Shutting up and listening #1: The virtuous hearer

Others have already said most of what needed to be said about Ron Lindsay’s performance at the Women in Secularism conference this past weekend. But I did want to quote one bit that stood out as both hilarious and telling:

By the way, with respect to the “Shut up and listen” meme, I hope it’s clear that it’s the “shut up” part that troubles me, not the “listen” part. Listening is good….

It would seem plain to most thinking people, though, that the two are inseparable. I don’t mean this only in the simple and obvious sense that you can’t really listen while you’re physically talking (though the obviousness of that fact should provide a clue). And listening isn’t just good. Listening – not merely each individual act but the habitual practice of fighting the impulse to impose our perspective and interests and attending to others' experiences and ideas - is an essential element of…inquiry. I would expect the leader of a center nominally dedicated to it to appreciate at least that much.

But this all reminded me of a book I wrote about back in 2011 – Miranda Fricker’s Epistemic Injustice: Power and the Ethics of Knowing. It’s important to recognize that we live and interact in an epistemically unjust culture. What’s at issue is not simply the sexist content of particular beliefs and pronouncements about women and men but the way women and men are treated as information-givers. Outside of Muslim theocracies, testimonial injustice has been to a large extent written out of law, but the culture remains, and is far from confined to religion.

Women are talked at, talked about, talked over, talked past, and talked down to (not to mention monitored, harassed, and threatened when they do speak). Women’s voices aren’t sought. They’re not listened to respectfully, and when they are, they’re not believed and their contributions aren’t incorporated into men’s views. (This is true in relative and absolute terms: when I say that women’s voices aren’t sought, for example, I mean that sometimes they’re not sought at all, sometimes they’re sought less aggressively or as an afterthought, and sometimes they’re sought but to a lesser extent relative to men’s.)

This isn’t a question of a few impolite or insensitive individuals, but is, in Fricker’s words, a “somewhat hidden dimension of discrimination” (p. 145). It’s harmful to women, but also to men – to the entire epistemic community. This epistemic discrimination of course contributes to the false, biased beliefs that emerge and persist, and complements other forms of discrimination. To act ethically as a community, we need to recognize ourselves as part of this epistemically unjust culture and appreciate how it shapes our responses to women as information-givers.

Fricker advises addressing the problem at the larger cultural and institutional level, but focuses on the individual ethical level: how we can and should learn and cultivate the qualities and habits of what she calls the virtuous hearer. As I’ve discussed at some length, all scientific, loving, humanistic relationships intrinsically involve respect and the attempt to minimize the tendency to impose our preconceptions; Fricker’s framework adds to this a recognition of epistemic injustice and the moral requirement – which falls in practice more heavily on those in dominant categories - to develop habits that challenge and counteract it.* Very generally, this can be summed up as “Shut up and listen.”

* In relation to helping people understand the structural problem, Fricker talks about the usefulness of thinking about situations in which they’ve been on the “losing” side of epistemic injustice. It’s easier to understand sex-based epistemic injustice, for example, if you can relate it to your own experiences with epistemic injustice as a member of an oppressed racial or ethnic category, and vice versa. Many people have faced it as a young person, or maybe as a low-level employee. I’ve tried in the past to appeal to people like Dawkins or Lindsay (or Peter Singer) by calling attention to parallels with religious privilege, but I recognize that there are significant differences that might render the analogy unhelpful and that it’s possible that some of these men have never been anything but epistemically privileged. In any case, I remain optimistic that people, even if they can’t draw on their own experiences of epistemic injustice, can understand the problem.

Women in Secularism 2

Best wishes for Women in Secularism 2!

Enjoy, and make history!

Will skeptics approach biopsychiatry skeptically?

I’ve been writing critically about biopsychiatry for a few years now. In that time, I’ve encountered a total of one prominent skeptic who was willing to do the same (as far as I know, following a backlash he hasn’t posted on the subject for two years). In that time, my posts on the subject on atheist-skeptic sites, regardless of context or tone, have been greeted by a barrage of ad hominems (directed at the authors I’m citing or at me) and anecdotes, factually unsupported assertions, and a resolute refusal to investigate the matter further.

I continue to be perplexed by this. This month, the head of the National Institute of Mental Health and the chair of the APA’s DSM-5 task force have publicly stated that psychiatric diagnoses lack scientific validity (I’m sure they now wish they could have given it a better spin, but it’s out there for all to see). The extant scientific evidence of the past several decades does not support the specific “diagnoses” or the genetic-biological model of psychiatry, as has now been recognized in a position statement by UK clinical psychologists. Belief in the validity of the diagnoses and model doesn’t stem from scientific knowledge, but from a gargantuan, wildly effective, and well documented marketing campaign that has lasted several decades.

If this were just about standing against pseudoscience or manipulation or about being right, or even about more abstract humanistic concerns, I wouldn’t have persistently written about it for the past few years in the face of the onslaught. But it isn’t. The acceptance of this false model has given psychiatry and drug companies unprecedented political power, and people – adults and children – are being coercively and forcibly drugged on a massive scale. In addition to the billions being funneled to pharmaceutical corporations, there have been catastrophic effects on people’s lives. It’s a political nightmare and a human rights disaster.

I’m disappointed that my efforts related to this for the past three years seem to have been almost entirely unsuccessful. The fact that the responses look the same as they did back in 2010 gives me some hope, though. The problem seems at root to be that skeptics aren’t, for some reason, investigating the matter. So all I’ll do right now is provide another list of sources, and urge people in the most heartfelt terms to read and engage with them fairly:

• The new article by Brett Deacon - “The Biomedical Model of Mental Disorder: A Critical Analysis of its Tenets, Consequences, and Effects on Psychotherapy Research”- whose full text is available via my link here (especially the conclusion, Tables 1 and 2, and the references).

