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

10 of 10 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

4 of 4 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: £23.62

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.

Copyright © MeTZelf
Comment Comment (1) | Permalink | Most recent comment: Oct 22, 2012 7:11 AM BST


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.

Copyright © MeTZelf


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
2004

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.

Copyright © MeTZelf


MODERN MEDICINE THE NEW WORLD: The New World Religion
MODERN MEDICINE THE NEW WORLD: The New World Religion
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
Originally published in French as
Médecine, religion et peur: l'influence cachée des croyances

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.

Copyright © MeTZelf


Fiction and Fantasy in Medical Research: The Large Scale Randomised Trial
Fiction and Fantasy in Medical Research: The Large Scale Randomised Trial
by James Penston
Edition: Paperback
Price: £7.99

4 of 4 people found the following review helpful
4.0 out of 5 stars Randomized trials aren't what they're cracked up to be, 7 Aug. 2011
Small books can have great messages. This one exposes in its few pages the pharmaceutical fraud governing our bodies and minds.

Large-scale randomized trials fool professionals with their facade of scientific respectability, the author explains. They fail to satisfy the fundamental principles of science, namely that the objects under study are precisely definable, the variables identifiable, the results directly observable and consistent, the research replicable, and the predictions emanating from it reliable. These principles were already established by Francis Bacon four centuries ago. Bacon also warned us of bias, which causes researchers to focus on results that seem to confirm their proposed hypothesis while ignoring contradictory evidence. And Bacon surely hadn't dreamed of the mega-profits that would be biasing pharmaceutical research in the 21st century!

Penston is no enemy of upfront pharmacology. Anesthetics for surgery, insulin, and antibiotics are examples of medicines that have an impressive record in helping to save lives. There is no need for large-scale randomized trials to investigate the benefits of these drugs, as their benefits are immediately apparent. However, many diseases and discomforts have proved resistant to medical researchers' best efforts. There have, in fact, been few important pharmaceutical breakthroughs in the last half century.

Most of the conditions treated by drugs in over-developed societies are not acute life-threatening illnesses but vague complaints, the natural consequences of aging, or even the test results of perfectly healthy people. In acute illness the patient either rapidly improves or dies. Both outcomes terminate the need for treatment. It is in the chronic categories mentioned above that the potential for the most humongous profits lie for the pharmaceutical industry. But how do you persuade doctors to prescribe medicines for such nebulous conditions, particularly when no benefit to the patient is discernable?

Whether or not originally designed for this purpose, large-scale randomized trials fit the bill. Because of their size, which includes thousands of words of text along with an array of tables and figures, they are highly susceptible to mystical statistical tricks, epitomized by the meaningless term "relative risk reduction." The fallibility of the background theory is illustrated by one such mega-trial, which wound up recommending the drug under study for a different condition than it set out to. Furthermore, because of their dimensions, the trials cannot be controlled or replicated, and they easily conceal fraud. Rules set up for them by professional organizations or government watchdogs, which are always directly or indirectly funded by the pharmaceutical industry, only serve to further obscure the fuzziness of the research and protect it against criticism. Busy peer reviewers may base a recommendation for publication on the abstract, which often suggests conclusions not justifiable by the body of the paper. The only valid generalization that can be derived from these trials is that the test drug has no beneficial effect on 98% or more of the study population. Yet randomized trials remain stubbornly sacrosanct. Finding fault with them is taboo, unless the treatment under investigation is not a bonanza drug but less lucrative, such as prayer.

This book is understandable to even the less sophisticated lay reader, so it should also be understandable to physicians, who are widely credited with superior intelligence. I wonder how they have received it? Have they embraced it (we should be so lucky)? Have they marginalized and defamed its author as they do Szasz and Duesberg? Or do they ignore him and hope nobody will notice, like they do Mary Boyle?

As regarding most of the books I review, no matter how enthusiastically I endorse the author's argument, the conclusions I draw from it are different from his. Penston is a physician. He fleetingly mentions that patients are misled, but his focus is not, as is MeTZelf's, on the individual's freedom and empowerment. Unsurprisingly, he is concerned with the ramifications for physicians. Guidelines based on these trials usurp the medical profession's power and dislodge physicians as the sole arbiters of their patients' treatment, Penston laments. He is worried about the trend that other medical professionals increasingly perform services formerly reserved for qualified physicians, and fears the specter of litigation on the grounds that a doctor failed to comply with guidelines produced by panels of experts with ties to the pharmaceutical industry. He admits that medicine is the business of managing patients, and suggests that only the clinical experience of physicians justifies that role. But clinical experience is also fuzzy and unreplicable.

