Biopsychiatry Illuminated

THE CANDLELIGHT PROJECT
by Bob Collier

8 December 2003
Issue 71

THE CANDLELIGHT PROJECT

Pseudo-Science Among Us
by Dean Blehert

Part 3

Pharmaceutical Science:

If there's little or no genuine science in the psychiatric classification, what is the scientific basis of the cure? I've hinted at this [in Part 2]: If someone gives you a cure to a non-existent condition, the cure is fraudulent. Or at best, it's the equivalent of "curing" tiredness with a snort of cocaine or "curing" sadness by getting drunk. But it's difficult for most of us to believe there's so little scientific validity to pharmaceutical cures when their spokespersons speak so authoritatively of complex brain chemistry, when professors of neuro-physiology hold forth on talk shows about neuro-transmitters, and so forth. It all sounds scientific. And certainly bio-chemistry is science. It's not a soft-headed your-guess-is-as-good-as-mine field (or mine field) like psychiatry. It's hard science, done in laboratories by technicians.

But suppose we use the "tiredness" example, begin with the assumption that it is impossible or too expensive or too difficult to locate and handle causes of tiredness, try cocaine, find it has unwanted side effects, then apply science (chemistry) to find cocaine-like drugs that can be made to seem less dangerous than cocaine? Notice that we are now applying science (chemistry) on top of an assumption that has no scientific validity: that it's optimal to ignore actual causes and simply suppress the symptoms.

Is this how psychiatry and the drug companies have proceeded?

First let's review, working from the DSM "scientists" to the pharmaceutical solutions: We have a condition like ADHD, which is not a single condition, but many -- and often is not a defect in the first place. And each of the various conditions that have ADHD as a symptom has it's own cause and remedy.

But psychiatrists are doctors (they are medical doctors, unlike psychologists, who can only recommend medication, not prescribe it). That makes them scientific authorities - even though many have little training in the methods of science, nor need they ever cure anything to qualify for their degrees in psychiatry.

So when psychiatrists vote a condition into the DSM, it increases the number of conditions psychiatrists can diagnose and treat and research and for which they can hope to receive MONEY -- federal funding, state funding, patient fees (usually in the form of insurance payments) and huge subsidies from the pharmaceutical industry, which contributes millions of dollars to the APA and offers individual psychiatrists free trips to conventions, paid vacations, jobs, grants, etc. (And, oh yes, free drugs. Samples, you see.)

The pharmaceutical companies work with psychiatrists to plan out campaigns to define new mental illnesses and match them with new drugs. The new drugs don't cure the supposed illnesses. They suppress symptoms. Psychiatrists will never define a condition such as: "Piles up a lot of projects, starts them, but before finishing any, starts more." Why? Because no drug would cure it. A person who behaves that way will be exhausted most of the time, have dispersed attention, etc. A psychiatrist will list those symptoms, call them the condition, and prescribe a drug to suppress the symptoms rather than show a patient how to finish one thing at a time. A psychiatrist will never define "Neglects clearing up meanings of words he misunderstands, but reads right on past them" as a condition, because no drug will cause a person to look up such words. A psychiatrist would rather list some of the symptoms such a person will manifest (blankness, anxiety, glee, stupidity, etc.), because there are drugs that will suppress such symptoms of a "learning disorder".

Thus, the conditions in the DSM are never the real conditions, but always sets of symptoms consistent with current pharmaceutical capability: They ignore (and really bulldoze out of view) underlying conditions and suppress symptoms. If you're in pain, take a pain killer. If you're sad, take a drug that gets you high. If you don't want to think about how bad things are, get drunk. The psychiatrists and pharmaceutical companies don't tell you to get drunk, but that is precisely the entire and only scientific rationale for the entire psycho-pharmaceutical industry: If you don't want to think about how bad things are, get drunk.