• The books listed here.

• Joanna Moncrieff’s book, or at least her talk about it.

• The articles by Marcia Angell in the New York Review of Books linked to at the post above, but I’ll provide the links once again:

• "The Epidemic of Mental Illness: Why?"

• "The Illusions of Psychiatry"

• and this exchange.

If you’re unwilling to read these materials – especially if you continue to post in defense of biopsychiatry - you should turn in your skeptic’s badge. If you read them and don’t come away convinced that what I’ve been saying is true, well, I’ll be surprised, but at least then we could have a real discussion amongst skeptics.

Giles Fraser, Erich Fromm, and assisted dying: reclaiming relatedness and love

Giles Fraser’s recent article arguing against voluntary euthanasia on allegedly humanistic grounds has provoked hostile responses from many quarters, and rightly so. Ophelia Benson and Eric MacDonald have done an outstanding job of responding to the article’s main thesis. I’m going to expand on these impassioned rebuttals to talk a little more about the vision of human relationships and of love underlying Fraser’s position. His isn’t an especially profound or well-reasoned piece of writing, but I think it’s a useful one to examine since it represents a particular vision of the world, a tragically attenuated one that finds human relatedness primarily or exclusively in pain and defines love narcissistically and coercively. As such, it’s fundamentally at odds with Erich Fromm’s ideal of loving relatedness, and in fact illustrates one of the unhealthy, failed approaches to relatedness that Fromm discusses.

Fromm argued that the embrace of pain, suffering, death, authoritarianism, and destruction doesn’t result from innate sadistic-masochistic or destructive drives, but is rather a response to frustrated efforts or a lack of opportunities to overcome alienation¹ - to fulfill our need to connect and relate productively.² He recognized that our possibilities for relating to other humans and to the world in loving, productive, healthy, free, fulfilling, “biophilic” ways were determined – and often constrained – by our historical and political context, and argued that many contemporary systems interfered with and subverted productive relatedness. So, he argued, we need to find or create spaces within our current society for these relationships and also work collectively to make society more conducive to their realization.

With regard to love, as I’ve discussed, Fromm understood it not as a transitory emotional state but as a general manner of relating to the world. Love as a productive orientation was characterized by care, responsibility, respect, and knowledge.³ My earlier post on the subject discusses this in more detail, but two aspects need to be highlighted again here. The first is that Fromm, as I noted, “stresses the indivisibility of the four basic elements of love: ‘To respect a person is not possible without knowing him; care and responsibility would be blind if they were not guided by knowledge. Knowledge would be empty if it were not motivated by concern’ (27).” The second relevant aspect is the specific meaning of respect Fromm talks about. Respect is based in objectivity – the loving person doesn’t narcissistically project their own understandings and projects onto others. As I said in the earlier post,

It’s a shame that objectivity is so often seen as a detachment from others and the hardhearted treatment of them as objects. That arrogant idea is the opposite of what Fromm’s saying: the objectivity at the heart of love isn’t about being detached from others, but about trying our best in practice to detach our perception of them from our own biases and perceived interests.

For Fromm, caring fundamentally requires humbly seeking to know and understand the wishes of others and avoiding projecting onto them our own wishes and ideas (including our beliefs about what’s best for them).

So an approach to others that respects their autonomous being and development, that doesn’t seek to dominate or exploit them, that refrains from narcissistically imposing our vision and desires is not just rooted in a “liberal” regard for the abstract rights or autonomy of separate, disconnected beings. It’s at the very center of what it means to love others, and therefore of what it means to find real joy and rootedness in the world. Love is joy is ethics.⁴

Fraser’s vision offers a striking contrast. The experiences and actions of suffering and “sacrifice” he discusses in his article aren’t argued to be pleasurable in themselves. They’re not portrayed (explicitly, at least) as divinely commanded or as paths to a relationship with some god. Rather, he presents them in terms of human relationships and fulfillment. So he attempts to make a secular argument against assisted dying, but in its assumptions and distortions it betrays its flawed and anti-humanist religious origins.

Suffering, death, and authoritarian relations of powerlessness and coercion are Fraser’s proposed means of uniting with the world. The experiences that lead to our immersion in the life of the world are pain, the deterioration of our bodies and the helplessness it brings (“[l]ying in a bed full of our own faeces, unable to do anything about it”), and maintaining others’ dying bodies whether they wish it or not. It’s through these experiences, according to him, that we come to appreciate our shared humanity - how bound our lives are to those of others – and to connect deeply with others. This, to Fraser, is love, and he finds it “extraordinarily beautiful.”

What’s remarkable about Fraser’s view is that these aren’t even just seen as important means of relating to and loving others and creating rootedness in the world – they’re understood as the only means. I think it would be mistaken to read his description of the “liberal” view in favor of assisted dying as an intentional straw man. Fraser’s depiction of the existential situation to which we’re consigned if we don’t relate through pain, suffering, bonds of authoritarianism, and the shared experience of death seems to reflect his genuine belief: that outside these forms of relating there is no real love or connectedness to be found. In his view, it’s only through these forms of relating that we overcome profound, disembodied isolation. Outside of these forms of relating, we regard ourselves – or, at turns, are actually like – “brains in vats… solitary self-defining intellectual identities who form temporary alliances with each other for short-term mutual advantage.” Our connection to others is lost, and we’re alienated from reality.

