“Psychiatry is a science…and it has the tools and knowledge at its disposal to help us when our lives break down. This is the official story we hear, the one gaining airtime in the media, the ear of government policymakers, and widespread dissemination through celebrity chat shows and popular magazines. But what if the actual truth about psychiatry were not so sanguine or clear cut as we have all been led to believe? What if there is another more insidious story to be told, one that threatens all of our preconceptions? An alternative story certainly does exist—a deeper and far more maddening story.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

The public has been led to believe that the diagnosis of mental illness by psychiatrists, and the prescribing of psychiatric drugs, is a practice grounded in science. In this video, we explain why this is not the case. We look at the problems with the diagnostic methods of mainstream psychiatry and we explore how Big Pharma has infiltrated and corrupted the psychiatric industry.

In 1973, a groundbreaking experiment was organized by David Rosenhan of Stanford University. Seven academics checked themselves into different psychiatric hospitals across the United States. Each told the psychiatrist on duty that they were hearing a voice in their head that said the word “thud”. Other than this, they acted normally. All the academics were diagnosed with schizophrenia, admitted to mental hospitals, and given antipsychotic drugs. Most of the academics were held for weeks against their will, and a few for over two months. Confessing that they were subjects in a scientific experiment only solidified the psychiatrists’ conviction that they were insane. The only way the academics managed to be released was to agree they were mentally ill and pretend they were getting better.

Another study conducted in the 1970s presented the same patients to different American psychiatrists in different locations. It was discovered that two psychiatrists gave different diagnoses to the same patient almost half the time. Yet another experiment showed that psychiatrists in the United States and Russia were twice as likely to diagnose a patient as schizophrenic than psychiatrists in England and Europe. Regarding these three studies, James Davies writes that:

“…in the history of psychiatry, [these experiments] were considered game-changers. They plunged psychiatry into severe crisis in the 1970s by exposing that there was something terribly wrong with the diagnostic system. Psychiatrists were not only defining sane people as insane, but when two psychiatrists at any given time were faced with the same patient, they would assign different diagnoses nearly half the time…Psychiatry was making these errors because it possessed no objective way of testing whether a given person was mentally disordered, and if so, precisely what disorder he or she was suffering from. Without such objective tests, the diagnosis a psychiatrist would assign could be influenced by his subjective preferences, and as different psychiatrists were swayed by different subjective factors, it was understandable that they regularly disagreed about what diagnosis to give.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

Leaders in the psychiatric industry recognized that these experiments exposed a deep problem at the heart of psychiatry, which required a solution. The solution devised was to completely revamp the manual used to diagnose mental disorders. This manual is called the DSM, or the Diagnostic and Statistical Manual of Mental Disorders, and as Herbert Pardes explains:

“If you don’t understand the history of the DSM, you cannot hope to understand modern psychiatry…the DSM contains every mental disorder with which you or I could be potentially diagnosed, and that’s its significance.”

Herbert Pardes, Quoted in James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

The second edition of the DSM, published in 1968, consisted of vague definitions of mental illness which left too much room for subjective interpretation. In the 1970s, psychiatrists put together a Taskforce to essentially tear up DSM-II and re-write a new manual – DSM-III. Allen Frances, Chairman Emeritus of the Department of Psychiatry at Duke University, explains how the release of DSM-III enormously impacted not just the psychiatric community but the public at large.

“DSM stands for Diagnostic and Statistical Manual. Until 1980, DSMs were deservedly obscure little books that no one much cared about or read. Then DSM-III burst on the scene—a very fat book that quickly became a cultural icon, a perennial best seller, and the object of undue worship as the “bible” of psychiatry. Because it sets the crucial boundary between normality and mental illness, DSM has gained a huge societal significance and determines all sorts of important things that have an enormous impact on people’s lives—like who is considered well and who is sick [and] what treatment is offered…”