The author does not question the state's licensing of drugs, nor its investing in physicians the power to forbid, advise, and even compel an individual to take them, on the premise that most of us are too stupid or ignorant to regulate our own drug use. Surely the non-existent science illuminating the decisions of those supposedly wiser than ourselves, as the author argues so well, exposes the folly of the state's interfering with private decisions? Drug regulation resembles the obedience once demanded of us by priests and kings on the authority invested in them as appointees of The Mighty Creator Himself. At a certain point in history, most of humanity revolted against kings and abandoned allegiance to priests. However, as illustrated by a survey that Penston cites, people today continue to regard doctors as the most trustworthy of all professionals. As long as we live in parliamentary democracies (or some variation of them as in the US) rather than in free states, belief in Dr. Santa Claus will continue to erode our liberty and bring us closer to complete pharmacracy*.

*This term was coined by Thomas Szasz. He was referring to the union of health care and state, rather than to rule by the pharmaceutical industry.

Copyright © MeTZelf


The Truth about the Drug Companies: How They Deceive Us and What to Do about It
The Truth about the Drug Companies: How They Deceive Us and What to Do about It
by Dr Marcia Angell
Edition: Paperback
Price: £12.23

13 of 13 people found the following review helpful
3.0 out of 5 stars Blowing the whistle, but not too loudly, 7 Aug. 2011
Marcia Angell was (chief) editor of the renowned New England Journal of Medicine for two decades. As stated on the back of the 2005 paperback edition of her book, she "had a front-row seat on the growing corruption of the pharmaceutical industry."

She fleetingly mentions possible negative effects to health by drugs, although she is not skeptical, for instance, of the need to medicate when high blood pressure, high cholesterol levels, or HIV are diagnosed. She has faith that in some distant future, genetic research will lead to new and helpful drugs. Naturally, she does not mention forced medical treatment, nor the effects of the massive amounts of drugs we collectively excrete on the earth we all share.

Angell's main beef is that the drug companies are too profitable. She correctly identifies that they are NOT a free-market success story. They live off industry-friendly laws and regulation, publicly funded research, monopoly rights, protectionism, and tax breaks. Their best client, the biggest single purchaser of prescription drugs, is government.

The pharmaceutical industry uses its wealth and power to manipulate congress, federal and state legislators, the Food and Drug Administration, and the courts. "[It] has essentially hired government to do its bidding." It has by far the largest lobby in Washington. Drug companies even hire family members of congressmen to lobby them. And they "donate" copiously to political campaigns. "Legislators are now so beholden to the pharmaceutical industry that it will be exceedingly difficult to break its lock on them."

Meanwhile, some of the public is growing more skeptical of the pharmaceutical industry, as evidenced, among other ways, by the many books criticizing it that have recently come on the market. In the preface to the paperback edition of The Truth About the Drug Companies Angell lists four titles that appeared around the same time as her own. Blech's book is not included, nor is that by Medawar & Hardon.

The industry is responding by increasingly disguising its propaganda as education. It hides behind supposedly grass-roots patient groups, which are in fact funded and often founded by drug companies. It advocates its products using paid anecdotal testimony, preferably by celebrities. Industry domination of medical schools and journals ensures that physicians are trained to reach for a prescription pad, and learn no other way of dealing with their patients' complaints.

Most of the new drugs coming on the market are me-too drugs. (Some other authors call them copy-cat drugs.) Drugs that are not proven to be better than existing drugs should not be allowed onto the market, Angell contends. But how does she expect the benefit of a drug to be proven, while she acknowledges that the research that delivers such evidence is subject to wide-spread manipulation and fraud?