This reflects an astonishingly narrow vision of what relationships of love and connectedness are. All of the means of productively relating to the world - loving others, healing and caring for and supporting other human and nonhuman animals day to day, cooking and eating together, laughing, creating, enjoying other people’s creations, having and raising children, playing sports, debating, dancing, reading, learning, exploring new places, chatting with strangers, growing plants, making a home, participating in the democratic life of a community, joining with others to fight for what you believe in, observing nature, doing science, listening to music, hiking a trail, sitting on a beach listening to the waves, giving the best of yourself to the world – are denied by Fraser.

His view is also fundamentally contrary to Fromm’s understanding of love as characterized by respect and humility. In Fraser’s vision, there’s no place for personal autonomy or self-determination, or for respecting others’ autonomy and self-determination, in loving relationships; indeed, love is contrasted to “our cherished sense of personal autonomy” and “the liberal model of individual self-determination.” In contrast to a loving orientation that humbly tries to understand another’s experiences and wishes and to care for them in accordance with that understanding, Fraser’s coercively imposes his own understanding and desires: “Shut up about being a burden,” he orders (in his fictional scenario). “I love you. This is what it means to love you.”

Even the act of helping to lessen someone’s “utterly intolerable” pain is portrayed not as an act of humble human friendship or love or even basic compassion but of “mercy.” The use of the word mercy here – a term which suggests an imbalance of power - clearly shows the authoritarian lens through which Fraser views human relations. (And it shouldn’t be forgotten for a moment that his post is an intervention in a debate about the legality of assisted dying. His authoritarian “caring” individual is also the representative of the state, backed by its coercive power.)

When set against Fromm’s expansive vision of active love and the rich possibilities for human relatedness and fulfillment, Fraser’s vision doesn’t appear, as he tries to portray it, as a humanistic alternative to an avoidance of experience and a dry and alienated liberal insistence on abstract rights. It’s revealed instead as an authoritarian project contrary to the very essence of love and based on a pathologically constricted vision of human experience and relatedness. With regard to assisted dying, both in terms of law and our personal relationships, the choice for humanists is between loving, productive, fulfilling relationships and a stunted, unloving, coercive approach that’s destructive to us all.

¹ As I’ve alluded to in the past and will discuss in more depth in the future, Fromm wasn’t attuned enough to the ideological sources of alienation. He fully appreciated that – and was at the forefront of analyzing how - capitalism and its culture impede our efforts to realize relatedness. And he did argue that this culture contributes to alienation itself. But he also consistently reinforced the idea that a profound alienation is a fundamental aspect of the human existential condition previous to and transcending culture. (See, among many examples, the first several passages in The Art of Loving.) He didn’t seek to analyze how this idea, this existential understanding of alienation, could itself be the product of culture – of consumerist and managerial capitalism, but also of the highly speciesist religious and philosophical traditions that influenced his thinking.

This unquestioned, culturally-shaped idea of existential alienation is a problem that mars many of Fromm’s arguments, sometimes in insurmountable ways. In this context, it’s necessary to note that, to the extent that Fromm’s arguments about alienation and relatedness proceed from these ideological assumptions, he exhibits some of the same biases as Fraser. While his arguments about relatedness and love can be discussed and contrasted to Fraser’s, as I do in this post, without reference to these assumptions, a comprehensive discussion of alienation and relatedness (which would even more fully reveal the flaws in Fraser’s thinking) has to address this problem.

² He didn’t argue, though, that pain, grief, and sacrifice were the opposite of joy and happiness or to be avoided at all costs. He saw them as unavoidable aspects of the human experience, and recognized that opening ourselves up to the world in order to experience real joy and happiness necessarily means experiencing also suffering and loss. The opposite of joy and happiness in Fromm’s view was alienation (of which depression was the extreme result) – a condition of not of sadness but of disconnectedness from the world (including ourselves).

³ This discussion wouldn’t have been an abstract one for Fromm, wherever he would have come down on the issue of assisted dying. His second wife was German photographer Henny Gurland. She had a Jewish father, worked as a photojournalist for the German Social Democratic Party, and was an outspoken anti-Nazi activist, and so had flee Nazi Germany and then Nazi Europe. She and her son Joseph and the philosopher Walter Benjamin attempted to escape from France through Spain to the US. They were attacked and caught by Spanish border guards while trying to cross the French-Spanish border on foot. Shot at from planes, Gurland got metal fragments in her side, adding to the pain she experienced from rheumatoid arthritis. After Benjamin’s suicide at the border, the guards allowed Gurland and her son to cross into Spain, and they escaped to the US via Portugal. She and Fromm married there in 1944. He treated Joseph like a son, and cared for her for the rest of her life, including moving to Mexico in the hope that it would improve her health. But she continued to suffer debilitating pain, often leading her to be bedridden, and was deeply depressed. As her health deteriorated, Fromm was caring for her almost full-time. She died in Mexico in 1952, probably from suicide. (This account is from The Lives of Erich Fromm: Love’s Prophet.) Fromm published The Art of Loving a few years later.