Allen Frances, Saving Normal

DSM-III was an overnight sensation. It quickly sold out and the American Psychiatric Association took 6 months to print enough copies to catch up with the demand. This so-called bible of psychiatry became the default manual which psychiatrists across the world used to diagnose mental disorders. With its release and remarkable success, it appeared as if the field of psychiatry had overcome its diagnostic problems. However, as James Davies writes:

“…even as the influence of the manual spread, the truth about its construction remained obscure. Most professionals using the manual simply did not know (and still do not know today) the extent to which biological evidence or solid research failed to guide the choices the taskforce made.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

One of the updates to DSM-III was the inclusion of a checklist of symptoms purported to define each mental disorder. For example, DSM-III lists major depressive disorder as consisting of nine symptoms, and it specifies that if a patient exhibits 5 of the symptoms for two weeks, then a positive diagnosis of the disorder can be made. An obvious question is why the threshold for depression was decided to be 5 symptoms for 2 weeks. In 2010, Daniel Carlat interviewed the psychiatrist Robert Spitzer, the leader of the Taskforce which created DSM-III, and asked him this very question.

“Carlat: How did you decide on five criteria as being your minimum threshold for depression? Spitzer: It was just a consensus. We would ask clinicians and researchers, “How many symptoms do you think patients ought to have before you would give them the diagnosis of depression,” and we came up with the arbitrary number of five. Carlat: But why did you choose five and not four? Or why didn’t you choose six? Spitzer: Because four just seemed like not enough. And six seemed like too much. [Spitzer smiled mischievously.]”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

Commenting on Spitzer’s admission, James Davies writes:

“Wasn’t the whole point of Spitzer’s reform to make psychiatric diagnosis a little more scientifically rigorous? But what, you may ask, is rigorous about a committee drawing arbitrary lines between mental disorder and normality?”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

Lest one think this absence of research and scientific evidence was an exception in the creation of DSM-III, a member of the DSM Taskforce, Renee Garfinkle, recounts an instance where a decision was being made as to whether to include a specific symptom in the checklist for a mental disorder.

“On one occasion, I was sitting in on a taskforce meeting and there was a discussion about whether a particular behavior should be classed as a symptom of a particular disorder. As the conversation went on, to my great astonishment one taskforce member suddenly piped up, ‘Oh no, no, we can’t include that behavior as a symptom, because I do that!’ And so it was decided that that behavior would not be included because, presumably, if someone on the taskforce does it, it must be perfectly normal.”

Renee Garfinkle, Quoted in Cracked: Why Psychiatry is Doing More Harm Than Good

In addition to adding a checklist of symptoms for each mental disorder, 83 new mental disorders were added to DSM-III. In an interview with Robert Spitzer, James Davies asked Spitzer about these new inclusions:

“So presumably, these disorders had been discovered in a biological sense? That’s why they were included, right?”, asked Davies. “‘No, not at all,” Spitzer said matter-of-factly….“No biological markers [for mental disorders] have been identified…Psychiatry is unable to depend on biological markers to justify including disorders in the DSM. So we look for other things…We have other procedures.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

One of these “other” procedures involved sending out questionnaires to select members of the American Psychiatric Association. The questionnaire asked the psychiatrists whether they thought a particular mental disorder should be included in DSM-III. If enough responded yes, the disorder would be presented to the Taskforce, who would then debate or vote about whether to add the disorder to the new manual. Donald Klein, a member of Spitzer’s Taskforce, explained that:

“…we had very little in the way of data, so we were forced to rely on clinical consensus, which admittedly is a very poor way to do things…There would be about twelve people sitting down at the table. And some would agree with the inclusion [of a specific mental disorder], and the others would continue arguing. If people were still divided, the matter would be eventually decided by a vote.”

Donald Klein, Quoted in Cracked: Why Psychiatry is Doing More Harm Than Good

Needless to say, consensus does not constitute scientific proof. There are countless examples where the consensus opinion of a group or experts proved to be dubious or wrong. Or as James Davies writes:

“If a group of respected theologians all agree that God exists, this does not prove that God exists. All it proves is that these theologians believe it. So in what sense is psychiatric agreement different? Why, when a committee of psychiatrists agree that a collection of behaviors and feelings point to the existence of a mental disorder, should the rest of us accept they’ve got it right?”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

In 2012, James Davies interviewed the Harvard psychologist Paula Caplan, who was a consultant to two DSM committees, regarding her thoughts on the methods that gave rise to DSM-III.

“It was so methodologically flawed, that it would fail an undergraduate examination. In fact, it was so full of basic errors, that I actually decided to use it on an undergraduate exam in which I asked students to point out every conceivable methodological error, because it had so many…All Spitzer’s research proves is that a group of psychiatrists working in the same institution gave the same label—rightly or wrongly—to a given set of behaviors.”

Paula Caplan, Quoted in Cracked: Why Psychiatry is Doing More Harm Than Good

In his book Cracked: Why Psychiatry is Doing More Harm than Good, James Davies explains how the general public and the psychiatric community at large has been fooled into thinking the DSM is a scientific manual.

“[People] do not know that the definitions of the disorders contrived, the validity of the disorders included, and the symptom thresholds people must meet to receive the diagnosis were not decided by serious scientific evidence but were the product of committee decisions…In short, most people do not know that the fundamental changes Spitzer brought to global psychiatry only required the consensus of an extremely small group of people.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

To make matters worse, many psychiatrists who have been members of DSM taskforces and committees have, and continue to, receive financial payoffs from pharmaceutical companies. This is concerning as pharmaceutical companies, driven by the profit motive, have an incentive to get as many people on psychiatric drugs as possible. If they can influence those who write the diagnostic guides, they can expand the market for their drugs through overly broad classifications of what constitutes mental illness. A study from the University of Massachusetts discovered that of the 170 panel members of DSM-IV, 56% received money directly from pharmaceutical companies. With respect to psychiatrists who took part in DSM committee meetings to discuss mental disorders for which psychiatric drugs are the default treatment, 88 percent had financial ties to drug companies.

“Today it is very difficult to find somebody or a large number of people who have not had some pharmaceutical support.”

Robert Spitzer, Quoted in Cracked: Why Psychiatry is Doing More Harm Than Good

The renowned psychiatrist Loren Mosher was so appalled by the financial chains that bind psychiatrists to pharmaceutical companies, that at the turn of the century he resigned from the American Psychiatric Association, claiming that “psychiatry has been almost completely bought out by the drug companies.” In his resignation letter he wrote:

“After nearly three decades as a member it is with a mixture of pleasure and disappointment that I submit this letter of resignation from the American Psychiatric Association. The major reason for this action is my belief that I am actually resigning from the American Psychopharmacological Association. Luckily, the organization’s true identity requires no change in the acronym…”

Loren Mosher, Quoted in Anatomy of an Epidemic

Psychiatrists’ financial ties to drug companies can account for what is called the medicalization of everyday life, which James Davies defines as “the process by which more and more of our human characteristics are seen as needing medical explanation and treatment.” Without scientific justification, for the last 70 years psychiatrists have continued to expand the number of mental disorders included in the DSM. In the 1950s, the first edition of the DSM listed 106 mental disorders. The latest edition, DSM-V, lists over 450 mental disorders. One hundred years ago, one in a thousand people were diagnosed as mentally ill. In the 1950s, this number grew to one in a hundred. Today, it is reported that approximately one in four people suffer from at least one of the many DSM mental disorders in a given year.

Social factors, such as the compulsive use of smartphones and social media and the decline of communal forms of social support, are undoubtedly contributing to a rise in mental health problems. However, in medicalizing normal human experiences and emotions, such as fear, anxiety, sadness, or depression, psychiatry has created the illusion of a mental health epidemic that has turned tens of millions of normal human beings into consumers of psychiatric drugs.

“…psychiatry has not only expanded its jurisdiction over more of us (one in four of us apparently now suffers from a mental disorder) but has also, by inflating the number of mental disorders, created a huge market for psychiatric treatments.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

In a 2007 BBC documentary, Adam Curtis interviewed the leader of the DSM-III taskforce, Robert Spitzer:

“So you have effectively medicalised much ordinary human sadness, fear, ordinary experiences?, asked Curtis. “Ì think we have to some extent,’ responded Spitzer. `How serious a problem it is, is not known. I don’t know if it is 20 per cent, 30 per cent. I don’t know. But that is a considerable amount if it is 20 or 30 per cent”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

The psychiatrist Allen Frances, the leader of the taskforce that created DSM-IV, also acknowledged that through the DSM psychiatrists are medicalizing normal human experiences and promoting the mass-drugging of modern citizens.

“…the situation I think is only going to get worse. DSM-5 is proposing changes that will dramatically expand the realm of psychiatry and narrow the realm of normality—resulting in the conversion of millions more patients, millions more people from currently being without mental disorders to being psychiatrically sick. What concerns me about this reckless expansion of the diagnostic boundaries, is that it will have many unintended consequences which will be very harmful. The ones I am most particularly concerned about are those that will lead to the excessive use of medication…

Allen Frances, Quoted in Cracked: Why Psychiatry is Doing More Harm Than Good

Or as Frances continues:

“Seven percent of Americans are now addicted to a legal psychotropic drug.23 Prescription drug abuse has become a bigger problem than illicit drug abuse. If there is a conceivable way to sell a new diagnosis so that people will incorrectly believe they have it, drug companies will have figured it out and will do it successfully—if sometimes illegally. ”

Allen Frances, Saving Normal

Surprisingly, it is not illegal for pharmaceutical companies to give money to psychiatrists, nor for psychiatrists to hide how much money they receive. As a few examples of how big a problem this is, the psychiatrist Frederick Goodwin, a former director of the National Institute of Mental Health, received $1.2 million from the drug company GlaxoSmithKline to promote mood stabilizers for bipolar disorder. In an interview with the New York Times, Goodwin explained that he was only “doing what every other expert in the field does.” Over a period of 4 years the psychiatrist Melissa Delbello, chair of the Department of Psychiatry at the University of Cincinnati, received close to half a million dollars from AstroZeneca. Charles Nemeroff, the chair of psychiatry at Emory University, who was called the “Boss of Bosses” by a leading psychiatric journal, received $2.8 million in personal income from the drug company GlaxoSmithKline, as well as a grant of $3.9 million to study psychiatric drugs made by GlaxoSmithKline. In 2000, editors at the New England Journal of Medicine tried to find a psychiatrist to write an editorial on depression, and found “very few who did not have financial ties to drug companies that make antidepressants.” 

“Some of us, believe that the present system is approaching a high-class form of prostitution.”

E. Fuller Torrey, Quoted in Anatomy of an Epidemic by Robert Whitaker

And as Robert Whitaker explains:

“The pharmaceutical companies would not have been able to build a $40 billion market for psychiatric drugs without the help of psychiatrists…The public looks to doctors for information about illnesses and how best to treat them, and so it was the academic psychiatrists—paid by drug companies to serve as consultants, on advisory boards, and as speakers—who in essence acted as the salesmen for this enterprise.”

Robert Whitaker, Anatomy of an Epidemic

To make matters more corrupt, pharmaceutical companies are by far the biggest funders of clinical trials on the efficacy and safety of psychiatric drugs. James Davies writes that “nearly all research into psychiatric drugs—antidepressants, neuroleptics, tranquilizers—is now pharmaceutically financed (e.g., nearly 90 percent of all clinical trials in the UK are conducted or commissioned by the [drug] industry).”  Those who receive funding from pharmaceutical companies, whether it be psychiatrists or researchers, must tailor their research, writing, and opinions to meet the demands of pharmaceutical companies, or else suffer financial and professional repercussions. As one example, the psychiatrist David Healy was offered the prestigious position of clinical director of the Mood and Anxiety Clinic at the University of Toronto. Before starting the position, he gave a lecture on depression and warned that antidepressants can provoke suicidal urges. Two months later, Healy received an email from the University of Toronto informing him that his offer had been revoked. Upon looking into the matter, Healy discovered that Eli Lilly, the makers of the antidepressant Prozac, fund 52 percent of the total budget of the Mood and Anxiety Disorder Clinic, and as Davies writes: “Healy began to suspect that the university pulled its offer because it feared that he, by critiquing Eli Lilly, would threaten an important funding source.” Or as Davies continues:

“…to palm from the pharmaceutical purse is to enter a Mephistophelian pact—one that gradually and often unconsciously erodes the recipient’s capacity to think and act objectively.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

Big Pharma is also one of the top buyers of TV advertisements, accounting for approximately 10% of all TV ad purchases. Many of these direct-to-consumer pharmaceutical ads entice people to take psychiatric drugs by communicating the debunk idea that mental illnesses are caused by chemical imbalances in the brain. One recent ad for Paxil stated that “Just as a cake recipe requires you to use flour, sugar, and baking powder in the right amounts, your brain needs a fine chemical balance in order to perform at its best.” In the United States, the FDA does not assess these pharmaceutical ads before they are released, which means that these lies reach millions of people before coming under any sort of scrutiny – if they ever do at all.

“The fact that the chemical imbalance theory has never been proven does not seem to matter to these corporations, which have made their public assertions as though they were based on scientifically established certainties.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

Along with spreading lies to the public, the advertisements of pharmaceutical companies also exert pressure on news networks not to speak negatively about pharmaceutical drugs, or the companies that make them, so as not to bite the hand that feeds them. Hence why it is so rare for mainstream media personalities to shine a light on the deep corruption of Big Pharma or even communicate simple skepticism regarding pharmaceutical companies or their products.

In the 1970s, news reports revealed that in the Soviet Union psychiatrists were diagnosing political dissidents as mentally ill, and forcibly giving them antipsychotics that caused brain damage and turned them into vegetables. An article in the New York Times argued that this practice was a form of “spiritual murder”. What is happening in the West may be more disturbing. Psychiatrists and pharmaceutical companies have successfully medicalized normal human experiences, such as fear, anxiety, depression, and sadness, and therein promoted the mass drugging not of political dissidents, but of tens of millions of ordinary men, women, and children. Or as Robert Whitaker writes:

“…in 2011 alone a staggering 254 million prescriptions of antidepressants were dispensed to the American public. The vast majority of these pills were not prescribed to the stereotypically “mad” characters depicted in Hollywood movies. No, most of their recipients were just like you and me, average people simply trying to make their way. Perhaps you are one of them. Perhaps someone you love is one of them.”

Robert Whitaker, Anatomy of an Epidemic

Ultimately, however, all the blame for this tragic problem cannot be placed on the lies spread by pharmaceutical companies, nor on the financial incentives psychiatrists receive from pharmaceutical companies. For a negative vision of suffering, which has infected the modern zeitgeist, is also contributing to the medicalization of everyday life and the mass drugging of modern citizens. This negative vision of suffering conveys the idea that all suffering is pathological and best dealt with by getting rid of it as swiftly as possible. In the final video of this series, we critique this vision and offer a positive vision in its place, so that we are better equipped to deal with the pains of life without considering ourselves mentally ill, engaging in unproductive behaviors, or taking psychiatric drugs that are at best ineffective and at worst dangerous to mental health. Or as James Davies writes:

“…the [negative] vision of suffering which now culturally dominates can explain why an increasing number of people have come to manage, understand and respond to their discontent in ways that are socially and individually disadvantageous…The growth of this [negative vision of suffering] is easily illustrated by figures that show how we are progressively managing our emotional troubles in contemporary life – not as potentially productive experiences to be engaged with and learnt from, but as harmful experiences to be removed with medication.”

James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good

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