Niall McLaren's Psychiatry Newsletter
Feb 2013
In This Issue
What's New
Q & A
Highlighted Books & Articles
The Mind-Body Problem Explained

"The Mind Body Problem Explained is a thoughtful, insightful and provocative exploration of the nature of the human mind, and sets forth a powerful argument for rethinking the medical model of mental disorders. The current paradigm of psychiatric care has failed us, and Niall McLaren's book will stir readers to think of new possibilities."

--Robert B. Whitaker, 
 Author of Mad in America, Anatomy of an Epidemic

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Hullo, this is a brief introduction as the first of what will be monthly newsletters on a new direction for psychiatry. Most of you receiving this have opted in but a handful of addresses were provided to me by colleagues who thought you'd be interested. If you'd like to stop receiving these please unsubscribe at the bottom of this email. 

 

I have just returned from an exhausting trip to the US to launch my fifth book, bravely entitled The Biocognitive Model for Psychiatry: The Mind-Body Problem Explained. The title comes from Dennett's book from 1991, titled Consciousness Explained, in which he emphatically did not explain consciousness. I hope I haven't fallen into his trap. I think the biocognitive model of mind-body interaction goes a long way to showing exactly how an informational state called the mind can interact with the physical machine called the body, but the final decision rests with the readers.  

 

I spent a couple of days in Los Angeles at the Harbor-UCLA Medical Center, in Torrance, South LA. This is the main public hospital for a huge swathe of the city, a flat and rather featureless area of mixed industry, run-down public housing, working class areas and gently ageing beachside suburbs. In fact, it's exactly the sort of hospital I like and it was very interesting being there. What quickly became clear during this visit is that psychiatry is facing a generational crisis. There seems little doubt that medical students and psychiatric trainees (residents) are getting sick of the standard approach dished out by the orthodox psychiatry and I found the training the residents receive at Harbor amongst the most forward-thinking I've seen. I found it very encouraging, as I've been sick of the status quo for nearly forty years. Trouble is, most trainees don't know the full extent of what else is available, mainly because orthodox psychiatry makes sure they don't get to hear of alternatives. All too often, I hear people say, "But how can you talk about a model of dualist interaction? Isn't dualism just magical thinking?" 

 

No, it's not.
The notion that a dualist model of mind necessarily means magical thinking is part of the 1960s prejudice. We won't go into all the details, but most people trained before about 1990, meaning most professors today, were totally flooded with the idea that science is not about unobservables, and the mind is unobservable, therefore science can never be about minds. From this came behaviorism and biological psychiatry. Behaviorism imploded somewhere about 1985, but biological psychiatry hangs on, the last outpost in the world of people who firmly believe they can sort out a person's mental problems by reducing their distress to brain scans and clinically insignificant genetic defects.

 

The modern generation, meaning anybody born from about 1980 on, doesn't have the slightest difficulty with the idea that the mind can be seen as an informational space generated by the brain. They (young people) think in terms of hardware and software, and it never occurs to them that talking about software is equivalent to talking about magic. So there is a very large gulf opening up between the generations. In the blue corner (conservative), we have the Old Brigade, firmly committed to the idea that their science must exclude all talk of minds on the basis that it necessarily implies magical thinking. In the red (radical) corner, we have the rising generation, who are sick of being told that everything is a chemical imbalance or genetic lesion, and want to return to the idea of psychiatry as a human-centered discipline. 

 

As an example, I saw a senior psychiatrist (in a town I won't name) interview a new patient. He knocked it over in 19 minutes. That is correct, less than twenty minutes. In twenty minutes, I'm not even through the first part of my standard interview! It takes me an absolute minimum of an hour to get a history, and I push people hard so we can get to the serious stuff. In order to keep to his time schedule, the psychiatrist dispensed with all that bothersome talk about how patient was feeling and what he thought had gone wrong in his life.

Thus, we end up with a slimmed-down, one-size-fits-all psychiatry, where slotting people into a diagnostic box is more important than finding out why they are depressed or paranoid.
Very sad, but I'm now sure that the march of time will win. 
Q&A 
 
I will begin answering one or more questions per month in each newsletter. Send your questions to [email protected] with the word 'question' in the title. Start submitting now for next month!
 
Highlighted Books and Articles

 

In Boston, I met Bob Whitaker again, author, investigative journalist and concerned person. I am a great fan of his and firmly believe his book, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill (New York: Perseus Books, 2002), should be required reading for all medical students and residents, not to mention psychologists, social workers, psychiatric nurses and caring citizens. It outlines the history of the "treatment" of mentally disordered people in the US, from the earliest hospital in Pennsylvania in 1751, to the present. 
 
The constant theme is that, despite 250 years of "progress," the outcomes of treatment for mental disorder in the US are now actually worse than they were in the past. Unfortunately, the psychiatric mainstream reacted very badly to his work, but he is a meticulous researcher and nobody has been able to fault his case in this book. Highly recommended.

 

There are heaps of good books available, it's hard to keep up with them, but I have to mention Martin Whitely's Speed Up and Sit Still: the controversies of ADHD diagnosis and treatment. (University of Western Australia Press: Perth, WA, 2010). Martin Whitely is not a psychiatrist, and not even medically trained, yet he has become an expert on the question of the inappropriate applications of psychotropics in schoolchildren. He worked as a schoolteacher, then entered the WA Parliament after becoming alarmed at the drugging of an entire generation. His very readable book charts the history of the "epidemic" of ADHD and shows how the epidemic was arrested and reversed in WA. First place in the world. If it can be done there, it can be done anywhere.

 

If anybody has a book they wish to recommend, let me know (better still, write a hundred words on why you liked it and I'll post them).

Cheers,
Jock