With thanks to James Davies for his great book ‘Cracked’ (2013). The opinions below are OBJECT’s own.
1. Psychiatric diagnoses are made by psychiatrists based on a book which lists recognised disorders and their symptoms. This is called the DSM – Diagnostic and Statistical Manual of Mental Disorders. With very few exceptions (eg. Alzheimers, Huntingdon’s) these disorders are NOT properly based on scientific studies or proof of any kind, they are merely agreed upon by a committee (mostly male of course) of eminent psychiatrists, sometimes by majority vote. Remember the joke about a camel being a horse designed by a committee?! Remember the Groupthink studies which showed that a strong leader can silence dissent and force through his own views?!
2. Voting is a political process, not a scientific one. When physicists research a new atomic particle, for example, they don’t sit around discussing it then take a vote before making a public announcement. They do experiments and analyse the results. It’s important to realise that official-sounding mental conditions are a reflection of our culture, not scientifically-proven fact.
3. It’s a bit like asking a group of theologians to agree on what God is like – they all have a vested interest, and the question assumes the answers to several others: ‘Does God exist’, and also ‘If he does, what is he like, and how do we know what he is like?’
4. The DSM is hugely profitable for the American Psychiatric Association (APA), which makes billions from its sales. Always note a profit motive.
5. DSM was first introduced in the 1950s to solve the embarrassing problem of psychiatrists often making different diagnoses from the same set of symptoms. Its aim was consistency, not to provide any proof or scientific base (sadly, there isn’t one). The fact that a committee of psychiatrists agree on the symptoms of, say, ‘hysteria’ doesn’t mean that it exists, and in fact it is no longer in DSM. In psychiatry, naming the problem tends to come before proving that it exists, which may never happen. We just all assume that it does, and take the medicine.
6. The need to revise DSM became clear after the famous Rosenhan experiments (1973) where sane people turned up at clinics saying they were hearing voices. All were admitted, and all had real trouble getting out, highlighting the lack of scientific standards in mental health care.
7. DSM is used to train psychiatrists – their training is largely about knowing the DSM: official disorders, definitions, symptoms, and drug treatments. There is little or nothing about mental problems stemming from ill treatment or from social problems or pressures, or about the benefits of the talking cures – psychotherapy, group therapy etc. So in order to qualify, (and even more so if they want to advance in their careers), psychiatrists have to accept and play by the DSM rules.
8. We know that many disorders in the DSM are heavily affected by culture, because other cultures have huge outbreaks of disorders that we never see. For example, ‘Koro’, the male fear that one’s genitals are retracting into the body, affected thousands in South-East Asia but nowhere else. Menopausal women in Korea (but nowhere else) experience ‘hwabyeong’, intense fits of sighing, heaviness in the chest, blurred vision and sleepless nights. Anorexia got into DSM a while back. But it was only when it broke out in Hong Kong in 1994 in a different form that its cultural roots became clear. In the West, anorexics always feel fat and have a horror of their own flesh. In Hong Kong, however, it was at first different: sufferers did not feel overweight, did not feel hungry, but instead felt disgust at the thought or sight of food. However as western ideas of anorexia flooded into Hong Kong in the mid-90s, cases of anorexia there started to follow the western symptom pattern too (Davies (2013), Cracked, p. 242).
9. Another proof that mental disorders are cultural not universal is: as the DSM gets revised every few years, things get taken out and put in. Homosexuality was regarded as a disorder until it was voted out in 1973, largely because of campaigning by the gay lobby. Wouldn’t we now say that it was prejudice, not science, that put it in DSM in the first place?
10. It is now thought that mental disorders are used, unconsciously or part-consciously, to signal mental need or distress that the sufferer can’t express in words or where words have failed to evoke the hoped-for reaction. Every culture has a ‘symptom pool’ of behaviours that grab attention and, hopefully, sympathy and help. The symptom pool varies from culture to culture, and as culture spreads, so often do instances of the disorder. For example, anorexia was unknown in Fiji until television arrived there, but soon became common afterwards.
11. As soon as a new mental disorder gets put into DSM, there is a statistical spike in diagnoses of it. Just before or just after the disorder has usually been in the news, especially if a celebrity has gone public as having it. Bulimia diagnoses spiked in 1992 when rumours about Princess Diana first came out, peaked in 1995 when she publicly admitted the behaviour and it got a lot of media coverage, and dropped after 1997. However psychiatry, in its culture-free pseudoscientific bubble, fails to acknowledge that there could be a cultural, imitative influence at work, indicating that bulimia behaviour is at least part conscious and deliberate.
12. The dodgiest disorder ever put into DSM was probably MPD, ‘Masochistic Personality Disorder’, which was scheduled to go into DSM at the next revision. People who ‘had’ this were thought to invite or attract harsh or painful treatment from others. How convenient! It took a female psychologist, Professor Paula J Caplan, to point out that the traits outlined were typically those of a victim of domestic violence. If ‘Masochistic Personality Disorder’ was put into DSM, perpetrators would be let off the hook and blame for violence would be laid at the door of the victim. Not to mention the fact that all the women in the world who are exploited sexually, financially, in surrogacy, porn, prostitution, strip clubs, families etc. could be said to have invited it and enjoyed it. Exploiter’s Charter, or what?!
13. You might expect that after this important insight, MPD would be removed altogether from the DSM. But no, it still got in there, under the equally scientific-sounding name SDPD – ‘Self-Defeating Personality Disorder’! Caplan had been fobbed off.
