatment. This obvious link should open up at least one new avenue of investigation into the rise in incidence of presumed congenital autism: agents that depress the central nervous system such as drugs to induce or delay labor and other medical treatments, not to mention extensive pollution of the environment by copious amounts of psychiatric drugs unknowingly excreted into the sewage system by the people who take them.

The second edition of Autism contains a new chapter reporting on findings in brain scans. In theory these scans show the flow of blood through the brain. This is supposed to reveal something meaningful, particularly when researchers believe they see autistic people's blood flowing differently from that of non-autistic people. Frith unconvincingly analogizes the autistic's brain to a pruned garden.

More importantly, making the scans is unethical. Such scans are at best unpleasant, and at worst downright dangerous. PET scans require radioactive material being injected into the bloodstream to track the blood as it travels through the brain. Neurotypicals ("normals") often fail to grasp that the object of the scan is not their benefit but to enhance the careers of the researchers. If indeed autistics are mind-blind as Frith posits, then they are even less likely to understand this. Informed consent would not be possible.

Another causal theory Frith proposes is altered dopamine levels in the brain. She fails to report that no such altered levels have ever been detected in the brains of autistic people or anyone else. This totally unfounded theory is cultivated by the pharmaceutical industry and gratefully embraced by psychiatrists. It is particularly grievous, as autistic people are among the many victims of the unnecessary pandemic of iatrogenic neurological disease. Nowhere in the book does Frith acknowledge widespread pharmacological abuse of autistic people, let alone denounce it.

In summary, Frith's book is fraught with conjecture, professional dogma, and scientistic gossip, while being factually anemic and almost criminally devoid of ethical concerns. It is offensively patronizing in failing to present the viewpoints of the people being discussed. It does not explain the enigma. It doesn't even define it.

The book's appeal is in reassuring parents that they are not guilty of their child's being different. In 1989, when people still remembered the psychoanalytic movement and Bruno Bettelheim's false explanation of autism, this was much welcome. Today the book joins many other works of biobabble, though it does so most charmingly.

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What Really Causes Schizophrenia
What Really Causes Schizophrenia
by Harold D. Foster
Edition: Paperback

2 of 2 people found the following review helpful
2.0 out of 5 stars It's the soil, stupid, 7 Aug. 2011
Foster, who advocates orthomolecular medicine, admits that schizophrenia is an "imprecise diagnosis." Yet he claims that researcher David Horrobin developed a diagnostic patch (skin) test that would allow family physicians, if they used it, to diagnose acute schizophrenia as accurately as a team of highly trained psychiatrists. How can something imprecise be accurately diagnosed? Highly trained psychiatrists can't even agree on what schizophrenia is, let alone diagnose it "accurately." Horrobin's test could only make sense if it were agreed that when the test is negative, the person isn't schizophrenic. Schizophrenia would then become defined as whatever it is the test detects. This redefinition of schizophrenia will of course never catch on, as it would undermine the role of the schizophrenia concept in justifying involuntary commitment and embarrass the psychiatric establishment.

Foster mentions the DSM nowhere in the book. He does list what he considers to be signs that a child will develop schizophrenia in later life, which sound like they were taken straight from Karl Brandt's desk: abnormal head size, asymmetrical or malformed ears, high steeped mouth, furrowed feet, webbed fingers, long third toe, a gap between the big toe and the next one -- in short, anything that might mar a person's beauty. To complete the horror, later in the book he discusses genetic screening. Perhaps Foster does not harbor eugenicist sympathies, and is unaware of the eugenicist origin of his views, although he mentions eugenics several times without denouncing it as the gravely immoral and despicable doctrine that it is.

Obviously Foster is not going to convince me that he knows the cause of something which I don't believe exists as a delineable condition. Yet there are a few things worth looking at in his book. So rather than reject the whole book off the bat, let's pretend that we all know and agree what schizophrenia is, and can readily identify it.

Dr. Foster is not an MD but a geographer, which by no means discredits him. That's why I'm mentioning it. It seems nowadays most physicians are too brainwashed to do much independent thinking. I'm quite willing to take a look at a geographer's opinion. It is all the more disappointing that he parrots the medical establishment a great deal: Schizophrenia is a hereditary condition; that's proved by studies such as on twins and the Genain quadruplets; insulin coma and electroshock are spectacularly effective, though unfortunately only for a short time; the brains of schizophrenics atrophy (not mentioning the drugs involved), etc. And like physicians, he explains away the presumed heredity not conforming to a Mendelian pattern by bringing "triggers" on stage. His disagreement with mainstream medicine seems to be only about those triggers.

