Semantics, Sullied Science, and the Federal Drug Administration

Abstract

While reading the 2nd edition of Disabling Treatments in Psychiatry by Peter Breggin, MD (2008), I was once again impressed with the care he takes to distinguish real investigatory science compared to the science of the new psychiatry in professional journals and in ever ubiquitous media sound bites. The latter are what most people believe. But real science is painstakingly careful. Genuine scientific studies satisfy criteria for design, methodology, analysis, and prediction. Ideally, subjects in human and animal studies are carefully selected so that study samples are representative, the studies are replicable, and the results reliable enough to yield validity and predictive power. Few studies are perfect, however, so certainty is difficult to achieve. Any uncertainty leaves room for unfounded, wish-fulfilling claims of certainty that can persist until real science exposes falsehoods plainly and persuasively. Such wishful claims are often founded on ideologies with false premises. The core premise in psychiatric drug studies is that mental and emotional distress is literally caused by actual, not merely metaphorical, disease. The disease premise ideology guides the study process all the way from subject selection through interpretation and drug advertising. IT'S JUST SEMANTICS What does it matter if we use the term mental illness or mental disease? It's just semantics, isn't it? The words illness and disease designate actual pathological conditions evident in cellular morbidity, while the connotations of illness and disease suggest medical treatment is needed, most likely meaning somatic treatment with drugs, electroshock, or psychosurgery. Now, although no cellular morbidity has been established for mental illness or mental disease, most people assume that the disease premise ideology is scientifically established. Thus, unwittingly, the terms mental illness and mental disease are taken literally. We do so, in contrast to our witting awareness when we say that we have a sick economy, without suggesting we should treat our sick or ailing economy with drugs, electroshock, surgery, or other medical procedures. Used adroitly, semantics can be used to short-circuit critical thinking, the kind of thinking vital both to science and everyday adaptive, constructive living. If we think in a critical, scientific manner about treatments in the new psychiatry, we would question the semantics of a long list of terms, starting with the term "new" that connotatively suggests "better." But, what is actually new today in the medical treatments of the new psychiatry? While the methodology has changed in terms of specific technology, employing different drugs, electroshock methods, and forms of psychosurgery, the orientation dates back much farther than Emil Kraepelin's early 20th century work promulgating psychiatric disease entities, notably "dementia praecox" modeled on an actual disease (syphilis) that has served as a basis for the American Psychiatric Association's Diagnostic and Statistical Manuals of Mental Disorders ( DSM ). …