Besides, anyone can say anything on the net. That could have been a 25 y.o., healthy-as-a-horse picture of health posting that comment.

Either way, if you can’t take the heat, stay out of the kitchen.

I was like, wow, he must be so philanthropic… why not give an anonymous donation of pens and pads to these poor doctors and medical institutions? That sounds condescending, but if he was sincerely interested in these low income medical practices, then I am sincere in my suggestion.

ATG - thanks btw for enlarging on the earlier comment, it was the lack of ‘notable’ that made it unclear.

Re the comment copied into this one, is it possible - at least in some cases - that you’re looking for a philosophical COI that may not exist - that some people genuinely care about their profession, or get back to remembering why they first wanted to go into that profession - and are willing to make ’sacrifices’ rather than engage in unethical practices which sacrifice their patients’ well being?

Anyone who doubts that psychiatry is a bastard, slave and whore to the pharmaceutical industry should read this letter

http://www.critpsynet.freeuk.com/Mosher.htm

Renowned Psychiatrist Loren R. Mosher Resigns
from the American Psychiatric Association in Disgust

Renowned Psychiatrist Loren R. Mosher Resigns
from the American Psychiatric Association in Disgust

This is a copy of a letter by Dr. Mosher resigning from the American Psychiatric Association. Note that Dr. Mosher was a pioneer in establishing programs of psychosocial community care in the field of psychiatry (e.g., Soteria House,); his many publications in that regard have been very influential (e.g.: Mosher, L., & Burti, L. (1989). “Community mental health: Principles and Practice”. New York: Norton.).

______________________________________________

Loren R. Mosher M. D.
2616 Angell Ave
San Diego, CA 92122

December 4 1998

Rodrigo Munoz, M.D., President
American Psychiatric Association
1400 94 Street N. W.
Washington, D.C. 20005

Dear Rod;

After nearly three decades as a member it is with a mixture of pleasure and disappointment that I submit this letter of resignation from the American Psychiatric Association. The major reason for this action is my belief that I am actually resigning from the American Psychopharmacological Association. Luckily, the organization’s true identity requires no change in the acronym.

Unfortunately, APA reflects, and reinforces, in word and deed, our drug dependent society. Yet, it helps wage war on drugs. Dual Diagnosis clients are a major problem for the field but not because of the good drugs we prescribe. Bad ones are those that are obtained mostly without a prescription. A Marxist would observe that being a good capitalist organization, APA likes only those drugs from which it can derive a profit - directly or indirectly.

This is not a group for me. At this point in history, in my view, psychiatry has been almost completely bought out by the drug companies. The APA could not continue without the pharmaceutical company support of meetings, symposia, workshops, journal advertising, grand rounds luncheons, unrestricted educational grants etc. etc. Psychiatrists have become the minions of drug company promotions. APA, of course, maintains that its independence and autonomy are not compromised in this enmeshed situation.

Anyone with the least bit of common sense attending the annual meeting would observe how the drug company exhibits and industry sponsored symposia draw crowds with their various enticements while the serious scientific sessions are barely attended. Psychiatric training reflects their influence as well; i.e., the most important part of a resident curriculum is the art and quasi-science of dealing drugs, i.e., prescription writing.

These psychopharmacological limitations on our abilities to be complete physicians also limit our intellectual horizons. No longer do we seek to understand whole persons in their social contexts rather we are there to realign our patients’ neurotransmitters. The problem is that it is very difficult to have a relationship with a neurotransmitter whatever its configuration.

So, our guild organization provides a rationale, by its neurobiological tunnel vision, for keeping our distance from the molecule conglomerates we have come to define as patients. We condone and promote the widespread overuse and misuse of toxic chemicals that we know have serious long term effects: tardive dyskinesia, tardive dementia and serious withdrawal syndromes. So, do I want to be a drug company patsy who treats molecules with their formulary? No, thank you very much. It saddens me that after 35 years as a psychiatrist I look forward to being dissociated from such an organization. In no way does it represent my interests. It is not within my capacities to buy into the current biomedical-reductionistic model heralded by the psychiatric leadership as once again marrying us to somatic medicine. This is a matter of fashion, politics and, like the pharmaceutical house connection, money.