14. She decided to take a look at the research underlying SDPD. There were only 2 studies cited – far too few for proper scientific conclusions. Worse was to come. One study assumed the existence of SDPD and surveyed old cases – clearly this method could not prove its existence. The other was a questionnaire sent by the Chair of the DSM Committee to a large number of psychiatrists asking them whether SDPD should be put into DSM. If they voted Yes, they were asked to suggest what the symptoms were. If they voted No, they were asked to leave the questionnaire blank. Hence this also was based on a presumption that SDPD was ‘a thing’! Even worse for scientific credibility, only 11% of those surveyed voted Yes to SDPD, so this research if anything indicated the OPPOSITE conclusion from what it was stated to prove. AND some of the psychiatrists surveyed had been specially selected as having publicly stated their view that SDPD existed!
15. If by now you are thinking that there has to be some underlying factor in all this foggery-fakery of dodgy disorders, you are right. Think drug companies, money, complicity, professional closed-mindedness … But first, one more ‘disorder’.
16. ADHD, ‘Attention Deficit (Hyperactive) Disorder. I like this one because all my family follow this pattern one way or another. Most likely you know at least one person who has (or should it be ‘does’?) ADHD – they are typically hyperactive, impulsive, inattentive, often labelled ‘naughty’ children. It’s an Autistic Spectrum Disorder. Added to DSM in 1995, a drug to calm the symptomatic behaviours very soon became available – Ritalin was widely prescribed to keep ADHD children calm and quiet. Diagnoses of ADHD soon spiked up to such an extent that globally over 5% of children are now thought to have it. This is the ‘bandwagon effect’ and happens frequently with disorders that get media coverage, especially after a celebrity gets involved. There are other ways to deal with ADHD behaviour. Some people (like me) parent differently to help ADHD kids to learn to fit in – I walked my kids to and from school to get some exercise, we ALWAYS hit the park afterwards, and my son learned his spellings while doing gymnastics on a rope ladder with me at his side. I had been that kind of kid so it felt normal to me. We worked with an enlightened teacher to learn ways NOT to get in trouble every day, so he had a choice over his behaviour. He’s done fine. No meds needed.
17. Bipolar disorder has followed a similar pattern, as does self-harm.
18. Other dodgy mental disorders in DSM include: sexual aversion disorder (disliking sex), reading disorder (dyslexia?), female orgasmic disorder (not orgasming), conduct disorder, oppositional defiant disorder and transsexualism.
19. Of course Big Pharma has a huge vested interest in the medicalisation of any kind of difference or distress. Drug companies bombard doctors with ‘training’, ‘conferences’, samples, and ‘keeping up to date’ as a doctor also involves reading apparently independent articles in professional journals – in which drug companies often have a financial interest. Drug companies even monitor doctors’ prescribing habits and target them if there is something they are failing to prescribe. It is virtually impossible to retain your independence as a doctor, especially when your training has conditioned you from the start to seek a solution first in a drug.
20. Transsexualism was also added to DSM in 1995, and we are still witnessing the corresponding huge increase in diagnoses, especially following the much-hyped transition of celebrities like Bruce Jenner. Transsexualism, or transgenderism, takes several forms. Some people who exhibit transgender behaviour merely do so in their dress and personal styling – hair, clothing etc. But for those who take the body modification route, the profits for Big Pharma are literally endless: transitioners need daily hormones in order to modify their bodies one way, and if they later decide to detransition, they will need the opposite sex hormones to change back again. Any surgery is fantastically profitable for the specialist and company providing it, and there is a very long list of transgender surgical modifications available- laser beard hair removal, voice modification, penis and breast removal are just the start. And if they change their minds, it can all be undone again and put back – except that of course it can’t, not really. Not totally. The body becomes an object to be tweaked and changed as much as possible.
21. The medicalisation of distress has become entrenched, with little attention paid to gaining insight into your own behaviour, becoming more realistic in your thinking, seeing from another person’s point of view etc. This is sad when as well as CBT there are excellent drug-free talking therapies available, such as Schema Therapy which identifies self-defeating behaviour patterns based on past experience, and gives intensive, drug-free support to replace them with helpful behaviours.
22. Transgenderism has also been popularised via large injections of cash from rich transgender American Trustafarians in particular. The source of the funding is often disguised, for example by the Tide Fund, a sort of money-laundering machine for charitable giving. Well-funded transgender charities and Transgender Studies departments at universities have sprung up, providing jobs, publicity and research funding to further the transgender cause at the expense of other, less voluntary, disadvantaged groups. Transgenderism is core to Pride now, to such an extent that Lesbians are calling to ‘Get the L Out’ of the ‘LGBT coalition’.
All in all, is transgenderism really a profitable and fashionable ‘bubble’ ? Will it soon fade away in clouds of embarrassment and excuses: ‘I didn’t know’, ‘I never believed it’ and ‘I was just trying to be nice to the latest hard-done-by minority’?
It’s best to be clear, and look at the facts BEFORE you jump on the bandwagon. Because the harms are very, very real and long-lasting – infertility, irreversible sex characteristics, complications of surgery, mental health problems, suicide statistics, divided families, working in the sex trade, lonely people, infiltration by criminals seeking to use trans status for no good, drug side-effects, etc.
Transactivists and transadvocates, be ready with your reasons and your excuses.
Written by Janice Williams