Psychologists claim psychiatry is useless
In a bruising attack, The British Psychological Society has claimed that psychiatrists are diagnosing people without any scientific basis. Is all psychiatry a waste of time?
Every year, a quarter of people in the UK experience a mental health problem of some kind. One in twenty are clinically depressed. Around the world, it is estimated that 450 million people are currently living with a psychiatric disorder.
Some of these conditions – such as depression, schizophrenia and anorexia – are familiar. Others are rare and obscure. Some concern personality, some are characterised by delusions or hallucinations, others are to do with mood. Each one is classified meticulously by psychiatrists and labelled according to the specific set of symptoms it involves.
Now, psychologists have launched a dramatic onslaught on this entire system of categorising mental illness, and on the psychiatrists who have created it. Labels like ‘psychopathic’, ‘narcissistic’ or ‘bipolar’, the British Psychological Society claims, are arbitrary terms without any basis in scientific research. It is time for a ‘paradigm shift’.
That mental illness is a real and serious problem is not in doubt. But many people now believe that words like ‘depression’ describe sets of symptoms (the mental equivalent of feeling nauseous and having a rash) rather than distinct conditions with a shared biological root (like chicken pox or cancer).
This is not just a pedantic question of terminology. If the labels psychiatrists use to describe a disorder don’t accurately reflect its nature or cause, they may be dealing with psychiatric problems in inappropriate ways.
One recent study, for instance, found that antidepressants are only of help to a seventh of patients who are prescribed them.
‘People break down as a result of a complex mix of social and psychological circumstances,’ says one critic. ‘Bereavement and loss, poverty and discrimination, trauma and abuse.’
Don’t label me?
Many psychologists charge doctors with inventing mental disorders so that they can fit patients into artificial compartments and treat them in the same standardised way. When somebody is struggling with misery, guilt, hopelessness and lack of motivation, an almost limitless number of causes could be to blame: childhood experience, material hardship, social exclusion, abuse. Yet psychiatrists, they say, simply slap the label ‘depression’ onto each patient and send them away with a pill.
But psychiatrists have leapt fiercely to their profession’s defence. Of course these categories are imperfect, they say, and no system of classification can ever describe the rich complexity of an individual’s psychology. But they are also a vital way of mapping problems that occur in the brain and finding ways to treat them. We have a long way to go before we reach a full understanding of what causes mental illness, they say – but let’s not give up just yet.
- Is it wrong to treat mental health disorders rather like we treat physical illness?
- ‘One day, depression will be a totally curable disease.’ Do you agree?
- Write a list of three things that make you angry, three things that make you sad and three things that make you happy. Read them out to the class one by one. What similarities do you notice?
- Remind yourself of the story of Shakespeare’sHamlet. List three of the factors that make him unhappy. How many of the factors do you think could be fixed by modern psychiatry?
Some People Say...
“Emotional and mental problems can’t be cured by drugs.”
What do you think?
Q & A
- Are you saying that depression doesn’t exist?
- Absolutely not, and neither are mental health experts on either side of this debate. What psychiatrists call ‘depression’ is unquestionably a debilitating condition, and not in any way a sign of weakness.
- What should I do if I think a friend has a mental health problem?
- Don’t just ignore it: tell them you are concerned and offer to talk. Be warm, supportive and non judgemental; but if you feel that your own psychological well being is becoming damaged by too much exposure to somebody else’s mental health issues, it’s okay to take a step back. If your friend’s problems persist, encourage them to seek help from a professional such as a GP or school counsellor.
- A doctor who specialises in mental health (literally ‘mind healer’).
- Someone who studies behaviour and mental processes (literally ‘mind expert’)
- People who suffer from this disorder (or disorders) have intense thoughts, feelings or ideas which are sometimes difficult to distinguish from the real world. Symptoms can include hearing voices or talking in a jumbled way that makes little sense to others. Contrary to popular belief, however, schizophrenia has nothing to do with split personality disorder.
- In the USA, these disorders are compiled in a book called the Diagnostic and Statistical Manual for Psychiatric Disorders, or DSM. The fifth edition of the DSM, which has come under fire for expanding the list of disorders, will be published this week.
- Paradigm shift
- An innovation that changes the framework for thinking about an area of knowledge. Galileo's discovery that Earth moves around the Sun is one example; Darwin’s theory of evolution is another. The theory that science (and perhaps other disciplines) progresses in ‘paradigm shifts’ was outlined by the philosopher Thomas Kuhn in a book called The Structure of Scientific Revolutions.