2. Dr Ghaemi vs Dr Frances
I am a little better than yesterday, and have another Nederlog on
psychiatry and psychiatrists.
1. On psychiatry
Background: An article by Mala Szalavits in "Health and
Family" (also elsewhere) from October 2012:
psychiatrist is Dr David Healy, whom I wrote about in The
of Medicines, who got
invited - I am a bit amazed to report - to talk to the members of the
American Psychiatric Association.
The article is interesting, also because it contains a number of links
to other interesting relevant material.
I hope Dr Healy is right but I don't know, for various reasons, one of
which is that I think psychiatry, for the most part, is dead,
as a science, and has been replaced since the 1980ies by the science of
public relations, that indeed has many ghostwriters who know how to
write medicalese looking papers in "professional journals".
Here is my view of the field, copied from a note to my "Arguments
psychiatry", with a few changes, and
six notes to make my intended meanings clear:
Personally, I have never taken psychiatry serious as a real
science, basically because I did read Freud, Jung, Laing and some
others in my teens , and decided that whatever
that was intented to
be, and whatever
that was good for - since many people do have psychological problems,
and some get thoroughly mad, and all such persons deserve some form of
help, however motivated, provided it is honest and not based on false
pretensions - it certainly was not real science, in the sense
that physics, chemistry, biology and most of medicine other than
psychiatry are real sciences. 
Then again, until 2009 I never worried about psychiatry, because it
seemed to me to be useful - more so than not - for at least two ends:
To help the insane, and to provide some sort of support for the
neurotic , where I mean by "the insane" those
who are thoroughly mad
not capable of helping themselves nor of functioning in society
(without a lot of help), and by "the neurotic" those with psychological
problems who can function socially, but who seek help from
professionals, since they cannot find it elsewhere, and they feel
miserable (depressed, fearful, nervous, unhappy etc.)
It also seemed to me, from what I knew about psychiatry and clinical
psychology, that much of that help was bound to be inept, since
most of what I had read in those subjects seemed mostly false to me,
but then in life one must make do with what there is rather than what
there should be, while society is fundamentally an interpersonal
contract for mutual help or protection.
It seems to me - after three years of reading since 2009 - that
psychiatry since the DSM-III of 1980 is an intentional fraud, an intentional scam, that is meant to
enrich psychiatrists and pharmaceutical companies by the selling of as
many psychiatric drugs as is possible , and that
for this purpose
whole diagnostic machinery of psychiatry, that never was really
scientific, because there was not enough knowledge about how the brain
manufactures human thought and feeling, has been transmogrified into an
that is designed on purpose to look and sound as if it is medical
science, but is in fact intentional bullshit
designed to give psychiatrists power without social control, without
being found out, and with the possibility, that comes with their having
a medical B.A., to sell as many medical drugs to laymen as they can. 
This is dangerous in itself, and the more since in the same period of
the last 30 years the social control of the drug companies has grown
much less, whereas great parts of what used to be more or less inept
psychiatric attempts at science have been replaced by professional
salesmanship and marketeering driven by the justified expectation of
Modern psychiatry, at least since the DSM-III, is not about helping
people with psychological problems in an honest way, but is about
selling them expensive drugs in a profitable way. 
Dr Ghaemi vs Dr Frances
learned about the existence of Dr Ghaemi when working through Question
1 of "The six
most essential questions in psychiatric diagnosis"
where I found he was one of the few psychiatrists who made some sense
(to my way of thinking).
Apart from what I read in the last link, I was not familiar with Dr
Ghaemi or his writings, until today, but it turns out he also has a
column on Psychology Today, which I know about because he
difference of opinion with Dr Frances.
Dr Ghaemi's view - also a professor of psychiatry, considerably younger
than either Dr Frances or myself - is this, and I copy from Psychology
Today, but remove the links to its thoroughly inane explanations of
terms, and to amazone.com, while the first line is a link to the
original by Dr Ghaemi:
considerably more than not, since indeed I have argued this same point:
The pernicious infuence of postmodernism on psychiatry in my long but
still relatively often downloaded DSM-5:
Question 1 of "The six
most essential questions in psychiatric diagnosis" ... so I am
is the ultimate flaw of the DSM system:
Many people, including,
it seems, the leadership of DSM-IV and DSM-5, have an unconscious postmodernist ideology. They
distrust science; nosology leaders (like some of the leadership of
DSM-IV) often have themselves been engaged in little, if any,
scientific work. "Take the experts with a grain of salt" betrays a
skepticism that, partly justified, can easily become an anti-scientific
cynicism. Some readers
may take this view to a nihilistic extreme, as did a national NPR
science reporter with whom I once spoke. If they do, they share the
same postmodernist ideology that has produced the DSM-5 which they
Unless we get beyond this
anti-science extremism, we cannot progress.