Well, it's ALMOST the entire rationale. There's a bit more to the strategy and science here. There's "refinement" - taking that idea (you don't feel good, so get drunk) and using sophisticated real science to make it look better. (That's where the real science is in this whole program: the cosmetics.) Here's how it works:

Traditionally, this approach (get drunk) has at least two major drawbacks: It doesn't cure anything, and it has bad side effects. Killing the pain doesn't handle the CAUSE of the pain. If you keep taking pain killers, you never find the broken bone and have it set; you never find the tumor and have it removed before it kills you. You never realize that you have your dead mother's illness because you are trying to keep her alive, realize that you are not her and don't need to perpetuate her illness. You never find that you are deficient in some nutrient, and that this deficiency is destroying your body. You just keep upping your intake of pain-killer (or alcohol or heroin or whatever). Not only doesn't this cure the cause of the pain, but often the pain (or whatever you are trying to handle) is worse if you stop taking the drug -- and more difficult to address by other means. Such drugs are, after all, toxic.

In theory, patients take them in small enough amounts to avoid being killed by them. (This is the theory, but the number of deaths each year from taking psychiatric and other medical drugs "as directed" is huge -- in the hundreds of thousands, per some studies.) But they are, none the less, poisonous and damaging to the organism. Thus, if one comes off the drug (often with unpleasant withdrawal symptoms) and then attempts to handle the original condition, it is suppressed out of view by the trauma of the drug itself. For example, if you get drunk day after day to forget your sorrows, then manage to get yourself sober and confront the messes in your life, those messes are harder to confront than they would have been if you'd dealt with them in the first place. The light of day itself is hard to confront.

And even while in use and apparently effective, the drug has other side effects: A few drinks cheer you up, but there's the hangover, brain damage, crazy behavior while drunk, loss of job, etc. Cocaine may stir you from depression, but you get "hyper" and difficult to be around, get nosebleeds and, eventually, more serious conditions (including a stopped heart). Even the most popular, non-prescription drugs (e.g., aspirin, Tylenol) have long lists of negative side effects.

Pharmaceutical companies try to avoid these problems as follows: First, they can't be suppressing symptoms if what they are knocking out is the bad condition itself. So they invent a supposed cause for the supposed condition or mental illness that their drugs supposedly remedy. They do this after the fact and with no valid scientific evidence that any such illness even exists, as we've seen. Thus the drug companies claim they ARE handling the CAUSE, not just addressing symptoms. In other words, because psychiatrists have taken a set of symptoms and classified those symptoms as the condition to be handled, if psychiatrists can suppress those symptoms, they can claim (on psychiatric authority) that they are addressing or alleviating (if not curing) THE condition.

If psychiatrists said, "There are various situations that cause a set of symptoms we call ADHD, and these situations include nutritional problems, environmental problems, study problems, and others, each with various remedies available," then it wouldn't make sense to announce a drug to "cure" or "treat" ADHD. It would be obvious that this would be the same as getting drunk to avoid thinking about bad news. But psychiatrists define ADHD (or Clinical Depression or Anxiety, etc.) as THE condition. ADHD is simply a name they've given to a bunch of vaguely described symptoms, but since ADHD is listed by psychiatrists in DSM IV as a mental illness, these symptoms have become an illness (like tuberculosis), not symptoms (like those associated with tiredness or hunger).

In other words, the condition is defined in such a way as to make the pharmaceutical company claims look reasonable. All these familiar symptoms that we thought were reactions to all sorts of complexities of life are actually a disease - haven't you heard? The scientists have discovered that those are actually a condition called ADHD, and you can take a drug to cure it. How wonderful! No more complexities of life to deal with!

(Note: The pharmaceutical companies don't really claim to cure anything. They only imply this -- for example, in ads for anti-depressants, showing smiling, lovely people looking vital, relishing life and family activities, tossing laughing babies into the air. They can't claim to cure, because the patients must continue to take the drugs indefinitely -- for life, as far as the pharmaceutical companies can predict. There's no evidence that any of their psychiatric drugs have ever cured the condition they claim to treat. Patients are warned to come off the drugs with great caution, and frequently find, when they do, that their condition -- once off the drugs -- has worsened.)

(And how odd that a drug that addresses the real cause of a real condition -- as claimed -- doesn't remedy that cause or cure that condition.)

Brain Chemistry:

Let's take a closer look at how drugs are designed and promoted so as to sound like reasonable and scientific solutions. We'll use, as our example, the "serotonin reuptake inhibitors" (anti-depressants like Prozac and Zoloft).