⁴ As Fromm argues in Man for Himself:

The experience of joy and happiness is not only…the result of productive living but also its stimulus…. There is nothing more conducive to goodness in the humanistic sense than the experience of joy and happiness which accompanies any productive activity. Every increase in joy a culture can provide will do more for the ethical education of its members than all the warnings of punishment or preachings of virtue could do. (p. 230)

Noam Chomsky and other scholars petition New York Times to examine its biased coverage of Honduras and Venezuela

Yesterday, Noam Chomsky and a group Latin America and media experts sent a letter to Margaret Sullivan, Times Public Editor. Here’s the full text without embedded hyperlinks (the text including evidentiary hyperlinks, a list of the relevant Times articles with links and quotations, and information about how to add your name to the petition are available here):

May 14, 2013

Dear Margaret Sullivan,

In a recent column (4/12/13), you observed:

Although individual words and phrases may not amount to very much in the great flow produced each day, language matters. When news organizations accept the government’s way of speaking, they seem to accept the government’s way of thinking. In The Times, these decisions carry even more weight.

In light of this comment we encourage you to compare The New York Times’s characterization of the leadership of the late Hugo Chávez in Venezuela and that of Roberto Micheletti and Porfirio Lobo in Honduras.

In the past four years, the Times has referred to Chávez as an "autocrat," "despot," "authoritarian ruler" and a "caudillo" in its news coverage. When opinion pieces are included, the Times has published at least fifteen separate articles employing such language, depicting Chávez as a "dictator" or "strongman." Over the same period—since the June 28, 2009 military overthrow of elected president Manuel Zelaya of Honduras—Times contributors have never used such terms to describe Micheletti, who presided over the coup regime after Zelaya’s removal, or Porfirio Lobo, who succeeded him. Instead, the paper has variously described them in its news coverage as "interim," "de facto,” and "new."

Porfirio Lobo assumed the presidency after winning an election held under Micheletti's coup government. The elections were marked by repression and censorship, and international monitors, like the Carter Center, boycotted them. Since the coup, Honduras's military and police have routinely killed civilians.

Over the past 14 years Venezuela has had 16 elections or referenda deemed free and fair by leading international authorities. Jimmy Carter praised Venezuela’s elections, among the 92 the Carter Center has monitored, as having "a very wonderful voting system." He concluded that "the election process in Venezuela is the best in the world." While some human rights groups have criticized the Chávez government, Venezuela has had no pattern of state security forces murdering civilians, as is the case in Honduras.

Whatever one thinks of the democratic credentials of Chávez’s presidency—and we recognize that reasonable people can disagree about it—there is nothing in the record, when compared with that of his Honduran counterparts, to warrant the discrepancies in the Times’s coverage of the two governments.

We urge you to examine this disparity in coverage and language use, particularly as it may appear to your readers to track all too closely the U.S. government’s positions regarding the Honduran government (which it supports) and the Venezuelan government (which it opposes)—precisely the syndrome you describe and warn against in your column.

Sincerely,

Noam Chomsky, Institute Professor Emeritus, MIT
Edward Herman, Professor Emeritus of Finance, Wharton School at the University of Pennsylvania
Greg Grandin, Professor of History, New York University
Sujatha Fernandes, Professor of Sociology, Queens College, CUNY Graduate Center
Corey Robin, Professor of Political Science, Brooklyn College, CUNY Graduate Center
Adrienne Pine, Professor of Anthropology, American University
Mark Weisbrot, Ph.D, Co-Director, Center for Economic and Policy Research
Miguel Tinker Salas, Professor of History and Latin American Studies, Pomona College
Katherine Hite, Professor of Political Science, Vassar College
Steve Ellner, Professor of International and Public Affairs, Columbia University, Universidad de Oriente
George Ciccariello-Maher, Professor of Political Science, Drexel University
Daniel Kovalik, Professor of International Human Rights, University of Pittsburgh School of Law
Gregory Wilpert, Ph.D, author of "Changing Venezuela by Taking Power"
Joseph Nevins, Professor of Geography, Vassar College
Nazih Richani, Director of Latin American Studies, Kean University
Steven Volk, Professor of History, Oberlin College
Aviva Chomsky, Professor of History, Salem State University
Keane Bhatt, North American Congress on Latin America
Chris Spannos, New York Times eXaminer
Michael Albert, ZNet
Oliver Stone, Filmmaker, "South of the Border"
Michael Moore, Filmmaker, "Capitalism: A Love Story"

Perhaps they could also work on their biased coverage of psychiatry. And think tanks….

Spin of a very high order

I found Phil Hickey’s blog Behaviorism and Mental Health via a link from Mad in America. There’s plenty there I disagree with, but also some good posts. I especially enjoyed “The Empire Strikes Back: APA Responds to NIMH,” which describes Kupfer’s statement as “spin of a very high order.” I was amused at how closely it resembled my own Spin-to-English translation.

From my post:

We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.

We haven’t actually been telling people this at all. We and our friends at the pharmaceutical corporations have been leading people to believe for decades that our diagnoses reflected brain disorders for which we had scientific evidence. The chemical imbalance myth? Ours. And we’ve grown rich and powerful in the process. Where would we be if we’d been open all along about how unscientific our diagnoses are?

From Hickey’s:

“We’ve been telling patients for several decades that we are waiting for biomarkers.”

I suggest that this is simply not the case. Psychiatrists have been telling their ‘patients’ for decades that they have chemical imbalances in their brains, that the chemicals involved are known, that the pills correct these imbalances, and that the pills are safe. All of these statements are patently false and extremely destructive. I have never heard (or even heard of) a psychiatrist who said to his [sic] ‘patients’ or to anyone else that “we are waiting for biomarkers.” The entire house of cards has been built on the illusion of scientific certainty, which the psychiatric profession promoted shamelessly.

He also links in another post to the full text of an article by Brett Deacon (University of Wyoming) in - it appears - the April issue of Clinical Psychology Review: “The Biomedical Model of Mental Disorder: A Critical Analysis of its Tenets, Consequences, and Effects on Psychotherapy Research.” I thought the extended discussion of nondrug treatments and research was extraneous, but it provides a fairly thorough yet still concise description of the problems with biopsychiatry.

Of most interest for this post are the two tables it features with quotations from people in the same organizations, and often the same people, claiming at one moment that the model is scientifically valid and admitting at another that it’s not (and that they never really believed it at all). (This reached the height of bad faith in the exchange following Marcia Angell’s two posts in the New York Review of Books, in which two of Angell’s detractors accused her of attacking a straw man by criticizing the chemical imbalance idea while their colleague reproduced it on the same page.)

But the concluding section of Deacon’s article is worth quoting:

…[I]n light of the evidence reviewed in this article, we cannot afford the societal costs of failing to engage in open and honest discussion about the validity and utility of the biomedical paradigm. The predominant approach to mental healthcare in the United States has produced neither clinical innovation nor improved outcomes, and is founded upon tenets that are acknowledged as scientifically premature or even fallacious by some of the very individuals and organizations who promote them…. The quality of care provided to individuals with mental health problems, the societal burden of mental disorder, and the credibility of professionals who treat patients with mental disorders will remain at risk until an honest and public dialogue occurs in response to questions that include, but are not limited to, the following:

• How can mental disorders be considered biologically-based brain diseases, or valid medical conditions, when researchers have not identified any biological variable capable of reliably diagnosing any mental disorder, distinguishing between individuals with or without a mental disorder, or distinguishing different mental disorders from each other?

• How can mental disorders be caused by a chemical imbalance in the brain when scientists lack a baseline standard of what constitutes a chemical balance with which to discern an imbalance, and do not possess a direct measure of neurotransmitter levels in the brain that possesses diagnostic validity or clinical utility?

• Given the historical lack of scientific evidence for the chemical imbalance theory of mental disorder, why have biomedical advocates promoted this story? Why have the APA, NIMH, and NAMI (among others, see Table 1) failed to publicly acknowledge that this story is unfounded? What have been the historical consequences of these actions? How have these actions been influenced by these organizations’ involvement with the pharmaceutical industry?

• If decades of biomedical research have not resulted in the development of clinically useful biological tests, innovative psychotropic medications, or improved mental health outcomes, should billions of dollars of taxpayer money continue to be preferentially allocated to biomedical research? Should zealous advocates of the biomedical model continue to head governmental agencies that determine national research and policy agendas?

• If psychotropic medications are safe and effective, why has the rate of mental health disability risen in close temporal association with their increasing use? Shouldn’t the widespread use of safe and effective psychotropic medications lead to less severe, chronic, and disabling mental disorders, as opposed to the opposite?

• If attributing mental disorder to biologically-based brain disease reduces mental health stigma, why has stigma not improved in the context of widespread promotion and increased public acceptance of the biomedical model?

• If the biomedical model of mental disorder is less valid and psychotropic medications are less effective than is commonly acknowledged, what are the implications for the unique legal authority granted to psychiatrists to involuntarily hospitalize and forcibly treat individuals with mental disorders?

HOORAY! VETO!

In a week when Minnesota has become the 12th state to recognize same-sex marriage and biopsychiatry has finally started to receive its comeuppance, Will Potter reports that

Tennessee Governor Bill Haslam has vetoed a bill that would punish whistleblowers who expose animal welfare, environmental, and workers’ rights abuses on factory farms and slaughterhouses. It’s a huge victory for Tennesseans, but it also has national significance. The tables have turned on Big Ag, and corporate front groups are desperately trying to pick up the pieces of the worst PR blunder in the industry’s history.

(And may Andy Holt’s statement be preserved for history.)

Haslam received thousands of calls and emails, and Potter’s online petition against ag-gag laws has gathered over 100,000 signatures.

Next up: North Carolina’s SB 648, the “Commerce Protection Act.”

Allen Frances angered by biopsychiatry’s fall; calls those who disagree crazy

I appreciated many of Allen Frances’ criticisms of the DSM-5, and linked here and elsewhere to some of his articles about it. Over time, though, I became more wary. What became increasingly clear was that he wanted to confine his criticism to the new DSM (and, admirably, the one he chaired as well); he continues to be desperately attached to the biopsychiatric model. This is understandable given that his life’s work has been based in this model and his sense of identity and purpose must be bound up with it. But I saw that it was leading him to some arrogant and callous views that I couldn’t in good conscience link to.

In his thinking, a problem is either a brain disorder or nothing. Psychiatric labels have to have biological meaning, so if Binge Eating Disorder isn’t a “real” brain disorder people who would be diagnosed with it must just be gluttons. Either illness or a character flaw. Either “patient” or “worried well.” This is not only false but is precisely the sort of perspective with which critics of biopsychiatry are commonly charged: that if we state that psychiatric diagnoses are scientifically invalid we’re denying the reality of people’s suffering. But I haven’t heard a critic of the brain-disease-drug model – and certainly not anyone from the survivors movement – say anything like this. We recognize distress and suffering and the need for help without any need to identify them with a broken brain. The false choice of disorder or nothing Frances presents is the product of biopsychiatry, not of its critics.

Now that biopsychiatry is imploding, Frances is lashing out at its critics in a post at HuffPo called – I’m not joking – “The Inmates Seem to Have Taken Over the Asylum.”

Mental health practitioners and patients are being poorly served by the organizations most entrusted to represent their interests. We have entered a truly remarkable silly season of interacting absurdities committed by the American Psychiatric Association, the National Institute of Mental Health, and the British Psychological Society. May, it turns out, is the cruelest month for mental health.

