The Secret Language of Biological Psychiatry
Comments by Fred A. Baughman, Jr., MD on:
Mind Over Manual
By SALLY SATEL
Published: September 13, 2007, New York Times, p A-23
Fred A. Baughman, Jr., MD, Fellow, American Academy of Neurology, Diplomate, American Board of Psychiatry and Neutrology
Author: THE ADHD FRAUD: How Psychiatry Makes Patients of Normal Children
EARLIER this summer, the American Psychiatric Association announced that a 27-member panel will update its official diagnostic handbook, the Diagnostic and Statistical Manual of Mental Disorders. The fifth edition, which is scheduled to come out in 2012, is likely to add new mental illnesses and refine some existing ones.
Editor's note: The FB means Fred Baughman,Jr., MD.
FB: In medicine a physical abnormality is a disease, also a disorder. To be perfectly clear: abnormality (macroscopic, microscopic, or chemical) = disease = disorder = chemical imbalance. Psychiatry often uses the term disorder instead of disease, not wanting to seem too outrageous while voting diseases into existence out of thin air, which, of course, is exactly what they do.
In 1972 I encountered, in my practice, children of an inbred Dutch family, who, I observed had a combination of defects: curly hair, dysplastic (deformed) nails and, fused eyelids ankyloblepharon that had needed surgical opening at birth. The abnormalities were obvious, so clearly, they had a disease (or diseases). I perused the scientific literature and discovering no indication that this combination of abnormalities had been encountered previously, wrote the case up and had it published as CHANDS: The Curly Hair-Ankyloblepharon-Nail Dysplasia Syndrome, in the journal, The Clinical Delineation of Birth Defects, Volume XII, 100, 1972. This is how diseases come to be; they exist in nature (in all plants and animals), are discovered, described and in all of the subsequent medical literature, thus, referenced and cited. But this is not how it is done in psychiatry which passes itself off as part of the medical profession diagnosing diseases and treating them when they do nothing of the sort. ADHD is not an abnormality/disease! Bipolar disorder is not an abnormality/disease! Not a single psychiatric entity/condition/disorder is! They are a fraud. What they do is a fraud. They vote their diseases/ disorders/ chemical imbalances into existence, and they modify those already in existence, by vote, in the committee of the Diagnostic and Statistical Manual of the American Psychiatric Association.
No treatment that they render is the treatment of a disease, because there is no disease, not ever--just another fraud. Having told the public/patients they have a disease/ disorder/ chemical imbalance and having elicited informed consent which is never informed but a lie, they give the patient a drug or drugs, which under the circumstances is not treatment but assault and battery poisoning.
For yet another example of their fraud, let me remind you of their persistent claims that genetic defects cause psychiatric disorders. When I discovered CHANDS in 1972, it appeared to be due to an autosomal dominant gene. It was not until 1979 that with Toriello and others (Toriello, H. V., Lindstrom, J. A., Waterman, D. F., Baughman, F. A., Jr.: Re-Evaluation of CHANDS, Journal of Medical Genetics, 16:316, 1979.) that we established that CHANDS was an autosomal recessive genetic disorder instead. Observe--the disease comes first and then, hopefully, the cause can be delineated. However, real diseases abound which have no established cause. For example in most cases of diabetes and cancer the cause remains unknown. (we are now learning that tens of thousands of cases of diabetes and untold numbers of deaths are being caused by psychiatry's use of the so-called atypical antipsychotic drugs being given to physically normal, troubled and/or troublesome children). In psychiatry, despite their vigorous claims that their diseases/disorders/chemical imbalances are genetic they are not and cannot possibly be for the simple reason that not a single, solitary psychiatric entity/condition is an actual abnormality/disease; they do not exist! None are physical realities! It is also for this reason that every diagnosis made and rendered by psychiatry, every treatment and every research project on every psychiatric disorder/disease/chemical imbalance is a fraud, because there is no such physical entity as a psychiatric disorder/disease/chemical imbalance, and, because, they know this perfectly well. The only end-points they are paid for and seek are to deceive all patients and the public and to sell drugs.
Psychiatrists, like all physicians, go to medical school, learn about all things physically normal (anatomy/form, physiology/function, and chemistry), physically abnormal (disease/pathology) and how to tell the difference. This is the essence of a medical education. They use it not to practice medicine, but to deceive patients and the public to make patients of normal people. Although psychiatrists, in effect, leave the medical profession when they enter psychiatry, they continue to assert they are physicians. For this reason they remain responsible for knowing the difference between things physically/medically normal and abnormal, and must be held accountable for the unending deception they perpetrate, for profit, on the whole of the public, whether actually ill or normal is of no concern to them--and the world. While everything they do is a fraud, their present, mostly successful efforts to sell the horribly poisonous, atypical antipsychotics to mostly normal children should gain them very special consideration when it comes to their sentencing. ]]]]]]]]]]]]]
High on the agenda will be the controversial diagnosis of childhood bipolar disorder. Recent data show that office visits by children and adolescents treated for the condition jumped 40-fold from 1994 to 2003. We still dont know how much of this increase represents long-overdue care of mentally ill youth and how much comes from facile labeling of youngsters who are merely irritable and moody. Psychiatric epidemics explode in remarkable ways while the frequency of medical diseases, such a PKU, gout, each case relying the demonstration of a physical abnormality, remain more or less the same.
FB: Writing of the controversial diagnosis childhood bipolar disorder, and its absolutely unreal (as only in psychiatry) 40-fold growth from 1994 to 2004, Satel states, "We still don't know how much this comes from facile labeling of youngsters who are merely irritable and moody.
Part of the confusion stems from the lack of a discrete definition of juvenile bipolar illness in the diagnostic manual. But there is a deeper problem: despite the great progress being made in neuroscience, we still don't have a clear picture of the brain mechanisms underlying bipolar illness or most other mental illnesses.
FB: Trying to pass psychiatric diagnoses off as diseases and saying confusion stems from the lack of a discrete definition of juvenile bipolar illness in the diagnostic manual (DSM), Satel ignores the fact that all medical diagnosis, depends on the demonstration or an abnormality, patient-by-patient, regardless of whether a disease exists in some text, or not. Alluding to great progress being made in neuroscience, and "...we still don't have a clear picture of the brain mechanisms underlying bipolar illness...." there is no doubt Satel is attempting to pass off bipolar illness as a neurological disease--needing drug treatment, of course, when there is no proof that it, or any psychiatric, DSM entry is an actual disease.
For perspective, we must return to 1980, when the revolutionary third edition of the handbook, the D.S.M. III, was published. In a radical break from earlier editions, which had been based largely on psychoanalytic principles of unconscious conflict and stunted sexual development, the D.S.M. III categorized illnesses based on symptoms. A patient was said to have a condition if he or she had a certain number of the classic symptoms for a certain period of time. This approach promoted inter-rater reliability the odds that two examiners would agree on what diagnosis to assign a patient.
FB: Saying the D.S.M. III categorized illnesses based on symptoms, Satel, further, leaves no doubt of her/psychiatry's claim that they diagnose illness, sickness, physical disease, but neglects to make clear that no matter how many symptoms all subjective that it is signs objective abnormalities, not symptoms that constitute and confirm the presence of a disease. Satel is about nothing so much as deceiving the public/patients.
Yet the manual remained silent on what caused the symptoms. The diagnosis of, say, schizophrenia did not reflect a known cause in the way syphilis is known to be an infection with a spirochete bacterium. The writers of the D.S.M. III were confident that science would one day fill this vacuum, yet three decades later psychiatry still lacks a firm grasp of the causal underpinnings of mental illness.
FB: Here, Satel compares schizophrenia, having no disease-confirming objective abnormalities to syphilis with abundant physical abnormalities, seeking to make it appear that the absence of a known etiology/cause for schizophrenia (while the cause of syphilis is known) is what makes schizophrenia appear not to be a disease. It is the fact that there is no known, proven, demonstrated, demonstrable physical abnormality in schizophrenia that leaves it not a disease. Many real, objective abnormalities/diseases have no known cause though they have been known/proven, even terrible diseases for centuries or decades. Most cancer, most diabetes, and most epilepsy have no known cause, case-by-case. This is but another time-worn semantic stratagem of pharma-owned psychiatry (with Satel the mouthpiece).
One manifestation of our limited knowledge is that many patients meet several diagnostic definitions at once. Roughly half of adults with clinical depression, for example, also have symptoms that fit the definition of an anxiety disorder. Do these patients actually suffer more than one illness, or do they just appear to?