In my opinion the most shocking revelation Angell makes in her book is about research on children. As an incentive to include children in drug testing, which Angell endorses, the US government grants a six-months' extension of a drug's patent rights. (This same legislation is now being pushed through the EU.) When the drug is a good seller, this proposition is immensely lucrative, so drug companies test drugs for conditions such as heartburn and "premenstrual dysphoric disorder" on children, even though these conditions never affect children. At the same time, the government's goal is defeated, because less lucrative drugs for rarer conditions that do affect children remain untested on them.

Except for her call to repeal parts of the Bayh-Dole act, and to repeal the extension of exclusive marketing rights for testing drugs in children, the solution Angell proposes is more regulation. With this she joins the ranks of the large majority of the population that continues to believe that regulation protects the individual citizen, even though it has never accomplished this in the past. She admits that every regulatory law legislated, no matter how well-intentioned, winds up benefiting the industry. Yet she proposes even more of those laws. This is the same logic by which some people think that if their appliance doesn't start to work when they kick it, they must have to kick it harder.

Who "except for libertarian extremists and The Wall Street Journal" could possibly want legal restrictions on pharmaceutical marketing removed, Angell rhetorically ponders. Yet she does not address arguments in favor of removing restrictions, except by the epithet "extremist" and by positing that before regulation, all sorts of "worthless and dangerous patent medicines" were peddled to a gullible public. The latter is true, but after a whole century of regulation, we have more of such worthless medicines than ever, and precisely the ones that are covered by prescription laws and regulation are the most dangerous.

When Angell mentions law suits brought by individuals or consumer groups, she suddenly seems to switch sides. She rallies to the defense of the drug companies, calling the charged offenses "alleged," a word she never uses to describe her own hefty accusations, and claiming that many of these charges are frivolous.

Angell has done a fine job of diagnosing the pharmaceutical industry's disorders, but most of the medicines she prescribes will do more harm than good. The one remedy she apparently finds unfathomable is leaving the individual citizen free to be responsible for his own health care.

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Deconstructing schizophrenia: an analysis of the epistemic and nonepistemic values that govern the biomedical schizophrenia concept (Psychiatrie & Filosofie)
Deconstructing schizophrenia: an analysis of the epistemic and nonepistemic values that govern the biomedical schizophrenia concept (Psychiatrie & Filosofie)
by J.D. Blom
Edition: Paperback

2 of 2 people found the following review helpful
3.0 out of 5 stars A psychiatric apologist, 7 Aug. 2011
I've lost count of how many books I've reviewed by authors who fail to reach the logical conclusion of their own arguments. Jan Dirk Blom, to use his idiom, takes the cake.

Blom tells us that he doesn't want to look at the schizophrenia concept from a social, ethical, or political viewpoint, nor does he wish to discuss the interests of the pharmaceutical industry in perpetuating it. Why he doesn't want to, you'll find out at the end of this review.

Like Mary Boyle, to whom he frequently refers, Blom tries to expose the schizophrenia concept's failure to meet the criteria set for disease concepts in biomedicine. However, unlike Boyle, he does not define a valid concept, nor does he provide an example. Blom's approach is to analyze the writings of the two men who are credited with "discovering" schizophrenia as well as four well-known contemporary authors on the subject, plus the DSM. For this he uses two sets of criteria.

One was devised by the Dutch philosopher Gerrit Glas, and specifies four levels of conception: everyday experience, clinical, scientific, and philosophical.

The other Blom adapts from the book Mystery of Mysteries by Canadian philosopher and biologist Michael Ruse. Blom's version lists seven "epistemic values" which he defines as "truth-seeking" as opposed to cultural or religious values. They are:

1. internal coherence or consistency;
2. external consistency, so consistency with other accepted concepts during the same era;
3. unifying power, or bringing together domains of knowledge which were previously not seen as related;
4. predictive accuracy;
5. fertility, by which he means engendering more ideas for research;
6. simplicity or elegance; and
7. validity

As Blom's book is rather heavy, literally as well as metaphorically, summarizing his analyses would go beyond the scope of this review. I'd like to lift out just a few interesting points he makes.

Kraepelin's "dementia praecox" was almost synonymous with degeneration. This is the idea that not only does the individual become progressively worse until he dies, but also his progeny will become worse from generation to generation. Blom suggests that Kraepelin arrived at this theory by fusing Darwinism and Christianity. Degeneration is conceived as evolution in reverse, man's moral decline, triggered by his alienation from nature. It is a medicalized version of the doctrine of original sin. The Biblical Adam and Eve fall from grace, bringing a curse of moral decline on the next generations. Blom tersely mentions the role that Kraepelin's views on schizophrenia played in fostering nazi atrocities.

It was Bleuler who renamed dementia praecox as schizophrenia, a term he considered better because he rejected the idea of degeneration. Bleuler was otherwise much influenced by Kraepelin, and seemed in no doubt that he was studying the same phenomenon as he. Unlike Kraepelin, Bleuler was a great fan of Sigmund Freud. He also cavorted with a popular medium, whose séances he attended. Though Bleuler regarded schizophrenia a biomedical disease, he used ideas from Freud and occultism to explain the content of psychoses. Blom suspects that Bleuler's patients were in fact a different population from Kraepelin's, but he does not explain what he thinks was different about them.

About the DSM Blom states that you can't criticize its theory, because it doesn't have any. The DSM states that psychosis is the prominent feature of schizophrenia, yet a few lines later it states that psychosis is not the core or fundamental feature of schizophrenia, contradicting itself. The definition of psychosis has changed so many times, that now the DSM plays it safe by omitting a definition altogether, opting instead for providing examples only, an explanatory method Blom considers suitable for children. One of the most revealing things Blom says about the DSM is buried in an endnote. He points to the lumping together of personality disorders and mental retardation in the same "axis." This suggests to him that the writers have the concept of degeneration in the backs of their minds.

Having throughout the book demonstrated the invalidity of the schizophrenia concept very well, Blom nevertheless alleges that it is a real disorder. He suggests regrouping it into smaller "hopefully valid symptom clusters" (my italics) and thinking up new names for them as well as new theories to explain them, in the "dynamic and innovative spirit" of Kraepelin and Bleuler. So he is saying that psychiatrists should continue inventing diseases, the way Kraepelin and Bleuler did.

And now, here's the big enigma: what does a psychiatrist who knows that the schizophrenia concept is fraudulent do for a living? You guessed it. Blom is employed at the Mental Health Service in the Hague (where, by the way, he was trained by Hoek, the epidemiologist). As a bigwig professor, Blom probably doesn't come into actual contact with the people who are labeled schizophrenic. So what does he do? Unlock the wards and order detoxification of the inmates? We should be so lucky. Here are two quotes, yes, honestly, from the same book:

"[M]ost mental health professionals may be trusted not to initiate any treatment until it is deemed necessary and/or desirable" (page 203)

"[P]harmacological research resulted in the development of potent medications that are today indispensable in everyday psychiatric practice." (page 232)

Necessary and/or desirable for whom? Indispensable for what? This is "epistemic"?

Perhaps Blom will dedicate his next book to the newly thought up mental illness categories he proposes. If he includes the viewpoints he was careful to avoid in this book, he could name the next one:
Reconstructing schizophrenia: New excuses for the continuing deprivation of liberty, poisoning, and torture of innocent people formerly called schizophrenics, at the hands of culpable people still called psychiatrists, who are empowered and handsomely paid by our pharmaceutically lobbied government to do so in the guise of biomedical epistemology

Copyright © MeTZelf


Medicines Out of Control?: Antidepressants and the Conspiracy of Goodwill
Medicines Out of Control?: Antidepressants and the Conspiracy of Goodwill
by Charles Medawar
Edition: Paperback

1 of 1 people found the following review helpful
4.0 out of 5 stars Down with the FDA, 7 Aug. 2011
Guess who made the statement below?
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And yet so little of this is considered that one frequently hears the long continued use of some sedative lauded with naive exultation, and without a word being said, or apparently without a thought being given, as to whether patients recovered better, or recovered at all, by taking it ...
A single dose, or an occasional dose from time to time, at the commencement or in the course of a mental disorder, as a palliative, may certainly be useful, but its habitual use is pernicious ... When that which may be used fitly as a temporary help - whether it be stimulant or narcotic - is resorted to as an abiding stay, the result cannot fail to be disastrous.
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It was pioneer psychiatrist Henry Maudsley, writing in 1895, that's right, 110 years ago. He was referring to chloral, one of a steady stream of drugs touted as THE solution to emotional problems. It was preceded by alcohol, opium, morphine, cocaine, and heroine, and followed by the bromides, barbiturates, benzodiazepines (such as Valium), amphetamines, and various types of "antidepressants," most recently, the SSRIs. Every one of these drugs was in its day prescribed by physicians (yes, even alcohol). Every one was considered effective and safe. Every one was widely used, including by children. Every one was claimed to be non-addictive. In fact, every one of these drugs except alcohol and the bromides were used to treat addiction to the previous drug of fashion once that drug's harmfulness could no longer be denied.