It started with DSM-5 offering its untested new diagnoses that will mislabel millions of the worried well as mentally ill -- turning our current diagnostic inflation into hyperinflation and distracting attention and resources away from the people who really need help.

Then the NIMH recklessly renounced all syndromal DSM diagnosis as invalid.

This is the point at which he should stop and think. Was it reckless because it was false, or reckless for some other reason? To stop supporting diagnoses that lack scientific validity isn’t reckless. Nor is stating this truth publicly. Quite the contrary: it’s terribly reckless to base interventions in the lives of people experiencing psychological distress on pseudoscience.

You can’t insinuate that the new DSM categories are scientifically invalid while implying that previous ones were mostly or all valid. Frances doesn’t even try to establish the scientific validity of psychiatric diagnoses – which, of course, he can’t. He simply implies a core validity through the use of terms like “diagnostic inflation.”

But NIMH has nothing to offer now in its place except an oversold and undeliverable promise of some future strictly biological model of mental illness that will take decades to deliver -- assuming it can ever be delivered at all.

It can’t be delivered. But of course a biological model of “mental illness” is what Frances’ profession has for decades led people to believe it was delivering, and what their pharma partners have quite literally sold, so this criticism is pretty rich coming from him.

Now the British Psychological Society has produced its own brand of extremist posturing, offering its own quixotic paradigm shift away from the notions that the brain has much to do with mental illness

That’s incorrect.

or that schizophrenia and bipolar disorder are useful constructs.

They’re not useful constructs. More to the point, they’re not scientifically supported constructs. Most people would see that as a serious problem.

Instead mental health problems should be framed primarily in psychological and social terms.

This is all Alice Through The Looking Glass foolishness. The NIMH biological reductionism finds its absurd reflection in the British Psychological Society pscho-social reductionism. Responsible leaders of powerful organizations should know better than to suggest that complicated mental illnesses can ever be reduced to simple and reductionistic answers.

This part is just bizarre. He’s accusing the NIMH of biological reductionism! But the problem with biopsychiatry isn’t that it’s reductionist. It’s that it’s false. That’s an important distinction.

And it’s odd to claim that understanding psychological distress in psychosocial terms is simple and reductionistic. Talking about how our psychology is shaped by our social context and experiences is not only the opposite of reductionistic but is as undeniable as any claim about humans can be. There have been and continue to be reductionistic psychosocial models, and many will be wrong or so incomplete as to be useless, but it shows how far down the biopsychiatric hole we’ve fallen that a psychiatrist could assert in all seriousness that a program of research and care founded in the recognition of the social causes of psychological distress is extremist and a silly dream.

We need a model of mental illness that attends to the biological, to the psychological, and to the social.

That “attends to” is doing a lot of evasive work here. But the full BPS statement is now available; anyone who reads it can see that this is precisely what it advocates (minus the “mental illness” language).

We need leaders who address the current unmet needs of patients -- who are not so enchanted with utopian grand designs for the distant future that they lose interest in the urgent problems of the present.

Every criticism Frances is making of Insel applies to all of biopsychiatry. Again, the claim that a socially oriented psychology is some “utopian grand design” is just laughable. (And stop calling people “patients”!)

DSM-5, the NIMH, and the BPS have all gone far wrong and all for the very same reason -- each has prematurely promised a grandiose paradigm shift when none is remotely possible. Paradigm shifts emerge from new scientific findings -- not from bloviating statements, however well intended.

The chair of the DSM-IV accusing others of grandiosity is a bit much. In any case, this bloviating evades the fundamental issue. Scientific findings do not support the biopsychiatric model. These people have gotten by for a long time with this game. Biopsychiatry’s existence as a “paradigm” and its use of medical language lend it an aura of scientific credibility which is doesn’t possess in reality. Nothing about the availability or quality of alternatives will alter the fact that the diagnoses and the model itself are scientifically unsound.

Patients and practitioners are the collateral damage of this ridiculous controversy. Patients who need help may well lose faith in a mental health establishment that seems so confused and is so confusing.

They should have lost faith in biopsychiatry long ago. For the love of Kraepelin, the model is false. To the extent that the model continues to hold sway in the “establishment” – and I hope the clinical psychologists’ statement is just an important stage in its collapse – it will continue to produce harmful pseudoscience.

It is past time to have just one thing in mind in preparing diagnostic manuals or statements about mental illness that will be widely disseminated. Will this help or hurt our patients' access to quality care?

That is an important question (stop referring to people as patients!). It’s not separable from the scientific question. If a manual or statement or intervention is based on pseudoscience, it’s very likely to hurt people.

So my plea to the American Psychiatric Association, to the National Institute of Mental Health, and to the British Psychological Society -- spare us your empty promises of premature paradigm shifts and instead help us take better care of our patients.

My plea to Allen Frances – acknowledge that, while there are many compassionate, well-meaning people in your profession, good intentions are perverted by the irrational insistence on a failed “paradigm.” The problem goes far deeper than the new DSM. You would do well for people and for your profession if you joined the British clinical psychologists in abandoning it.

Today offers alternative perspective on AGW from the Heartland Institute

Before they attended to the real news - about Prince Harry - Today did a short piece this morning on catastrophic global warming. To offer a contrary perspective, they showed part of an interview with denialist Jay Lehr, introduced by something along the lines of “But not all scientists agree.” Way to cover science, NBC.

Long Time Gone

Truth vigilantes, they aren't

And the New York Times continues its proud tradition of uninvestigative journalism.*

Patients and parents concerned about mental illness have every right to be confused.