A chemist working for a pharmaceutical company notices that a chemical being researched for some other purpose (for example, treating ulcers or lowering blood pressure) makes test subjects less nervous or less apathetic (or whatever). Human subjects on this drug don't seem to care as much about what had been distressing them. The new drug is then developed as an anti-depressant. And, after the fact, researchers look for a scientific explanation for the drug's effects.

(And, yes, this "after-the-fact" sequence does lessen the reliability of what's found. The researchers are being paid to find what they are supposed to find. They are not objective.)

They find that there's a neuro-transmitter (substance used to carry "messages" from one nerve cell to another -- in this case, in part of the brain) called serotonin, and that once serotonin has carried its message, a chemical in a nerve cell reabsorbs the serotonin into the cell, so that it is no longer available to carry messages. They find that the new drug inhibits the "reuptake" action of the chemical that catches the serotonin and reabsorbs it, so that more serotonin remains floating around between cells, available to carry messages -- maybe increasing transmissions between nerve cells.

So they theorize, maybe depression is caused by too little serotonin floating free. Then they study brain activity of people they rate as depressed and find that these people have less than normal available serotonin and that while on the drug they have more serotonin. So they say, "This indicates that a serotonin deficiency (a chemical imbalance -- too much reuptake chemical) causes depression.

Now this is science -- sort of. First of all, I've simplified the science. Second -- so have they, since the researchers picked on one of many effects caused by the drug and ignored others. They also assumed more than they proved: they find a chemical phenomenon associated with an emotional state, and assume that the chemical phenomenon is the CAUSE of the emotional state. (Why not vice versa?) They also brush over the fact that in many cases the drug simply doesn't work (no lessening of depression), which suggests that not all depression has the same chemical characteristic. So the science is a bit sloppy. But that's not the main problem -- which is that more or less genuine science has been joined to pseudo-science -- like putting a pretty wig on a skull. Here's how that works:

Assume that the chemistry is correct, that the main effect of the drug is to increase the amount of available serotonin, that all people when depressed have less serotonin available and that all people, given the drug, have more serotonin and are less depressed as a result. Now that's a lot to assume and a lot more than is known. But assume it. What does it amount to: If you don't want to think about something unpleasant, get drunk. Getting drunk, too, has chemical effects on the brain, and they occur in every case. And it works as long as you can stay drunk. In other words, all the more-or-less-real chemistry entered into the equation doesn't change the basic rationale: We are still failing to distinguish between symptoms and causes.

Let's grant that one can consistently identify people who are "clinically depressed". (And this is doubtful. Psychiatrists, at any rate, are notorious for diagnosing murderers as harmless and harmless people as dangerous.) Grant that such people have less serotonin free between brain neurons. But we also know that if we kick a person off his job, steal his wife, take away his children or his home or his car, put him into no-win situations, tell him repeatedly that he's good for nothing and of no use to anyone, keep him from getting food and sleep, etc. -- if we do all or some of this, he will almost certainly get depressed -- and may then have a serotonin deficiency. If we then restore wife, job and a sane environment and make sure he's well-fed and rested and generally repair what we broke, he will probably recover from depression -- AND cease to have a serotonin deficiency (assuming, again, that the chemists have their chemistry right).

Which was cause? Which was symptom? Did we cure his depression by removing free serotonin from his brain, thus causing him to lose his job, etc.? Or vice versa? Do we raise flowers by watering and fertilizing them so that they grow from their roots upward? Or do we reach down to the roots with our hands and yank the flowers up out of the roots?

A car that won't go has wheels not turning. A car that moves has wheels turning. Does this mean that you repair a car that won't go by spinning the wheels? Or do you find out why the car isn't moving and fix that? You could jack the car off the ground, then manually spin the wheels and say, see, it's fixed. And in a way it would be as long as you kept spinning the wheels with your hands.

We know that mental state affects physical state. Anger stirs up the adrenals, which affect heart beat, digestion, thyroid -- even brain chemistry. Fear, joy, anxiety, hatred, apathy -- all affect the entire organism. But which comes first, the anger or its chemical effects?

The argument of bio-psychiatry (the science created to vindicate the pharmaceutical approach) is that one should differentiate between a "real" fear (meeting a mugger with a knife) versus a phobia; between a "real" anger versus an anger disorder, and so forth. The disorder versions of our emotions are caused by chemical imbalances. You can distinguish between them by whether or not the "real" source of emotion is plainly visible in the environment.

