James Davies, Cracked: Why Psychiatry is doing more Harm than Good

cracked

Now the drugs don’t work

They just make you worse

But I Know I’ll see your face again.

(The Verve)

Who was this professor who was “making money” on the fact that the pharmaceutical companies and psychiatry were making money on human suffering? I was curious. The occasion to buy the book presented itself at British airport, where it stood in multiple copies just near the chips and the bio apple juice. I had seen it at Waterstones as well, it was an essay about the failures of psychiatry and probably was a best-seller.

The essay is a series of well-organized interviews and clear-cut reasoning. It covers all the main topics about the reliability of psychiatry, the deficiencies of the DSM and the unavoidable effects of the collusion of psychiatry with the pharmaceutical companies. The lack of scientific evidence about the biological theory of mental disorders is pivotal.

I read it keeping both a skeptical and open-minded point of view but I must admit that it damaged my shell of tranquility and trust. I have titled each brief section in order to facilitate a quick reading of the main topics of the essay. However, this review only reports the main themes and does not carry my personal opinion. Perhaps I’ll write about my personal point of view soon.

The Rosenhan experiment:

Professor Davies moves from the so-called Rosenhan experiment, published on Science in 1973. Five psychiatrists traveling incognito feigned auditory hallucinations in an attempt to gain admission to different psychiatric hospitals in the United States. The results were discouraging and illustrated the danger of dehumanization and labeling of the psychiatric institutions, and most of all the shortcomings of the psychiatric diagnoses.

Historical excursus on the genesis of the DSM (Diagnostic and Statistical Manual of Mental Disorders)

James Davies goes over every stage of DSM’s evolution from its first edition in 1952 to its last biblical revision in 2013. The conversations with eminent psychiatrists are genuine but disheartening. The conclusion is that

“what is striking about the construction of DSM is that the procedures it followed often had very little to do with ‘science’ as most people understand the term, because, in short, the evidence was lacking”.

The corruption of statistics. How the machinery psychiatry-research-pharmaceutical companies works. Kirsch’s experiments on placebo

Davies clearly explains how the machinery of psychiatry works in the U.S. and Great Britain.

Firstly, the universities are financed by the pharmaceutical companies and the independence of university research is then under pressure. The studies are manipulated and the embarrassing data are covered and excluded in a number of legal and scientifically accepted ways.

Thirdly, the drugs are rebranded in order to increase the sales and in parallel with the introduction of new disorders. The aim is to extend the target of drugs. During the last decades, the number of psychological disorders defined by the DSM have unbelievably increased. The number of drugs prescriptions have then worriedly improved as well. The example of Prozac is emblematic. One pill continued to be marked as an antidepressant, the other (rebranded as Sarafem) they marked as a so-called pre-menstrual corrective. The essay also covers several examples about children diagnosed with ADHD.

Fourthly, the trust pyramid. Psychiatrists at the base genuinely rely on the data and follow a vertical system of reciprocal trust in which the pharmaceutical representatives expertly integrate themselves.

In the end, Davies insists of Kirsch’s experiments on placebo and the antidepressants. The data clearly show that antidepressants don’t work in the manner people usually think they do and above all are not more effective than placebo.

The cultural aspect

The classification of a number of human feelings and the consequent medicalization is a philosophical and ethical subject as well. Psychiatry has in some ways substituted the myths and rituals about death and sorrow. Says Frances, chair of DSM-IV:

“Reclassifying bereavement as a symptom of depression will not only increase the rates of unnecessary medication, but also reduces the sanctity of bereavement as a mammalian and human condition. It will substitute a medical ritual for a much more important time-honoured one. It seems to me that there are cultural rituals – powerful and protective – that we shouldn’t be meddling with. But by turning a normal painful experience into a medical illness we are doing precisely that”.

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