Monday, November 27, 2006

What's Wrong with a Child? The Tragic Consequences of Biopsychiatry's Naturalistic Worldview

The second in a series of articles the NY Times is doing about the increasing number of American children whose difficulties are diagnosed as serious mental disorders is entitled "What's Wrong with a Child? Psychiatrists Often Disagree." The piece could have been more accurately called "What's Wrong with Psychiatry?" for it dramatically illustrates the highly subjective nature of psychiatric diagnoses.

The article opens with an introduction to Paul Williams, a 13-year-old who "has had almost as many psychiatric diagnoses as birthdays."
The first psychiatrist he saw, at age 7, decided after a 20-minute visit that the boy was suffering from depression.
A grave looking child, quiet and instinctively suspicious of others, he looked depressed, said his mother, Kasan Williams. Yet it soon became clear that the boy was too restless, too explosive, to be suffering from chronic depression.
Paul was a gifted reader, curious, independent. But in fourth grade, after a screaming match with a school counselor, he walked out of the building and disappeared, riding the F train for most of the night through Brooklyn, alone, while his family searched frantically.
It was the second time in two years that he had disappeared for the night, and his mother was determined to find some answers, some guidance. What followed was a string of office visits with psychologists, social workers and psychiatrists. Each had an idea about what was wrong, and a specific diagnosis: “Compulsive tendencies,” one said. “Oppositional defiant disorder,” another concluded. Others said “pervasive developmental disorder,” or some combination. Each diagnosis was accompanied by a different regimen of drug treatments. By the time the boy turned 11, Ms. Williams said, the medical record had taken still another turn — to bipolar disorder — and with it a whole new set of drug prescriptions.
“Basically, they keep throwing things at us,” she said, “and nothing is really sticking.”
A caption beneath a photograph of Williams reads "In his short life, Paul has taken antidepressants, antipsychotic drugs, sleeping pills and so-called mood stabilizers." One can only wonder what such a combination of drugs is doing to this young man's developing central nervous system, not to mention other organs. Consider the fact that despite use of terms like "disorder," "diagnosis," and "illness" there are no medical tests for any of the conditions listed in the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders and there is even further cause to question the wisdom of administering mind-altering drugs to children or, for that matter, adults to whom psychiatric diagnoses have been given.

According to Duke University professor of psychiatry and behavioral science, Dr. E. Jane Costello, psychiatry's system of diagnosis is "
still 200 to 300 years behind other branches of medicine." This assumes, of course, that psychiatry is a legitimate medical practice, lagging behind its elder siblings. But other than the fact that its practitioners are licensed physicians with the authority to prescribe medication, what is it that biological psychiatry has in common with other fields of medicine which do not rely solely on emotional and behavioral symptoms to determine the existence of disease? To what extent is biological psychiatry a medical science? These are questions that even those within the profession have asked. In his letter of resignation from the American Psychiatric Association, the late Dr. Loren Mosher wrote:
"Biologically based brain diseases" are certainly convenient for families and practitioners alike. It is no-fault insurance against personal responsibility. We are all 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 (emphasis in the original).
I realize that to many, the idea of questioning the validity of biopsychiatry is tantamount to rejecting heliocentricity but that is just a testimony to how successfully pharmaceutical companies have indoctrinated the public (and in many cases, general practitioners) with their reductionistic philosophy of human nature. In his book Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Industry and Depression (chapters from which can be read here), Dr. David Healy, notes that the class of antidepressants known as SSRI's (selective serotonin reuptake inhibitors) has "given rise to a new language in which we understand ourselves - a biobabble to replace the psychobabble of Freudian terms that so coloured our identities during the 20th century."

To borrow terminology from the sociology of knowledge, the drug companies, in concert with the psychiatric community, have been highly effective shapers of America's plausibility structure. Leslie Newbigin, in The Gospel in a Pluralist Society defines and describes plausibility structures as:

...patterns of belief and practice accepted within a given society, which determine which beliefs are plausible to its members and which are not. These plausibility structures are of course different at different times and places. Thus when, in any society, a belief is held to be "reasonable," this is a judgment made on the basis of the reigning plausibility structure.
Biological psychiatry, like counseling, is an inescapably hermeneutic exercise. The individual seeking to assist another in resolving intra-and/or interpersonal problems inevitably makes assessments and judgments about what is going on in the individual's life. These judgments assume a system of values and beliefs about human nature, motivation, and behavior.

Multiple interpretations can be offered to account for whatever emotional and behavioral symptoms an individual reports. Likewise, multiple conceptions of what is in need of being changed and how that is to be accomplished exist. Counseling and biopsychiatry, therefore, involve placing the counselee or patient in some larger contextual framework of meaning. In other words, all approaches to counseling and/or psychiatry seek to make sense of a person and his or her situations in terms of a broad interpretive framework or worldview. Given this fact, as well as the serious health risks associated with psychiatric medications, I'm dismayed by the relative absence of Christian leaders sounding cautions against psychiatric labeling and medicating.

1 comment:

Brent said...

I've wanted to bring up this issue in my Sunday School class, but my wife cautions me that I'll be stepping on the toes of half (if not three fourths) of the class members who are on the stuff. If you include those who have been on pills or will someday be on pills, you're pretty much including everyone. It is astonishly pervasive in the Christian world. I'm really glad to see it coming to the surface.