Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good?
by Richard P. Bentall. New York University Press, 2009
Despite advances in our understanding of mental illness, treatments leave patients no better off today than they did almost half a century ago—according to British clinical psychologist Richard P. Bentall. In his provocative book, Doctoring the Mind, Bentall takes on the conventional field of psychiatry, arguing that it works in a way that is “profoundly unscientific” and fails to actually help patients who are suffering from mental problems.
The root of the problem is psychiatry’s heavy focus on the biomedical approach, which, research shows, is “fatally flawed,” Bentall writes. Antipsychotic drugs are not working well, and the impression that they do is actually the result of “skillful pharmaceutical industry marketing,” he claims. The same is true for antidepressants, Bentall says, citing studies that found appalling methodological flaws in the drugs’ clinical testing. For example, in some studies “patients were removed and replaced by new patients if they failed to show an early response to the antidepressant.”
But it’s not only the treatments that ail the field of mental health care; the diagnoses themselves can be equally problematic, Bentall says. That’s because the current system of categorizing psychiatric problems is fundamentally wrong, he argues. For example, many patients show both bipolar and schizophrenia symptoms, blurring the boundaries between the two disorders. Such diagnoses, then, are “about as scientifically meaningful as star signs.”
Doctoring the Mind is a very accessible and well-organized book, but what makes it most engaging is the glimpse inside the world of mental illness that Bentall’s patient stories provide. His accounts illustrate the point that a conventional approach often leaves doctors stumbling blindly in the dark. Some of the stories are so bewildering that it is hard to comprehend how they happened. One example is Andrew, who was brought into a facility for psychiatric examination. Presumably in an attempt to find behaviors that fit a diagnosis, health care professionals focused on the fact that Andrew was “excessively polite.” One of the reasons for keeping him in the institution, then, became to work out whether his politeness was “part of his normal personality or his illness.”
So what does it take for mental health care to get on the right track? Bentall thinks part of the answer is taking into account the circumstances that most likely led to mental problems in the first place. But rather than trying to make broad diagnoses such as schizophrenia, we should look at individual symptoms, he says. For example, research has already elucidated potential experiences that may contribute to the development of paranoia. Such an approach, however, would require nothing less than “completely rethinking the values and goals of psychiatric care.”
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16 Comments
Add CommentThat's definitely going to the top of my reading list; maybe not the very top but it'll be up there. Mainly because I totally agree that conventional psychiatric care hasn't changed much. Being a psychologist, it is clear that Bentall has had a conflicting view of psychiatry from the get-go. But that potential bias aside, the book seems to make for a very interesting read. I would venture to say that it has been that way for well over the half-century mark that Bentall kindly gives it. Trying to fit the wide array of afflictions associated with mental illness into a diagnostic nutshell just doesn't seem to work. Hopefully more clinical psychologists like Bentall and psychiatrists can help move the field of psychiatry into new territory. Thanks for bringing my attention to this book.
Reply | Report Abuse | Link to thisAt the root of the problems with psychiatry is a complete lack of understanding what it is that constitutes a "mind." The consequence of this ignorance is blind treatment of observable symptoms. The logic of chemical psychiatry is similar to the logic behind draining blood to cool feverish patients. www.mindmadereal.com
Reply | Report Abuse | Link to thisPsychiatry disgraces the honorable traditions of medicine with its blind devotion to coercive treatment and "research" manufactured by drug companies. Where else do ex-patients organize themselves to protest against treatment methods used by their doctors? Can you imagine an organization of cardiology patients protesting against their treatment? Or cancer patients, or diabetics?
Reply | Report Abuse | Link to thisSo does this mean Tom Cruise is exonerated?
Reply | Report Abuse | Link to thisIt seems that for the past 50 or more years, all ANY doctor is willing to do is, THROW DRUGS AT THE SYMPTOMS. Forget what the cure is. There is more MONEY in treatment. A common example is," this only has a 10% chance of working, but I am going to prescribe this drug before we move on to something else". Just like the big drug companies convinced the government that 99% of our children MUST be on Ritalin !
Reply | Report Abuse | Link to thisSorry if that view offends anyone, but it is how I ( and a lot of others ) feel about the medical profession now days.
Weather someone has a Hangnail, or a major mental illness, we must go see ten different doctors, and get ten different tests run, then get ten different prescriptions filled before anyone really starts working on what is wrong.
Reply | Report Abuse | Link to thisBig Drug Companies, and Insurance Companies are the farmers, and we are the cash cows that they are milking.
Is that not a common sense. Lobbying works. Look at US congress, senate, white house and everything works. Lobbyists can manufacture, plant and prove their dirty hypothesis beyond doubt. Their cheerleading shamless tabloid media like CNN, FOX, NYT (Scientific American in race to join them) will convince potato couches that what they are hearing is hardcore truth. The result is victory for evil lobbyists even if means murder, occupation and genocide on part of war and zionist criminals.
Reply | Report Abuse | Link to thisDoes anyone have a clue what it was that Iahmad said ? I sure don't.
Reply | Report Abuse | Link to thisI not trying to be mean or anything, I just can't understand what was said.
Iahmad didn't make any sense at all to me....
Reply | Report Abuse | Link to thisAntidepressants work for many types of pain and nerve damage. There is no question about it.
Mental illness gets worse with age, because the damaged cells reproduce.
The cells somehow need to be replaced with healthy ones that function normally.
Knowing how you should feel, think, and act... isn't the same as being normal.
I have two old friends...sad to say.. I avoid talking them to them as much as possible because
it's too stressful.
The "mental health" industry is pretty much a joke. People who have "problems" are hectored and bullied until they elicit desired behaviors. and what are the desired behaviors? Behaviors that reinforce the philosophy-of-the-mind to which the mental health practitioner adheres. Having tricked or forced such reinforcement out of the "patient" the practitioners convinces themselves they are correct in their chosen philosophy-of-the-mind. Given this reality it would seem that the mental health practitioners are the ones who are out of touch with reality far more than the victims of their "treatments". If you want to sort out "mental cases" from the general population... look to those staffing the mental health care industry... they have self-selected themselves... and they are the ones living in a quasi-psychotic dreamworld that requires psychotic-style evasive thinking to support their world view.
Reply | Report Abuse | Link to thisThink of the experience of the "mentally ill" in a treatment setting.
Reply | Report Abuse | Link to thisThey are utterly isolated from any honest or genuine interaction with anyone. They are gawked at and examined minutely in every detail of their behavior... or else disregarded like furniture... and it is never clear to the "patient" which is occurring.
The staff sits in meetings to discuss the patient behind their backs... and the patient's life is being determined by these secretive meetings.
There is no interaction that is not manipulative and socially dishonest on the part of the staff.... they are trying to "objectively observe" or to "change behaviors".
Then we wonder why people who have been "treated" end up being social isolates and "a little weird". They have been placed under a microscope and that every behavior or thought... no matter how insignificant... is going to determine how they are regarded by others.
It is the treatment that torments them into this... same as any other person who has been tormented and confused by captors.
The treatment system itself is abusive and demeaning and creates more problems than existed in the first place.
Once a person has been convinced by "mental health care providers" that they cannot trust their own mind... how can they not end up confused and lost?
People who are having "mental health issues" generally start on the road to recovery when they figure out the "health care providers" have little to nothing to offer in the way of help and are more than a little deluded themselves.
Consider the mental health care provider.
Reply | Report Abuse | Link to thisHere we see people who claim an interest in the human mind and how it works in relation to the real world.
Yet.. they choose a career that isolates them socially from the rest of society...no one feel comfy around them.... no one likes the idea of the company of someone who is boxing them into some prefab category... same as no dark-ages serf liked the company of the witch-finder.
So we have people who claim an interest in the human condition and how humanity thinks about it and reacts to it.... yet these same individuals lack the native insight to figure out they are isolating themselves from the subject they would like to study.
They are like zoologists who study chimps pickled in jars or locked in zoo cages rather than head out in the wilds to watch them at home in their natural habitat.
Can a zoologist watching captive chimps learn much of anything about wild chimps? Not really... same as one can learn little about free humans from studying humans in the solitary confinement wing of a prison.
And so..... we look at the mental health industry and its staff. these are people who do not have the savvy to figure out they are socially isolating themselves... and are thus preventing themselves from any meaningful, authentic, unrehearsed contact with the rest of society... from the rest of humanity.
And so they drift ever farther away from an understanding of the real world and the people in it with each day. These are truly a sad lot... they have sent themselves on the road to a inescapable social hell... and they take it out on their patients.... people the "helping professionals" try to manipulate into soothing them by agreeing with them.
So... let the rest of us realize who it is who is trying to enlighten us as to the workings of the human mind.... let us consider who it is who would lord it over others as the gatekeepers of insanity or sanity..... they are people who demonstrate with their very choice of career that they have precious little comprehension of human nature to start with... and have embarked upon a lifepath that ensures they will forever be isolated from that in which they claim expertise.
i am a business management consultant also a patient who recently recovered from brain tumor surgery and recovery procedure. i must say, my experience (as a business consultant vs. patient) of going through the MIND related business was extremely frustrating. Thanks for my 10+ years of meditation, yoga and other wellness dietary practices, I was able to manage, recover fully without use of any prescriptive drugs. Now, I am a believer in the Preventative Healthcare Model. If only the insurances paid for my preventative healthcare cost!!
Reply | Report Abuse | Link to thisi am a business management consultant also a patient who recently recovered from brain tumor surgery and recovery procedure. i must say, my experience (as a business consultant vs. patient) of going through the MIND related business was extremely frustrating. Thanks for my 10+ years of meditation, yoga and other wellness dietary practices, I was able to manage, recover fully without use of any prescriptive drugs. Now, I am a believer in the Preventative Healthcare Model. If only the insurances paid for my preventative healthcare cost!!
Reply | Report Abuse | Link to thisWell - we really have no technical clue about how the brain is wired, yet the mental health "professionals" claim to be able to alleviate our problems. Nice try - but no thanks ! An unfortunate side effect is that in popular culture such claims of cause and effect are turned about and used as excuses for our irresponsible behaviour: mommy didn't love me therefore I am a jerk. It's really not my fault ..... Spare me !
Reply | Report Abuse | Link to thisI am one of many that has used anti-psychotics with positive effect. Science does not know all there is to know about how the brain works and mental illness. Everyone has certain oddities that could border on mental illness. I would expect a fair amount of exploration and guessing in diagnosis for a while yet.
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