Thursday, February 20, 2014

The Proud Critics of Psychiatry

I received an e-mail first thing this morning from a person who identified himself as Peter C. Gøtzsche, MD.  It looked official, but if this was not sent by Dr. Gøtzsche, all he has to do is send me an e-mail and I will delete this post.  For those unfamiliar with why he might be sending me e-mails he is the author of the "Psychiatry Gone Astray" post that I critiqued.  The body of the message was straightforward and said:

Incidentally, I found out that some one has written about you and the way you treated my paper about the 10 myths in psychiatry. See attached"

The attachment read: "Asshole of the Day - George Dawson, MD"  The proud author of that post made this statement after a completely respectful response to him on this blog.

Anyone who has been around the Internet and knows about malicious code would have to be a fool to click on an abusive attachment like this and put their data and identity at risk.  Although this is a very simple message it says a lot about the way people expect to treat psychiatrists and get away with it.  Dr. Gøtzsche had sent me an earlier e-mail saying he had responded to my criticism of his criticism of psychiatry.  At this point I have not read it for various reasons including the low volume of web traffic from the Healy web site, the fact that I have been physically ill and exhausted, and my focus on other areas such as the recent series I am attempting to post on the reality of dangerous drugs.

Implicit in the e-mail is that his original "paper" had been treated poorly.  I put "paper" in quotes here because as far as I am concerned it is a blog post.  Where I come from a paper is published in a referred, peer reviewed journal.  It is certainly possible to get rhetorical criticism against psychiatry published in that format, but even then it would not be beyond criticism.  I also disagree with any implication that his opinions were treated poorly.  It is called arguing and as every scientist, philosopher, and rhetorician knows there are at least two sides to every story.  Practically all of the psychiatry critics don't seem to understand that these arguments can be done without taking things personally and using emotional invective.  What many people don't seem to grasp is that it is also part of the scientific method.  Arguments, theories, speculation, conjectures, etc. all have to withstand scrutiny over time.  Even though every top scientist and mathematician expects these challenges, apparently only the critics of psychiatry consider themselves to be above criticism.

There is an asymmetry to the position that psychiatrists should not object to being criticized no matter how irrational, unscientific, or personal the criticism is.  The implicit contention here is that the blog post was "treated" poorly but what about the way psychiatrists are treated and their work with people who have conditions that are treated by nobody else?  And as I pointed out in my original criticisms, why do none of these critics ever look at closely at their own fields and the huge problems that exist there?  

These dynamics are why there is such a blizzard of unscientific and unreliable criticism of psychiatry on the Internet and in the popular press.  This is what happens if you are a psychiatrist who dares to speak out against it and not get into the usual patterns of silence or taking the position that you are somehow better than your colleagues.

My message to these people, no matter who they are is quite simple.  If I have not been deterred by 35 years of irrational and mean spirited criticism - name calling is certainly not going to stop me now.

So to all of the proud critics of psychiatry - flame away!  But don't expect me to engage you in a "debate".  Anyone with an ounce of self respect knows that is not what is going on here.

George Dawson, MD, DFAPA 


Supplementary 1:  The other important disclosure that I have relative to the critics is that I have no conflict of interest or appearance of conflict of interest.  I have no book to sell.  I am not invested in pharmaceutical or medical device makers apart from mutual funds where I have no control over the investment decisions.  I have never been paid for my commentary or writing and don't see that ever happening.  I am not a paid spokesman for any commercial or professional organization.  This is a completely noncommercial blog with no advertising.  If I post copyrighted material here I have to pay for those rights out of my own pocket.  I have no relationships with any pharmaceutical companies. I do not consider myself to be a celebrity and I am therefore not trying to enhance my celebrity status and in fact will be he first to admit that hardly anybody reads this blog.  This entire blog is written in my spare time and yes I have a day job.  I encourage a similar analysis of any critic of psychiatry you might be listening to.


  1. Strangely enough, there really is an Ahole article. However, you don't need to read an email attachment; it can be Googled. Not really worth the effort reading it though as it is full of personal attack.
    For the topic at hand, I read Dr. Gøtzsche's response last evening before reading your response here. I was surprised at how his reply strayed into a personal attack. Note that I was no fan of his first article there for its populist tone and that was before I even knew your website existed. I think I will write more about this, and probably more coherently, when it is not the early a.m. Middle insomnia is unforgiving. But a few brief thoughts:

    One is, why is the educated anti-psychiatry crowd going this route? Actually this is a rhetorical question. I am sure there are many reasons and I will never truly know why they are. Anyway, I ask this question as someone very sympathetic to their cause, but one they are quickly losing. I understand the rants of the uneducated masses who have been harmed, but when the discussion amongst doctors devolves like this, it is painful to watch. However, the fact that the subject is being debated is a good thing which brings me to my second point.

    The exchange between you and Clark in your Heat Map article was inspired. I admit I don't understand why he showed so much deference in telling his story, yet I was very impressed by his respectfulness and tenacity in telling it. You didn't attack him, just gave your experience in reply, and by the end of it both of you slightly but significantly altered your course. He, to admit some of what he wrote may be biased opinion and express his wish that both camps would find a common ground, and you, to not continue to say you don't see what he experienced in your travels, but rather to say that you might like to write an article advising those finding themselves in a similar situation as his. I wish more discussions around this subject worked like this.

  2. Thanks - In my previous analysis of the Psychiatrist as Bogeyman as well as the concept of folk psychology looks at the issue of why anti-psychiatry criticism degenerates rapidly into name calling and ridicule. It runs through practically all of that literature. I try to have a different standard here and hope that is noticeable. The other thing that is striking in the antipsychiatry literature is a complete lack of scholarship of the field. It is the only literature that I am aware of where rhetoric is is supposed to carry the day and all of the real literature and what actually happened is ignored.

    And thanks for the report on the two posts - I have not read them and don't see a need to. The nature of the posts as you describe them comes as no surprise to me.

  3. Plenty of name calling related to this post all very consistent with the original. Just this morning I was accused of being a whore for Big Pharma to "defend these drugs". This is standard antipsychiatry rhetoric and of course nothing is further from the truth, As I have pointed out, I had Big Pharma figured out long before any of the current critics did.

    And this is further notice that there are plenty of venues for posting these wild and defamatory accusations, but this is not one of them. Sending them here is a waste of your time.

  4. Yes, that call to action, reminiscent of third-grade behavior, seemed just an intent to annoy.