Stop referring to people experiencing psychological distress or exhibiting behaviors labeled abnormal or disruptive as “patients.”

The head of the federal agency that finances mental health research has just declared that the most important diagnostic manual for psychiatric diseases lacks scientific validity and needs to be bolstered by a new classification system based on biology, not just psychiatric opinion. The hitch is that such a biology-based system will not be available for a decade or more.

No, the hitch is that it won’t be available. The evidence compiled over the past 50 years leads to no other reasonable conclusion. There is a better possibility that Saddam Hussein’s WMDs are going to turn up. You should question Insel about why he holds such unwavering faith in the biopsychiatric model in the face of several decades of evidence that does not support it.

Dr. Thomas Insel, director of the National Institute of Mental Health, posted his critique of the manual in a “Director’s Blog”on April 29 and expanded on his reasoning in a recent interview with The New York Times. He was critiquing a forthcoming revision of the American Psychiatric Association ’s Diagnostic and Statistical Manual of Mental Disorders, the first major reissue since 1994. Although there have been controversies over particular changes in diagnostic descriptions, he said, the new revision involves “mostly modest alterations” from its predecessor.

This is important. It points to the fact that the problem goes deeper than this edition of the DSM.

The psychiatric association’s diagnoses are mostly based on a professional consensus about what clusters of symptoms are associated with a disease, like depression, and not on any objective laboratory measure, like blood counts or other biological markers. The mental health institute says scientists have not produced the data needed to design a system based on biomarkers or cognitive measures.

This isn’t something the institute “says.” It’s not a matter of opinion – it’s a claim of fact. It’s your job to investigate the truth of that fact claim, not simply to repeat it and then repeat contrary statements and spin. If you were to do so, you would find a hint in David Kupfer’s admission. You would find that he was compelled to make this admission at long last because the reality is that they don’t have the scientific evidence to support their diagnoses. The diagnoses lack scientific validity. The model is not supported by science. That’s quite a shortcoming.

You would also find that all of the hedging spin you typically, lazily repeat does not accord with the truth. The diagnoses aren’t “mostly” based on consensus. They’re not approximations, imperfect, or inexact. The problem isn’t diagnostic inflation or abuse, and it isn’t “overmedication.” It isn’t a lack of training in “proper” diagnosis. The core problem isn’t the medicalizing or misdiagnosing of the “normal.” The problem is that the diagnoses lack scientific validity. The model is not supported by science.

To fill the gap, the agency started a program two years ago to finance research in biology, genetics, neuroscience, cognitive science and other disciplines with the ultimate goal of helping scientists define disorders by their causes, rather than their symptoms.

There is no gap. There is a set of invalid diagnoses based on a false model.

The underlying problem is that research on mental disorders and treatment has stalled in the face of the incredible complexity of the brain.

It hasn’t stalled. Or slowed. Or stagnated. Scientifically, biopsychiatry has been a failure from the start.

That is why major pharmaceutical companies have scaled back their programs to develop new psychiatric drugs; they cannot find new biological targets to shoot for.

There are no old biological targets. There are no biological targets. There are decades of propaganda convincing people that there are biological targets, but there aren’t in fact biological targets.

And that is why President Obama has started a long-term brain research initiative to develop new tools and techniques to study how billions of brain cells and neural circuits interact; the findings could lead to better ways to diagnose and treat psychiatric illnesses, though probably not for many years.

There are better ways to understand and address psychological distress right now. Of course, it isn’t difficult to improve upon a false model. And stop referring to “psychiatric illnesses” and “symptoms” when the whole purpose of your editorial statement is to respond to the growing recognition that there is no scientific evidence of psychiatric illnesses.

Meanwhile, the diagnostic manual remains the best tool to guide clinicians on how to diagnose disorders and treat patients. Consensus among mental health professionals will have to suffice until we can augment it with something better.

Bullshit. Your job is not to prop up biopsychiatry or the pharmaceutical industry. It’s to find and report the truth. It’s bad enough that you’re stragglers in uncovering this epic medical and human rights scandal. The least you could do at this point is grow some semblance of a journalistic spine.

*OK, I actually think it’s a good and worthwhile paper in many ways. But I’m angry at the moment.

UK clinical psychologists call for abandonment of biopsychiatry

“I believe there is nothing more important that a professional body can do than speak the truth about the evidence – and that is what this statement does.” – Lucy Johnstone

Tomorrow,

the UK Division of Clinical Psychology, a sub-division of the British Psychological Society, will issue a Position Statement…which calls for the end of the unevidenced biomedical model implied by psychiatric diagnosis.

There are two articles about this positive development in the Observer, neither of which, unfortunately, is very good and both of which irresponsibly mislead in both their headlines and actual content. Lucy Johnstone’s post at Mad in America (MIA will make the text of the position statement available tomorrow morning) is a better introduction.

The basic position of the DCP parallels my own:

The main difference – and of course it is a crucial one – between the position of these eminent psychiatrists [those who’ve recently publicly acknowledged the lack of validity of psychiatry’s diagnoses] and the DCP is that the former are determined to pursue the biomedical model at all costs. Indeed, NIMH has…announced the intention of launching a 10-year programme to pin down, once and for all, the elusive biomarkers that have evaded researchers so far. The project starts from the remarkably unscientific position of assuming what needs to be proved: in their words that ‘mental disorders are biological disorders.’ Flawed as this enterprise is, it will allow traditionalists to continue to claim that ‘We’re getting there – honestly!’ In the meantime, the overwhelming amount of evidence for psychosocial causal factors is once again relegated to a back seat.