Even if this reasoning were valid, it would be purely academic, because in practice, most psychiatrists and doctors don't bother to inquire after real environmental factors. If the patient complains of depression, he's given an anti-depressant. Most insurance companies and HMOs expect doctors -- including psychiatrists -- to spend only a few minutes with each patient. There's no time -- not if you want to be paid by the insurance company -- for any questioning or therapy other than prescribing the miracle drug of the week, which only takes a few minutes, and, in the short term, seems to save money for the insurance companies and HMOs. This discourages even psychiatrists who WANT to look for real causes from doing so.

Besides, once the disorders are in the DSM, any doctor - not just psychiatrists, but ANY doctor can prescribe psychiatric drugs for them. Thus, some psychiatric spokespersons say that these drugs should be used only after an expert (that is, a psychiatric expert -- a label akin to "military intelligence") has eliminated the possibility that the patient needs to be counseled to help him/her handle some environmental difficulty -- like the loss of a loved one or problems at work. But in practice, the patient has come to a doctor, who is not a psychiatrist and has not been trained as a counselor, who knows only that the patient says "I'm depressed" and that he has in hand the latest drug for depression -- which he then prescribes.

I've heard a psychiatrist who felt psychiatric drugs were being over-prescribed explain at great length that this is not mainly the fault of psychiatrists, since the drugs were being prescribed mainly by family doctors. This is probably true, but the family doctors can prescribe the drugs only because the psychiatrists and pharmaceutical companies have invented the illnesses and their treatments and persuaded insurance companies to pay for the treatments and, in many cases, persuaded politicians to pass laws requiring insurance companies to pay for those (and ONLY those) treatments.

But even if every patient complaining of a condition (for example, anxiety) were carefully questioned to determine whether or not this is a "REAL" anxiety or a "mental disorder", the reasoning itself is shallow. It assumes that if no cause is immediately visible in the environment, there must be no such cause. Suppose someone is afraid of dogs. They have no "reason" to be afraid of dogs. No dogs are bothering them. There aren't any dogs in their neighborhood. They can't recall having any trouble with dogs. Therefore the phobia must be a chemical imbalance in the brain? That's ignoring the way people make irrational associations. Typically such a phobia drives from something earlier (and probably painful enough to have been pushed out of view - its details forgotten) that in some way (maybe an utterly nonsensical way) is stirred up by the sight or smell or sound of a dog.

Freud gave this approach a bad name, because he didn't ask; he TOLD the patient what the patient REALLY feared, and did so based on unproven theories about what people really fear and speculations about what dogs might "symbolize". But there are hundreds of thousands of people who've rid themselves of fears simply by spotting and examining the real sources of those fears (and other unwanted emotions and pains). Freud's follies don't discredit (as they're said to do by bio-psychiatrists) the fact that what we react to when we react is not necessarily something that comes immediately to view, yet is no less real for being suppressed out of view.

The current psychiatric view is that if no cause is immediately evident, one should simply assume a bio-chemical cause and medicate it. Here again the failure of psychiatry (the ineffectiveness of talk therapy) has led psychiatry to an unusual and perhaps desperate solution.

And usually, since it is faster than helping a person handle complex life situations, a psychiatrist will ignore even obvious external causes and go immediately to medication. Or if he refuses to medicate, the patient will find a psychiatrist who WILL, because the patient's insurance won't cover any other treatment.

Note that, even if you don't believe that a condition can have causes (the "real" kind) that are not immediately visible in the environment and that the patient doesn't even know about, still, there is no evidence that the causes of these conditions are chemical imbalances in the brain. All that's KNOWN is that in some cases a drug (that affects brain chemistry) can suppress symptoms. If it were true that where no obvious environmental cause is evident, it is correct to assume that the cause is a chemical imbalance, then the result of remedying that imbalance would be a cure, but this is never the case.

Or perhaps we should say, these drugs do not remedy the imbalance. They just cope with it, at best. Because, again - and this is something psychiatrists and pharmaceutical chemists don't even TRY to refute -- these drugs cure nothing and usually leave the patient worse than when he started, once he goes off the drugs or, in many cases, if the patient doesn't increase the dosage gradually over the years. (It can be argued that they are worse while ON the drugs, which we'll look at under "bad side effects" later.)

