Is Psychiatry a Science?

[barts]

To the litany of quackery that is much of the medical profession, in my view, we can add psychiatry, and its discount brand psychology.



Louis Lehand's piece in the New Yorker, Head CaseCan psychiatry be a science?, makes the argument well.

Everything in it, from the science (do the meds really work?) to the metaphysics (is depression really a disease?), will confuse you. There is little agreement about what causes depression and no consensus about what cures it. Virtually no scientist subscribes to the man-in-the-waiting-room theory, which is that depression is caused by a lack of serotonin, but many people report that they feel better when they take drugs that affect serotonin and other brain chemicals.

There is suspicion that the pharmaceutical industry is cooking the studies that prove that antidepressant drugs are safe and effective, and that the industry’s direct-to-consumer advertising is encouraging people to demand pills to cure conditions that are not diseases (like shyness) or to get through ordinary life problems (like being laid off).

These complaints are not coming just from sociologists, English professors, and other troublemakers; they are being made by people within the field of psychiatry itself. As a branch of medicine, depression seems to be a mess. Business, however, is extremely good. Between 1988, the year after Prozac was approved by the F.D.A., and 2000, adult use of antidepressants almost tripled. By 2005, one out of every ten Americans had a prescription for an antidepressant. IMS Health, a company that gathers data on health care, reports that in the United States in 2008 a hundred and sixty-four million prescriptions were written for antidepressants, and sales totalled $9.6 billion. As a depressed person might ask, What does it all mean?

Most psychiatry (but not all, there are truly insane people) is an elaborate con designed to bilk people out of much money as possible who are experiencing perfectly normal reactions to events.

Today, much of psychiatry is simply drug pushing or a consequence of a placebo effect that comes from speaking with a "witch doctor" or even a rabbi, priest, or bar tender. Even a good friend will do.

If it makes you feel better to think your shrink is a scientist, then good for you. But that doesn't make Dr. Phil a scientist.

[lsbskins1]

You know, I'm sure I will be accused of many things with this response. I expect, since my degree field is a Social Science, I will be accused of self-interest. Since I have suffered from depression, I will be accused of "falling for the crap". What the fuck ever...

Clinical depression is not the fucking same as feeling sad because your dog died. I've felt both and...FUCKING HELL!!!!!!....they are different. All this is, is the new version of "You are just weak.Get over yourself." You know what? Debate site or not, this is something I take very personally. Nobody says that cancer is fake because there have been greedy quacks who exploit sufferers and nobody suggests cancer isn't real because some people lie on the internet or lie on the "Please Help This Poor Child" jars they put on the convenience store counter. Nobody suggests there is no such thing as a healthy diet because assholes like to sell books and some fuckity fuck assholes think there is a magic pill they can take to lose weight.

Are psychiatry and/or psychology the same as physics, with mathematical equations and solutions that, once discovered, don't really change? Well, fucking hell, of course not. Does that make them the stuff of quackery? No, it makes them VERY GOD DAMNED COMPLICATED.

[Jack]

I think the key is the lack of standards and repeatable experiments that keeps psychiatry from being considered a rigorous science on the order of geology or biology. It's a very subjective discipline and the scientific method can't be applied to its practice.

[Angry Citizen]

Psychiatry is a "soft" science. That means the degree of error is significantly larger. Psychiatry has a greater amount of "quackery" involved, but I would say that about all "soft" sciences. "Soft" sciences differ from "hard" sciences in that it's harder to call someone a quack. All I have to do to spot a quack physicist is to write a few equations. To spot a quack psychiatrist, you run the risk of being wrong - with life-altering consequences.

[JimmyNic]

I don't think anyone should pretend that psychiatry and psychology are hard sciences - neuroscience is far too young for that to be the case. As the brain is our most adaptive organ there are many arguments about what constitutes good mental health that there would not be when considering many of the other body parts. There is a long way to go.

Is Psychology useless as a discipline? Certainly not, and neither should it be labelled as a "discount brand" of psychiatry. We have already learnt much about human behaviour from psychology and in the future we will learn even more because of it. It also remains true that psychologists do help people overcome behavioural difficulties in a way "a good friend" probably couldn't. Should they be considered in the same light as doctors? Probably not, for the reasons listed above.