When the DSM
leadership--whether in the 3rd, 4th, or 5th revision--gerrymanders
psychiatric definitions for professional purposes, nature will not follow suit, and our
biology, genetic, and pharmacology studies will be doomed to fail, as
they have in the past three decades.
This is a much sadder
reality in psychiatry today than the APA Board of Trustees approval of
The generation of
psychiatric leadership that gave us DSM-III, IV, and 5 has had its day.
The future will belong to new generations of psychiatrists who, we
can hope, will think for themselves, without personal commitments to
these errors of the past.
(PS: "First do no harm"
is a pious slogan not to be found anywhere in the Hippocratic writings.
It was invented in the 19th century by a British writer. The
Hippocratic phrase is: "As to diseases, try to help, or at least not
harm." By sacrificing science to "pragmatism," all versions of DSM
prevent the profession from identifying diseases, making it harder to
help, and ensuring that harm will ensue.)
Dr Frances, as it happens, does not address these points at all - which
does not amaze me. For more, see my DSM-5:
Question 1 of "The six
most essential questions in psychiatric diagnosis", where
you'll also find more of Dr Ghaemi with my discussion of those views.
As to "First do no harm": I was aware "primum non nocere" does not literally
occur in the Hippocratic corpus (also not in Greek), but it is quite
close to what the man wrote (in English in fact: "As to diseases make a habit of two things -
to help, or at least, to do no harm"). It is often
referred to as Hippocratic, I would say with at least as much license
as "I disapprove of what you say, but I will
defend to the death your right to say it" is attributed to
Voltaire. ("The spirit, if not the letter.")
Also, the principle is not so much "pious" as moral - but I agree with
Dr Ghaemi's point, since I hold that the end of human medicine should
be the well-being of human beings (other than the medical doctor, to be
3. Dr Nardo
In fact Dr Nardo's texts have been rather often referred to by me in
Nederlog, since he is the same as
or at least:
His blog goes by that name, and he recently has also used his name
He is a sensible and intelligent man, who wrote a lot of interesting
texts - he started in December 2005 - about his own field, and in his
some about his own road towards psychiatry, whence he arrived after
starting out specializing in internal medicine.
I have somewhere remarked I found that odd, but subsequently realized
that if one is a student of medicine it may well seem one can be more
helpful to people by helping them undo their confusions and delusions,
than by practicing invasive medicine on them.
It seems this was a correct guess:
developed in the course of internal medicine practice, realizing that
many of the patients I saw may have come for help with physical
symptoms, but the real problem was "supratentorial" [a doctor code word
for "in the mind"]. Without actually noticing it happening, that’s
where my interest was drawn. It wasn’t the major psychiatric illnesses
– it was what the term "neurosis" means.
In fact, I
have myself played with the notion that I might want to study medicine
(not: psychiatry) when I was around 18, but then got a job for several
months encoding medical abstracts for being fed to computers (at that
time: in the form of punch cards), in the course of which I had access
to more medical journals than almost anyone ever has or had, which
cured me forever from wanting to study medicine .
(Otherwise, I might have tried, probably with no good outcome of any
He also has an interesting term and concept:
It’s the danger behind the Hippocratic Oath’s injunction to "Do No
Harm." (...) That’s what Therapeutic Zeal means, becoming too invested
in treating and overlooking the dangers.
It seems a
useful concept and term, though there are possible varieties, and there
is room for Therapeutic Profitability, as is the case with many
postmodern psychiatric drugs, Therapeutic Trendiness, and
Therapeutic Indifference: I recall the late Sixties - "Mother's
Little Helper" time, when barbiturates were
available through doctors as if it were candy:
|"Kids are different
today, I hear ev'ry mother say
Mother needs something today to calm her down
And though she's not really ill, there's a little yellow pill
She goes running for the shelter of a mother's little helper
And it helps her on her way, gets her through her busy day"
... while these
days the kids are prescribed Ritalin, which
is chemically like cocaine, and seems to be what moved Dr Frances
against the DSM-5.
I also recall that in the late Sixties / early Seventies I had friends
who studied physics and chemistry and who used to prepare their exams
that young women then could very easily get "for slimming purposes",
though everybody knew - in the circles I moved, in Amsterdam -
dexedrine was addictive (it's an amphetamine) and
could lead to serious problems.
Nearly at the end Dr Nardo writes
Yet with my
abiding interest in the history of medicine and psychiatry, and
something almost like a hobby preoccupation with the shoals of
Therapeutic Zeal, I was totally unprepared for what happened in
psychiatry in these last thirty years – so unprepared that I didn’t
even really see a lot of it happening.