Unsurprisingly for a geographer, many of Foster's triggers are geographic: soil deficient in selenium and calcium, chilly climate, industrialization and urbanization. The soil theory seems to me defective, because nowadays our diets are unlikely to be based on locally grown produce. Furthermore, in vast areas of inland Africa where we could expect this same deficiency, the incidence of schizophrenia is said to be lower, and recovery higher, as Foster himself states elsewhere in the book. Sunshine probably does protect against schizophrenia, not the way Foster means, but because homelessness is less of a problem in warm weather, and therefore less likely to be attributed to a mysterious disease.

Some of the other triggers Foster lists are copper, toxic waste, road salt, allergies to wheat and milk, the consumption of too much sugar, exposure to viruses during early gestation, a tick-borne spirochete, low oxygen levels in the air, the high level of hormonal activity in youth, histamine, insufficient exercise, traffic noise, and stress. These factors cause increased levels of adrenochrome, a metabolite of adrenalin, which in turn affects thyroid function, he asserts. I'm not competent to pass judgment on the biochemistry involved, and I'm sure I'm not doing justice to it here. I do believe that some of these "triggers" may be real conditions, and that physicians fail to recognize them. The people they affect are conveniently swept into the schizophrenia model, providing employment for psychiatrists and relieving somatic physicians of the duty to investigate further. Sidney Walker III has written in a similar vein.

Among the cures Foster suggests are the elimination of certain products from the diet and treatment with thyroid gland hormone. He also advocates reducing stress by providing those who need it with food, shelter, and employment, not to mention respect. I quite agree with him on the latter, provided people don't have to take psychiatric drugs to be eligible. There's nothing orthomolecular about food, shelter, employment, and respect.

Foster is right, of course, when he says that the dopamine theory which dominates today's psychiatry is wrong. He points out that the parkinsonism afflicting people on neuroleptics proves that they had no excess of dopamine to begin with. Further proof is in psychiatry's obvious inefficacy. He cites an ordinance legislated in King County, Washington, requiring the mental health system to submit annual reports demonstrating efficacy. In the year 2001 the system treated 7,831 patients with a budget of $90,000,000. That year, by its own admission, four (4!) people recovered, thus $22,500,000 per recovery.

Yet Foster cannot resist blowing the "mental health is underfunded" trumpet. If his recommendations really cure what we're pretending is schizophrenia, why do we need a mental health system at all, let alone more funding for it?

I am certain that many people who are in contact with the mental health system would be quite interested in giving Foster's methods a try. It will harm them a great deal less than psychiatry.

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MEDECINE, RELIGION ET PEUR. L'influence cachée des croyances
MEDECINE, RELIGION ET PEUR. L'influence cachée des croyances
by Olivier Clerc
Edition: Paperback

1 of 1 people found the following review helpful
5.0 out of 5 stars Medicine as a form of social control, 7 Aug. 2011
Also published in English as
Modern Medicine, The New World Religion: How Beliefs Secretly Influence Medical Dogmas and Practices

The French title is better at capturing the essence of this book.

Clerc is by a long shot not the first to draw parallels between medicine and religion, which is fine, because it cannot be done often enough. He does lay the accent slightly differently. The only religion he has in mind is Catholicism.

Clerc sees both the church and medicine as authoritarian, pushing the believer/patient into an infantile role, dependent on the religious/medical practitioner for delivery from harm. He is rightly keen to point out that we, the masses, share the blame by being all too eager to sell our independence out to the church/medicine for relief of our fears of impending doom and death.

"The structures have changed, but the fundamental dynamics have not; the goals of the game are still power, control over the population, and financial gain. ... Dominant or dominated, both are playing the same game, whose rules are dictated by power and fear."

Surprising to me is the role this author assigns to Louis Pasteur as the father of modern medicine. Is he? Pasteur, mentioned frequently throughout the book, is the only representative of medicine named, leaving me to wonder whether he is the only one Clerc studied. Rather than shower praise on Pasteur, the author posits that his medical beliefs were distorted by his religion (Catholic). Pasteur's field, immunization, Clerc considers archetypical of medicine's religious-like promise of divine protection and salvation, like baptism.

To mature and break free of religion/medicine, Clerc proposes, we must shed our fears. So far so good, but how do we accomplish that? Clerc seems to believe that alternative forms of medicine like homeopathy, natural medicine, and holistic medicine will help us, because those practitioners teach their patients self-reliance. Really? Clerc further advocates upgrading the doctor/patient relationship to a loving one. But if educated and self-reliant, why does the patient need any relationship with a doctor at all? Loving is how I would characterize the ideal parent/child relationship, the one Clerc is urging us to discard.

In summary, Clerc's message is wise and insightful, but as with every author, we should not let down our guard for the occasional lapse in logic.

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