The concern that psychiatrists have been over medicating people is entirely valid, but it does not discount the entire practice. It's not so long that doctors were pulling out people's tonsils out of habit rather than sound judgement, and yet we did not dismiss medicine as a result. Many of the problems of mental health are probably caused by our bodies being unsuitable for modern life, like many medical problems. Would we have as many cases of ADHD if we didn't force children to engage in activities that are fundamentally uninteresting to them? I doubt it. Much the same could be said of other problems, although that is not to discount genuine disorders. There are many psychologists that oppose the medication of appropriate responses to life, it is not merely the public who are concerned.

[minorwork]

You know, I'm sure I will be accused of many things with this response. I expect, since my degree field is a Social Science, I will be accused of self-interest. Since I have suffered from depression, I will be accused of "falling for the crap". What the fuck ever...

Sure. Self-interest. No, not falling for the crap.

Clinical depression is not the fucking same as feeling sad because your dog died. I've felt both and...FUCKING HELL!!!!!!....they are different. All this is, is the new version of "You are just weak.Get over yourself." You know what? Debate site or not, this is something I take very personally. Nobody says that cancer is fake because there have been greedy quacks who exploit sufferers and nobody suggests cancer isn't real because some people lie on the internet or lie on the "Please Help This Poor Child" jars they put on the convenience store counter. Nobody suggests there is no such thing as a healthy diet because assholes like to sell books and some fuckity fuck assholes think there is a magic pill they can take to lose weight.

You're not on point. The issue is NOT whether there are or not differences, but whether the practice of clinical psychology and science can function without evidence based science to aid in the problems of those distressed.

Are psychiatry and/or psychology the same as physics, with mathematical equations and solutions that, once discovered, don't really change? Well, fucking hell, of course not. Does that make them the stuff of quackery? No, it makes them VERY GOD DAMNED COMPLICATED.

Complicated is not sufficient to give clinical psychology or psychiatry the status of being an evidence based science. Does that make them pseudosciences? Quack? Just a different name isn't it? Fire up the crystal ball, Tarot cards, incense. Get an office, a prescription pad, a nurse, some certificates on the wall. The 12 Step programs are in the same boat as clinical psychology and psychiatry.

[Medensis]

Psychology finds its base in statistical analysis. More people who act like this do it because they have this disorder and such and such. So, psychology has rules but it doesn't consider exceptions. Like children who are naturally energetic. Like stated above, the better we get at detecting brain abnormalities associated with certain symptoms like repeating yourself in conversation or talking about trains all the time, the more psychology becomes a science. I can't discredit psychology as a science because it's base is just that. It's just a really shitty science. No need to get offended by that.

[minorwork]

Psychology finds its base in statistical analysis. More people who act like this do it because they have this disorder and such and such. So, psychology has rules but it doesn't consider exceptions. Like children who are naturally energetic. Like stated above, the better we get at detecting brain abnormalities associated with certain symptoms like repeating yourself in conversation or talking about trains all the time, the more psychology becomes a science. I can't discredit psychology as a science because it's base is just that. It's just a really shitty science. No need to get offended by that.

Rules?? What rules?

You speak of descriptions of people. Descriptions do not make psychology a science.

[Medensis]

Rules are symptoms. You show this and this and the rule is that you have this. However, some people might have this and this symptom but not have this disorder. It's like medicine without needles.

[minorwork]

Rules are symptoms. You show this and this and the rule is that you have this. However, some people might have this and this symptom but not have this disorder. It's like medicine without needles.

That's taxonomy.

[Medensis]

That's taxonomy.

Essentially. Taxonomy with pills.

As an Adult Specialist at a mental health facility, I can assure you, without certain medications to stabalize patients, I'd be a zoologist.

[minorwork]

Essentially. Taxonomy with pills.

As an Adult Specialist at a mental health facility, I can assure you, without certain medications to stabalize patients, I'd be a zoologist.

Pharmacology is a science. Clinical psychology is not.