FB: Here Satel would have us believe there is such a disease as clinical depression, perverting our concept of the human condition of human character. Appending disorder to anxiety she would have us believe that it, too, is a disease. When will we awaken to this total perversion of science and medicine, no less so for who it is that speaks in such specious terms. It is not even a clever deception but they get away with it because they are doctors, professionals, and because they are the professionals the public needs to trust. It is this trust psychiatry so duplicitously tramples, word-by-carefully-chosen-word. I suppose they deserve a fair trial those who do this who see through their medical words, not medical at all.
Conversely, very diverse patients often qualify for the same diagnosis. You can have three patients with schizophrenia, but all that really means is that their symptoms fit a particular pattern, says Dr. Michael First, a psychiatrist who was the editor of the current handbook, the D.S.M. IV. They may not have the same pathophysiology and, as a result, they may not require the same treatment.
FB: Here, brandishing the word pathophysiology Michael First, a psychiatrist, a physician (probably with a white coat as well) seeks to convince the patient, every patient, everyone who will be a patient that the diagnoses he is sure to make are actual diseases/chemical imbalances needing medical treatments, pills, not love, not talk, an embrace, understanding, sympathy, willpower, the comfort of one, of many.
Indeed, the link between diagnosis and treatment is relatively weak. Antidepressants like Prozac help treat not only depression but also panic disorder, obsessive-compulsive disorder, bulimia, and social phobia. This explains why clinicians often treat by symptom rather than diagnosis. Paranoia, for example, is treated with an antipsychotic drug whether it occurs in the context of schizophrenia, bipolar illness, or methamphetamine use.
FB: Saying This explains why clinicians often treat by symptom rather than diagnosis, Satel seeks to substitute the word diagnosis for sign/abnormality/disease/disorder (all of which mean there is a physical abnormality), knowing as she does so there is no abnormality/disease, that her every word and phrase is not in the least science, medicine or the truth but utter deceptions/deceit/betrayal.
Why aren't we closer to understanding the relationship between manifest illness and its underlying causes? One obstacle is the staggering complexity of the brain. Another may be what Dr. First calls the unfortunate rigidity that all-or-nothing diagnostic checklists and sharply bounded categories impose. In order for the condition of a patient to meet the definition of clinical depression, for example, he or she must have five out of nine symptoms. But does a patient with only four symptoms have a different disorder, or no disorder at all?
FB: And the deceit continues, heaping one pseudo scientific utterance upon another: manifest illness when there is no illness/sickness disease at all. The staggering complexity of the brain as a reason they have validated not a single solitary real disease, when, in psychiatry science is entirely eclipsed by lies and profit motive. And, finally, Satel lays this on us: In order for the condition of a patient to meet the definition of clinical depression, for example, he or she must have five out of nine symptoms. But does a patient with only four symptoms have a different disorder, or no disorder at all? Here, Satel sallies forth suggesting that 4 or even 5 of 9 symptoms constitute a disorder which she knows is the same thing as a disease (disorder = disease). She also knows that symptoms, as we have discussed are the same thing as complaints and are wholly subjective. For this reason 99 or 100 symptoms, if present, do not constitute a disease, only signs /abnormalities do. Satel is clearly dedicated to deceiving, of this there is no doubt.
One way to improve the classification of mental illnesses would be to define certain pathologies along a continuum so that patients who are truly ill will not fall short of qualifying for a diagnosis. Take major depression. The symptoms could be weighted so that suicidal preoccupation or immobilization, the most extreme and debilitating aspects, would get high scores, while loss of energy and interest for a short periods would get lower scores. Thus, a patient with few, but severe, symptoms would not be excluded.
FB: Observe Satel's use of pathologies (meaning physical abnormality = disease) where there is not a single pathology; her use of truly ill when none at all are truly ill and, at last her wish that patients with a few, but severe, symptoms not be excluded from the being called ill/sick/diseased. They claim that half of the nation will have a severe mental illness at some time in their life. How many more do they want?
A more nuanced approach could also make a real difference for population surveys of mental illness and clinical trials, both of which tend to rely on rigid symptom checklists.
An updated manual, however, is unlikely to transform treatment substantially after all, revising diagnoses is still just another way to describe mental conditions we do not fully understand. But these refinements may well stimulate valuable new inquiry, enabling swifter progress in understanding the mechanisms of disease, better deployment of treatments we have and more efficient discovery of new ones.
FB: Here, unable to contain herself, Satel erupts with understanding the mechanisms of disease, leaving no doubt she was speaking of diseases all along.
Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute, is a co-author of One Nation Under Therapy.
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