Mad in America
Originally posted January 10, 2018
Here is an excerpt:
Mainstream psychiatry has been afflicted by at least two types of scientism. Firstly, it parodies science as ideology, liking to talk in scientific language, using the language of EBM, and carrying out research that ‘looks’ scientific (such as brain scanning). Psychiatry wants to be seen as residing in the same scientific cosmology as the rest of medicine. Yet the cupboard of actual clinically relevant findings remains pretty empty. Secondly, it ignores much of the genuine science there is and goes on supporting and perpetuating concepts and treatments that have little scientific support. This is a more harmful and deceptive form of scientism; it means that psychiatry likes to talk in the language of science and treats this as more important than the actual science.
I have had debates with fellow psychiatrists on many aspects of the actual evidence base. Two ‘defences’ have become familiar to me. The first is use of anecdote — such and such a patient got better with such and such a treatment, therefore, this treatment ‘works.’ Anecdote is precisely what EBM was trying to get away from. The second is an appeal for me to take a ‘balanced’ perspective. Of course each person’s idea of what is a ‘balanced’ position depends on where they are sitting. We get our ideas on what is ‘balanced’ from what is culturally dominant, not from what the science is telling us. At one point, to many people, Nelson Mandala was a violent terrorist; later to many more people, he becomes the embodiment of peaceful reconciliation and forgiveness. What were considered ‘balanced’ views on him were almost polar opposites, depending on where and when you were examining him from. Furthermore, in science facts are simply that. Our interpretations are of course based on our reading of these facts. Providing an interpretation consistent with the facts is more important than any one person’s notion of what a ‘balanced’ position should look like.
The article is here.