We’re in a moment of extraordinary opportunity. It won’t help to listen to the self-serving claims that abandoning a false, unscientific, and harmful model is dangerous and that there is no alternative. There has long existed an alternative in the form of a radical humanist (or post-humanist) reality-based psychology/psychiatry. While the movement claims no absolute consensus or single direction, there’s a rich tradition of thought and practice to draw from (including but of course not limited to Fromm) that can point the way toward a revolutionary transformation of our understanding of and approach to psychological well-being. It’s an exciting time.

Habeas Porpoise? Really?

Oh, who am I kidding? Of course I love it.

Arie Trouwborst, Richard Caddell, and Ed Couzens, whose article about the orca Morgan in Transnational Environmental Law I mentioned previously, have a follow-up post at the Cambridge journals blog.

The Amsterdam District Court reviewed the previous decision, yet after consideration upheld the finding that Morgan’s transfer was legitimate. We consider this verdict to be demonstrably legally flawed. The Court based its determination primarily on a surprising appraisal of the ASCOBANS text, finding that a removal of an orca for rehabilitation purposes did not constitute “intentional taking” (such taking being precluded under the treaty). Moreover, the Court considered that enduring captivity was justified by the need to conduct research pursuant to obligations under ASCOBANS. This is deeply perplexing, since ASCOBANS does not consider permanent captivity for research (or any other) purposes acceptable. The judgment remains highly unsatisfactory in the light of these and other treaty obligations, while the Court seemingly ignored evidence that the facility to which the orca had been transferred does not engage in substantive research into cetacean ecology.

It must have been difficult for people to keep a straight face while arguing that Morgan’s captivity at Loro Parque was about research. It’s very obviously a theme park in which animals are exploited for human entertainment.

Democracy and more democracy (US style)

Yesterday, former US-backed dictator Efraín Ríos Montt was convicted of genocide in Guatemala.



Corey Robin reminds us that Ríos Montt found a strong ally and supporter in Ronald Reagan, who didn’t hesitate to praise him as “a man of great personal integrity . . . totally dedicated to democracy.”

In continuing democratic developments, FAIR has a piece criticizing Paul Richter’s Los Angeles Times article about The Bolivian government and several others expelling USAID from their countries. I’ve been talking about how shamelessly the corporate-mainstream media spins news about Latin America, and particularly those movements and governments that oppose US imperialism (here’s more). I expected to find, and did find, that reports of Evo Morales’ announcement of the expulsion follow this pattern:

They repeat the same phrases and tropes. They present the story as “Morales accused the US government of imperialistic and antidemocratic interference; US officials vehemently denied the allegations and talked about how wonderful their motives and actions are in the country,” and leave it at that. They give little voice to Bolivians. They present little or no historical or contemporary context. They undertake no independent investigation of the actions of USAID in the region.* They imply that the expulsion was an impulsive reaction to John Kerry’s calling Latin America “our backyard”…

But Richter’s piece – “USAID develops a Bad Reputation Among Some Foreign Leaders” - is another story. The article reads like planted PR spin from the State Department or the CIA, like Office of Public Diplomacy-type propaganda that isn’t even trying to disguise itself as a news report. (And it’s indicative of the sorry state of affairs in US journalism that these can be so indistinguishable.)

Richter “reports”:

USAID "threatens our sovereignty and stability," the eight-nation Bolivarian Alliance of the Americas fumed in June in a resolution that accused the United States of political interference, conspiracy and "looting our natural resources."

The problem is USAID doesn't just try to boost economies, healthcare and education in poor countries. It also spends about $2.8 billion a year teaching campaign skills to political groups, encouraging independent media, organizing fair elections and funding other grass-roots activities intended to promote democracy and human rights.

Some foreign leaders view those American efforts as thinly veiled attempts to weaken the status quo or even engineer a change of governments.

"A lot of governments are nervous about this growth in civic participation they're seeing," said Thomas Carothers, vice president at the nonpartisan Carnegie Endowment for International Peace. "When it's connected to foreign governments, it's even more unsettling — maybe subversive."

Their anxieties were intensified by George W. Bush's aggressive advocacy of a "freedom agenda," which called for democratic transformation in the Arab world, and President Obama's support for the 2011 "Arab Spring" revolts that toppled or challenged leaders in the Middle East and North Africa.

Sure, Richter. They hate our promotion of democracy.

* And when they do, they fail to pursue even the information the agency provides them:

In a 2010 Freedom of Information Act request, The Associated Press asked USAID for descriptions of the Bolivian recipients of grant money. The response did not go into detail but did include such items as $10.5 million for "democracy-building" awarded to Chemonics International in 2006 "to support improved governance in a changing political environment."

A related USAID brochure said components of the three-year "Strengthening Democratic Institutions" program included "teaching basic citizenship principles and skills" in all of Bolivia's nine states, including the lowlands opposition stronghold of Santa Cruz.

Here’s a bit more detail.

Atheists might appreciate this analogy

Of Insel’s recent actions:

Some people have likened this to a ‘revolution’….

Rather I think that this ought to be seen as a Reformation, as in Protestant….

We have an old, hegemonic institution, once revered but increasingly regarded as sclerotic – the DSM system / Catholic Church. This institution is, in theory, the one true embodiment of an idea – biological psychiatry / Christianity. But along comes a critic who believe in the idea, perhaps more fervently than ever, but want to reform the institution that they believe has failed its mission – Thomas Insel / Martin Luther.

Quite.

I don’t think Neurocritic realizes just how appropriate that analogy is.