In other words, this idea most of us have been given by the media that science has proven that mental illnesses are all the result of chemical imbalances in the brain is simply pseudo-science. Science has shown that in some cases chemical states of the brain can be associated with certain conditions. Science has not shown that these conditions are caused by these chemical states or cured by treating these states chemically. In many cases (e.g., ADHD) no one has even managed to find a chemical state in the brain that can be associated with ADHD (or supposed cases of ADHD). One researcher made headlines years ago with claims that he had found brain shrinkage in a high proportion of ADHD cases. What the newspapers didn't say (and the researcher didn't tell them) was that these "ADHD cases", when their brains were studied, had already been on Ritalin and other drugs for a long time, and that these drugs are known to cause such brain shrinkage. In other words, what he really "discovered" was the validity of previous research indicating that Ritalin damages the brain.

What the current rationale amounts to is, "We don't know what causes these conditions, we don't know how to cure them, and when we can't see any obvious environmental cause for them, we may as well assume they're chemical imbalances, so that we can justify suppressing the symptoms with drugs. Meanwhile we'll keep researching to find more chemical mechanisms in the brain that seem to be associated with these conditions, in order to give a greater semblance of science to what we're doing."

All drugs (alcohol, tobacco, Prozac, marijuana, cocaine, Thorazine, Valium, LSD, arsenic, caffeine, aspirin, etc.) mess with brain chemistry to some degree. The real science here is chemistry. Real chemists make some verifiable pronouncements about brain chemistry, which lends a scientific aura to the whole pseudo-science of promoting a drug that suppresses a symptom (pushes it out of view). They then invent a chemical explanation, claim that the chemical mechanism is the CAUSE of the situation. Thus Ritalin and related drugs in the speed family, such as dexidrene, are given to millions of children in the United States to control ADHD -- and schools are paid hundreds of dollars a month by the federal government for each child they diagnose as ADHD!

All this despite the fact that there is no scientific evidence that the supposed disorder, ADHD, exists, there are no scientific tests for ADHD, there is no known chemical imbalance (scientifically validated) associated with this supposed condition, and, while there's evidence that some active children become less active when given Ritalin (except for the ones who get wilder), there's NO evidence that this improves them as students or yields any long-term gain in their grades or achievement. Some people swear by it, as, for centuries, people swore to the efficacy of bleeding the sick or visiting witch doctors, but it ain't science.

Notice that I'm not delving into statistics or anecdotes. I'm not telling you about kids put on Ritalin who soon after commit suicide or kill people. Nor am I telling you about kids who claim to have gotten better on Ritalin. I'm leaving the war of anecdotes to others. I don't have to go into statistics, because in the key areas there are none. There's simply NO evidence that Ritalin has improved students' ability to study. There IS evidence to the contrary -- for example, the general decline in student IQ, which, when graphed, exactly parallels the graph of increased psychiatric intervention in our schools.

But my main point here is to deal with the LOGIC and ILLOGIC of the current psychiatric scene, because most of us are instantly paralyzed by the idea of challenging SCIENCE, with all its complexity and power. I'm not making the whole case here for the damage caused by these drugs. I'm trying to remove from this picture the blinding aura of SCIENCE, the idea that the experts have proven all these things, that it must all make sense if it's printed in big books in big words and spoken with authority by intelligent-sounding voices on "All Things Considered"; the idea that all these invented conditions are scientific developments and realities, and that all these people who are supposed to have these conditions are somehow changed from what we used to think they were, now that we "know" that they "suffer from mental illnesses".

I want to remove some of the false preconceptions from the way we think about these things, so that we can look at what's really there and make up our own minds on the subject. I'm more interested here in unraveling the LOGIC of psychiatric claims to being scientific than in producing scholarly references to studies and statistics. The big question here is, do the premises make sense? Are we dealing here with science at all? If not, all the scientific trimmings in the world won't make it scientific. A million studies of ADHD patients won't produce scientifically valid results if there's no such condition as ADHD. You may as well research the mental chemistry of the angels standing on the head of a pin.

Copyright © Dean Blehert THE FINAL PART OF 'PSEUDO-SCIENCE AMONG US'

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