In addition, APA has entered into an unholy alliance with NAMI (I don’t remember the members being asked if they supported such an organization) such that the two organizations have adopted similar public belief systems about the nature of madness. While professing itself the champion of their clients the APA is supporting non-clients, the parents, in their wishes to be in control, via legally enforced dependency, of their mad/bad offspring. NAMI, with tacit APA approval, has set out a pro-neuroleptic drug and easy commitment-institutionalization agenda that violates the civil rights of their offspring. For the most part we stand by and allow this fascistic agenda to move forward. Their psychiatric god, Dr. E. Fuller Torrey, is allowed to diagnose and recommend treatment to those in the NAMI organization with whom he disagrees. Clearly, a violation of medical ethics. Does APA protest? Of course not, because he is speaking what APA agrees with but can’t explicitly espouse. He is allowed to be a foil; after all he is no longer a member of APA. (Slick work APA!)

The shortsightedness of this marriage of convenience between APA, NAMI and the drug companies (who gleefully support both groups because of their shared pro-drug stance) is an abomination. I want no part of a psychiatry of oppression and social control.

Biologically based brain diseases are convenient for families and practitioners alike. It is no fault insurance against personal responsibility. We are just helplessly caught up in a swirl of brain pathology for which no one, except DNA, is responsible. Now, to begin with, anything that has an anatomically defined specific brain pathology becomes the province of neurology (syphilis is an excellent example). So, to be consistent with this “brain disease” view all the major psychiatric disorders would become the territory of our neurologic colleagues. Without having surveyed them

I believe they would eschew responsibility for these problematic individuals. However, consistency would demand our giving over “biologic brain diseases” to them. The fact that there is no evidence confirming the brain disease attribution is, at this point, irrelevant. What we are dealing with here is fashion, politics and money. This level of intellectual/scientific dishonesty is just too egregious for me to continue to support by my membership.

I view with no surprise that psychiatric training is being systemically disavowed by American medical school graduates. This must give us cause for concern about the state of today’s psychiatry. It must mean, at least in part, that they view psychiatry as being very limited and unchallenging. To me it seems clear that we are headed toward a situation in which, except for academics, most psychiatric practitioners will have no real relationships, so vital to the healing process, with the disturbed and disturbing persons they treat. Their sole role will be that of prescription writers, ciphers in the guise of being “helpers”.

Finally, why must the APA pretend to know more than it does? DSM IV is the fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than scientific document. To its credit it says so, although its brief apologia is rarely noted. DSM IV has become a bible and a money making best seller - its major failings notwithstanding. It confines and defines practice, some take it seriously, others more realistically. It is the way to get paid. Diagnostic reliability is easy to attain for research projects. The issue is what do the categories tell us? Do they in fact accurately represent the person with a problem? They don’t, and can’t, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder. So, where are we? APA as an organization has implicitly (sometimes explicitly as well) bought into a theoretical hoax. Is psychiatry a hoax, as practiced today?

What do I recommend to the organization upon leaving after experiencing three decades of its history?

1.. To begin with, let us be ourselves. Stop taking on unholy alliances without the members’ permission.

2.. Get real about science, politics and money. Label each for what it is - that is, be honest.

3.. Get out of bed with NAMI and the drug companies. APA should align itself, if one believes its rhetoric, with the true consumer groups, i. e., the ex-patients, psychiatric survivors etc.

4.. Talk to the membership; I can’t be alone in my views.

We seem to have forgotten a basic principle: the need to be patient/client/consumer satisfaction oriented. I always remember Manfred Bleuler’s wisdom: “Loren, you must never forget that you are your patient’s employee.” In the end they will determine whether or not psychiatry survives in the service marketplace.

Sincerely,

Loren R. Mosher M. D.

As an FYI, when someone says they have an incurable disease, you don’t jump on the rest of their post no matter how much you disagree with it. Not to be condescending but if I remember correctly, you said you thought you might be on the autistic spectrum. As a result, you might not realize that this is one of those unwritten rules that people on the spectrum can have problems with.

AA

I’m trying to figure out what the “philosophical COI” is in the case of people who could make a s***-load by drugging the monkeys out of every kid and adult in their practices but, oddly, don’t. Writing books? Speakers’ fees? None touch what could be gained– from drug kickbacks, publishing, speakers’ fees, ghostwriting, etc.– from promoting the drugs.

But we know of a local pediatrician who was busted by his wife for sleeping with his (male, as it happens) drug rep. Now, is that a philosophical or financial COI?

Stephen Barrett (a psychiatrist/ex psychiatrist - not sure which) is against this happening because he believes that the type of training and length of time it takes psychiatrists to become psychiatrists is what enables psychiatrists to know when to prescribe, what the side effects are, what drug interactions there are, what action to take when this kind of thing happens to a patient…apparently.