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PSYCHIATRY SHRINKING FROM THE TRUTH PSYCHIATRY SHRINKING TRUTH FROM THE If psychiatry is not based on scientific method and has such a poor track record in curing mental illness, why does the profession enjoy such high status? omething goes wrong with your life: you lose your job, your marriage breaks up or your lover leaves you. Perhaps a well-intentioned friend or relative suggests that you consult either a psychiatrist or a psychologist in order to get some help. The idea seems to make sense, because at the moment you are not feeling very happy. Think again! The advice may not be so good. "Psychiatry" is defined as "the specialised branch of medicine which deals with the diagnosis, treatment and prevention of mental disorders".! "Psychology" is defined as "science of nature, functions and phenomena of the mind, characteristics".’ Psychiatry and psychology are related disciplines, with psychology forming the theoretical, non-med- ical basis of psychiatry. Most of us believe that psychiatry and psychology are sciences, in the same way that, for example, chemistry or physics are sciences. According to press reports, Tasmania's Port Arthur massacre gunman Martin Bryant s assessed by four psychiatrists. These consultations yielded four separate diagnoses: one said he was a paranoid schizophrenic, another said he was a psychopath, another diag- nosed Asperger's syndrome, and a fourth disagreed with the other opinions but apparently declined to give a specific diagnostic label other than to say that Bryant did not have Asperger's syndrome. Suppose I gave four samples of the same substance to four experts in the field of analytical chemistry, and the first decided that the substance was copper sulphate, the second decided that the substance was hydrogen cyanide, the third decided that the substance was sodium chloride, and the fourth decided that the substance was xenontetrafluoride. How seriously would we take chemistry's claim to being scientific? We would dismiss chemistry as pseudo-science and relegate it to the same intellectual dustbin as astrology. One wonders why psychiatrists still lay claim to being scientific, when it is obvious that they do not employ scientific method. Clearly, there is a dearth of objectivity in psychia- try, since the diagnosis you get depends on whom you ask. Unfortunately, the evidence points to both disciplines, psychiatry and psychology, as being no more scientific than astrology or numerology, yet, even so, both continue to enjoy high status. Researching psychiatry in Australia is no easy task. For example, there do not appear to be any specific statistics kept on such matters as the number of suicides in the profes- sion each year. On the whole, there is a dearth of locally based statistical data, so the research on which one must rely is primarily American. This lack of local data need not concern us unduly, since the principles on which the profession relies are the same in both Australia and the USA. The general public always seems prepared to accept unquestioningly any theory that suggests we are all dysfunctional and in need of some form of psychotherapy. Indeed, this is the view advanced by certain psychotherapists. How logical is this view? Suppose that we are all abnormal and in need of psychotherapy. Therefore, by definition, we all suffer from faulty judgement—but then, so too do those who suggest we are ail in need of psychotherapy. So how do we know they have got it right about the rest of us? This para- dox is one of the many logical problems faced by psychiatry and psychology. Psychiatrist Walter Afield tells how psychiatry tends increasingly to define behaviour as an illness that previously was not viewed as pathological. For example, he tells us of an experience at a recent conference that he attended, "where Russian psychiatrists were talking about [how] in America you talk about treating marital maladjustment reactions and in Russia we just call that bad luck".* One would expect that since psychiatry is a specialist medical qualification, NEXUS - 27 Sydney, NSW, Australia E-mail: starchild@start.com.au DECEMBER 1999 — JANUARY 2000