A. R. Cushny wrote in his 1928 textbook: "Numerous drugs have been proposed for the cure of morphinomania [morphine addiction] but none of them seems to have the slightest effect." This statement, when extended to addictions to all sorts of drugs and their proposed cures, is still as true today.

In 1957 R. A. Hunter wrote an equally enduring truth: "...not only do the patient's symptoms for which barbiturates were in the first place prescribed, return in full force when a dose wears off, which might but for drug-taking have subsided without treatment - but they are reinforced by the symptoms of barbiturate abstinence ... From then, the drug is no longer taken for the original symptoms, but simply to ward off increasingly distressing abstinence symptoms. The cause of this exacerbation may not be recognized by doctor or patient - both may think his original illness has got worse. This may lead to yet further increase in barbiturate dosage with the result that not only do abstinence symptoms become severer, but the symptoms of barbiturate intoxication are added as well... Thus a mild psychiatric disturbance, in all likelihood amenable to one or two sympathetic interviews, becomes converted into a serious and perhaps protracted illness." A half century later there are hundreds of psychiatric drugs on the market, but not one to which Hunter's statement would not apply.

By quoting these statements, Medawar & Hardon have amply demonstrated that the inefficacy and harmfulness of the SSRIs was more than predictable. However, the main issue that they address in their book is not the folly of psychiatric drugging nor the phoniness of most drug claims, but the facade of drug regulation. This applies to all modern medicines, although it is most blatantly demonstrated by the SSRI story.

Their book's catchy title hints that there is no control. Government watchdog agencies in reality cater to industry interests, not, as we like to imagine, the individual consumer's. Actually, "patients" are the one party that these agencies have consistently ignored.

Medawar & Hardon have done an excellent job of presenting their case. But what about a solution? Immensely to their credit, they exercise restraint in not proposing unrealistic schemes. In fact, they propose none at all. They only fleetingly mention the need for "honest science and decent democratic values" without a suggestion how such might be achieved or judged.

This is what MeTZelf proposes: Let's do away with (bogus) government regulation and prescription laws.

"What?" many an astonished reader will respond. "But we need protection. Think of thalidomide." Indeed, think of thalidomide. This is what Medawar & Hardon say about it:

The thalidomide crisis will always be unique because of the innocence of the victims and the sudden, shocking evidence of harm. But thalidomide happened because there was no independent control for drug safety - whereas the SSRI crisis had grown under the aegis of an elaborate and expensive global system of drug control. (their emphasis)

The logic of this statement is flawed. If the SSRI crisis grew under drug control, how can the authors conclude that lack of drug control caused the thalidomide crisis? This might be explainable if the SSRI crisis were more contained than the thalidomide crisis, but they concede it is not. In numbers, the SSRIs have far outstripped thalidomide. The mischief these two drugs have caused is incomparable because of the uniqueness of thalidomide's harm, as the authors rightly state, yet the harm from SSRIs is also shocking, albeit less graphically sensational. Government drug control has obviously only set the scene for more crises, not in the least place by lulling the public into forsaking the vigilance that the thalidomide crisis might have taught us.

Furthermore, whereas in many European countries thalidomide was sold over the counter, SSRIs have always been available everywhere by prescription only. Far from fostering wise use, prescription laws, like watchdog agencies, discourage vigilance. In addition, they stimulate consumption. Manufacturers of all sorts of goods invest in persuading consumers to use their products, but no persuasion is as compelling as a doctor's prescription.

The only fair appraisal can be that watchdog agencies as well as prescription laws, like most of the drugs they regulate, do more harm than good. Although the authors do not reach this conclusion, Medicines out of control? presents a powerful argument for the abolition of government interference in the drug market.

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