I believe him, and apart
from having read a lot from his recent wrtings, there are three other
reasons why "what happened
in psychiatry in these last thirty years" was hard to get:
First, it was all carefully kept secret, and what happened - secret pharmacological funding, ghostwriting,
non-publication of experiments, miscodig of data - and what was
made available to the public, including practicing psychiatrists, was
presented in quite different terms than are factually adequate, and, it
seems, generally with a lot of public
relations techniques. Second, there was no fast internet, which
makes it very much easier to access huge amounts of data and to find
different points of view. Third, especially the lack of - widespread -
fast internet for most of the past thirty years made if far more
difficult for the few who did see what was happening, such as Dr Szasz and Dr
Healy, to make themselves heard.
Then again, whether "what happened in psychiatry in these last thirty years" can be rapidly undone remains to be
seen, especially as the pharmaceutical companies have vast amounts of
money, very effective public relations, no conscience, and a very
strong profit motive.
Jan 27, 2013: Corrected some
typos and added some links I had forgotten.
The relevance of "in my teens" - in fact: 17-19 - is threefold: First,
I still could very well remember my childhood: It just wasn't as
psychiatrists said it was (and at 17 I was no more tricked by the
contention that "you must have repressed it" than I am now: without
specific evidence that's just a dishonest claim); second, if ever I was
to be convinced by
psychiatric theories it was then; third, the fact that I wasn't is
probably mostly due to a combination of being very intelligent and
being so in a specific way.
To elucidate the third point some: I have known some very intelligent
men, including psychologists, who were far more impressed by psychiatry
especially - Freud than I ever was. The reason Freud and other
psychiatrists didn't much appeal to me is that I have a mathematical
type of mind: Theories make real sense to me only if they are logical
deductions from credible assumptions.
Psychiatry seemed arbitrary and literary ("literary" as in "fictional
literature") - to me, both of which are not
science, even if psychologically speaking that is how real science gets
started: In the imagination.
 I read far and widely in and around
various sciences, and met very
few who did. Psychiatrists and psychologists who believe their fields
are real sciences should read some good introductions to physics,
biochemistry or mathematics to get some firm grasp of what real science
is really like.
 I did choose the terms "insane" and
"neurotic" on purpose, in part
because the former is a legal term, and because both terms are
currently not part of the DSM.
 Having worked my way through part of
the psychiatric writings that
belong to purported foundations for the DSM-5 (Submission to the DSM-5
Task Force of the APA) and through a
recent disquisition on the fundamental questions of psychiatry
Question 1 of "The six
most essential questions in psychiatric diagnosis") I am not capable of
seeing how anyone with a good
intelligence (IQ > 130) and a good grounding in science and logic
can see this otherwise, and be honest and impartial.
 It is not as if there is not an
eminently clear very strong, human all too human, very well known
for psychiatry having been made intentionally into a pseudocience: Billions
of dollars of yearly profits on
All that psychiatrists have as arguments against this are fallacies:
That one should trust them, "because" they are "medical
that one should trust their diagnostic system, because it is
medicalese almost no laymen can see through.
It's the same line or argument as the thoroughly corrupt and atheistic
Renaissance popes and cardinals used - see Barbara Tuchman's "The March
 To make that very clear, I copy and
somewhat rewrite something I wrote in September last year, speaking
about psychotherapy - understood as the provision of help to people
with psychological problems, which I am in favor of - in general:
The point I want to make
present section is that especially psychiatrists and psychologists, who
are, in terms of years and level of education the highest trained among
the psychotherapists, and who tend to pretend that they have a level of
expertise, knowledge and insight that ordinary people - "layman" -
lack, are almost all of them bulllshitting if
are some of my
reasons - and
as it happens my academic degrees are in philosophy and psychology, so
indeed I am not speaking in ignorance:
professionals, and NONE of the psychiatrists is able to give anything
like rational, empirically supported, scientific answers to the
following questions (and there are quite a few more that are relevant
that they rarely can answer, about epistemology, statistics,
probability, logic and science, for example, but these are too
technical to consider here and now):
What is a human
human self, a human character?
(2) What is consciousness, and why do we have it?
(3) How does the brain generate commonsense experiences?
(4) Do we all experience similar things in similar circumstances?
(5) What is meaning and why and how can we communicate with language?
ALL of the psychotherapeutical
professionals, and ALL of the psychiatrists presuppose SOME sort of
answers to ALL of these questions, indeed like anyone else who can
function in a human society without creating major problems for others
- but ALL of the professionals mentioned bullshit you or delude
themselves if they pretend to be able to answer these questions, other
than by what is mostly faith or illusion, if indeed not intentional
bullshit meant to make you pay.
 Why, you may ask: Many reasons, that
can be conveniently summarized by saying I learned a lot more about
what medicine involves, in practice and in theory, and I realized it
just wasn't for me. Actually, this is good advice for people who are
interested in studying a certain science: First read some of the
introductory texts that are used in universities, and check out the
professional journals of the science, to see whether it is like you
(that I prefer
to call M.E.: The "/CFS" is added to facilitate search machines) which
is a disease I have since 1.1.1979: