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> The Myth of "The Myth of Mental Illness"
On Saturday, September 9, 2006, Professor Robert Spillane of the Macquarie Graduate School of Management addressed a dinner meeting of Australian Skeptics in Sydney. The topic of his talk was The Mind and Mental Illness: A Tale of Two Myths. I wrote a brief response at the time, but I wanted to wait until Professor Spillane's written version of the speech had been published in the Skeptic before doing much more. The article attracted more critical responses than anything published in the journal for some time. You can read Professor Spillane's article here, and my response appears below.
(Disclaimer: I am a graduate of MGSM and Professor Spillane was one of my teachers there. He was not one of my teachers when I did my undergraduate studies in epistemology and cognitive science at the other end of the Macquarie campus, and I suppose I should be grateful for this as had he been I might not have achieved the grade point average that I did. We would almost certainly have disagreed about some things.)
At first sight and to someone who is unfamiliar with those who oppose psychiatry in all its forms, Robert Spillane seems to be using a classical syllogism to make a point that might be surprising:
He took a similar approach in his speech at the Sydney Skeptics dinner as he did in his article in the Skeptic, but the written article spent much more time on the arguments against the existence of the mind, therefore apparently making a much stronger case for the non-existence of mental illness. The problem for me, however, is that I do know some of the background and I am aware of the opposition to psychiatry coming from one source in particular. That source is Scientology. What Professor Spillane was offering as an argument was not a syllogism where the truth of the premises led inevitably to the truth of the conclusion. What he was offering was an argument of the form:
This is a logical fallacy called Modus Tollens, specifically a subset of fallacies which come under the heading "Denying the Antecedent". If you start with an axiom that there is no such thing as mental illness then the non-existence of the mind becomes a convenient piece of evidence supporting your position. In another context this form of fallacy can be seen in arguments by creationists: They say "Evolution implies continuous and gradual change from one species to another, there is no continuous fossil record, therefore evolution is wrong" when what they really mean is "Evolution is wrong, therefore ...".
I am going to limit my comments to what was said at the dinner, because that was essentially a condensation of the article in the Skeptic.
For the dinner function the speaker was advertised as coming to talk about philosophy and the mind. I spent some enjoyable times studying this sort of stuff at university, so I looked forward to an entertaining evening.
The presentation started out with a mention of how René Descartes had proposed the still-unsolved problem of the interaction between a material body and an immaterial mind. So far, so good. Professor Spillane then went on to solve the duality problem by simply declaring that there is no such thing as a mind. Again, an interesting, although apparently naïve, philosophical position. (He went into this in much more detail in the written article. I will leave it up to the professional philosophers to assess the level of naïvety in the expanded form.) The next statement led into uncharted waters by declaring that as there is no such thing as a mind there can be no such thing as mental illness. Well, it was an uncharted area for anyone who hadn't met Scientology before.
I may well have been the only person in the audience who had had anything to do with Scientology and I also have some vicarious knowledge of the mental health system, so the red flags started popping up for me shortly afterwards.
The first real red flag came when the speaker, who claimed extensive professional experience in the mental health treatment system, said that the terms "mental illness" and "mental disorder" are interchangeable. Not in the state of New South Wales they aren't, and anybody who has been professionally involved in the area knows this. (The terms have to do with how long patients in the system can be detained without a court order - someone declared "mentally disordered" can only be held for three days before either being released or brought before a magistrate; in the case of "mentally ill" the detention can be up to seven days. The difference is based on how dangerous the patient is to himself and to others.)
Some of these warning signs were stories such as the one about the millions of children being prescribed Ritalin, but the turning point for me was when Professor Spillane mentioned that anti-psychiatrist Thomas Szasz was one of his dearest friends. (Szasz worked with the Scientologists to create the Citizens Commission on Human Rights, a blatant anti-psychiatry Scientology front organisation.) He then went on with more CCHR nonsense such as the claim that ADHD was invented in 1987 simply to create a need for Ritalin. (Methylphenidate was patented in 1954, so inquiring minds want to know why it was invented 33 years before what it was supposed to treat. That is assuming that "inquiring minds" exist, of course). We were eventually told that schizophrenia is just people hearing themselves think like everybody else does and that anorexia nervosa is just girls having conscious hunger strikes to get their own way and annoy their parents. By the end of the night we were hearing scary stories about government plans to drug all schoolchildren. At no stage was CCHR or Scientology mentioned.
Part of the teachings of Scientology founder L. Ron Hubbard is that psychiatry is bad. His original feelings on this might have been influenced by the fact that he was mad and he felt threatened by a medical speciality which existed to treat that madness. Put another way, he felt that if there were no psychiatry there would be no madness for it to treat and this would make him sane by definition. (This is not meant to make sense. Remember that Hubbard was insane.) The real reason that Scientology opposes psychiatry, however, is that Scientology's target market is people who are depressed, unhappy, susceptible to suggestion, and don't feel that they fit in to society. Anybody offering to treat these conditions with some behavioural therapy and a course of Prozac is an obvious threat to a cult which wants to brainwash people into paying several hundred thousand dollars to cross a mythical bridge to personal awareness.
CCHR would not be such a problem if the Scientology links were made obvious, because this might make other people think twice about dealing with them. Certainly, Scientology is mentioned in their literature (I have a book called "Documenting Psychiatry: Harming in the name of healthcare" which mentions that the cult paid for the printing of the book, as if that were the only involvement) but the true horror is well hidden. On the other hand, it might not worry some people who deal with them. Alternative medicine supporters gleefully accept the CCHR's attacks on drugs such as Ritalin and Prozac because this supports their shared ideology that there is no such thing as mental illness. (In one bizarre confluence of insanity, The National Vaccine Information Center, one of the most virulent anti-vaccination organisations in the world, issued a newsletter promoting a CCHR seminar.)
I know people who have suffered from depression and other mental illnesses. There are some people I don't know any more because they committed suicide. I have friends whose son was crippled when his schizophrenia led him to leap from a window. I have seen the skeleton-like frames of young girls with feeding tubes up their noses and twenty-four-hour supervision in a locked hospital ward who, according to the anti-psychiatrists, are just killing themselves to make a point to their parents. I have watched as someone had charcoal forced into their stomach to soak up poison, and I know several families who have had to keep all knives and razor blades locked away to prevent their children cutting themselves. That anyone would deny that these are problems and campaign against effective treatments for these illnesses is almost beyond belief.
Unfortunately (or fortunately, depending on your point of view), the dinner was not the sort of place where I could hurl furniture and insults, and the question (and answer) at the end which opened the crack to allow me to introduce an exposure of the Scientology connection was declared the last question before everyone went home. I am sure that most of the audience would not have been aware of the background to what they had been told, and I am equally sure that nobody openly declaring that they wanted to promote Scientology or its principles would have ever been invited to speak there. A real psychiatrist in the audience later told me that she could not remember the last time she heard so many specious claims in such a short time.
So here are the questions I would have liked to ask: