Dear Dr. Torrey: Please, Stop The Lies!
After reading E. Fuller Torrey’s latest article in the Treatment Advocacy Center newsletter, in which he sharply criticizes Dr. Sandy Steingard for writing about anosognosia on madinamerica.com, and then goes on to attack me for my various writings, I have to confess that this time—after getting over the feeling that my head was going to explode—I thought, my patience with such dishonesty is running out.
As usual, Dr. Torrey has lied to make his criticisms, stating that I wrote things I never did, or completely mischaracterizing the context in which they were written. Thus, my public plea now to Dr. Torrey: Please, stop the lies. Your writings are libelous and slanderous, and–given your prominent public presence–they make it exceedingly difficult for our society to have an honest discussion about the merits of psychiatric medications, and their place in our society.
Here is what you write about me in your latest article.
1. Lie number one. “Whitaker is dead wrong in alleging that schizophrenia is caused by the antipsychotic drugs used to treat it (see Anatomy of an Epidemic.)”
I, of course, don’t allege any such thing. Here is what I wrote in Anatomy of an Epidemic. In chapter six, I reviewed the scientific literature regarding how antipsychotic drugs affect the long-term course of those diagnosed with schizophrenia. In the course of doing so, I wrote about research done in the 1970s and early 1980s that revealed that antipsychotics worked by blocking D2 receptors in the brain, and that in compensatory response to that dopamine blockade, the postsynaptic neurons increase their density of D2 receptors. Two Canadian investigators, Guy Chouinard and Barry Jones, then wrote that this drug-induced increase in D2 receptors made the brain “supersensitive” to dopamine, and thus potentially made patients more biologically vulnerable to psychosis.
This is what Chouinard and Jones wrote:
“Neuroleptics can produce a dopamine supersensitivity that leads to both dyskinetic and psychotic symptoms. An implication is that the tendency toward psychotic relapse in a patient who has developed such a supersensitivity is determined by more than just the normal course of the illness.”
So what am I doing in this passage? I am quoting what researchers concluded from their biological investigations into how antipsychotics affect the brain. So, Dr. Torrey, here is my challenge: Please point to where I wrote in Anatomy of an Epidemic that schizophrenia is caused by the antipsychotic drugs used to treat it.
2. Lie number two: You write that in Mad in America, I described schizophrenia as a term “loosely applied to people with widely disparate emotional problems.”
Once again, let’s go the source. In chapter seven of Mad in America, I write about the evolution of this diagnosis over the past century, and noted that in the 1960s and 1970s, American psychiatrists—in a form of lousy diagnostic practice—were applying that term to a wide range of patients. I was reporting on criticism of diagnostic practices that had been made by people within the field. Thus, I concluded at the end of this passage about diagnostic practices at that time, that “people with widely disparate emotional and behavior problems—some anxious, some morbidly depressed, some hostile, and some afflicted with odd notions and bizarre thoughts—were regularly funneled into a single diagnostic category, schizophrenia, and then treated with neuroleptics.” (p. 174, of 2002 paperback edition of Mad in America.)
I was writing in that passage about poor diagnostic practices in the past. Then, in the epilogue of Mad in America, I wrote about the diagnosis of schizophrenia today. (p. 285):
“There remains today great uncertainty over what schizophrenia is, or isn’t. The public has been led to think of schizophrenia as a discrete disorder, one characterized by abnormal brain chemistry. In truth, the biological underpinnings of madness remain as mysterious as ever. In fact, schizophrenia is a diagnosis applied to people who behave or think strangely in a variety of different ways. Some people so diagnosed are withdrawn. Some are manic. Some act very “silly.” Others are paranoid. In some people, the crazy behaviors appear gradually. In others, psychosis descends abruptly. Any well-reasoned concept of ‘madness’ would require teasing apart all these different types and would also require an understanding of how outcomes for the different types—in the absence of neuroleptics—might differ. Yet there is little research in American circles devoted to seeing this more complex picture.”
Again, Dr. Torrey, I urge you to consult your attorney on this. Read him what you claimed I wrote in Mad in America, that I described schizophrenia as a term “loosely applied to people with widely disparate emotional problems,” and then read him this passage. See if he congratulates you for your accuracy in your summing up—with quotes—of what I wrote.
3. Lie number three: “For the treatment of schizophrenia, Whitaker recommends ‘love and food and understanding, not drugs.’ “
This quote comes from chapter nine in Mad in America, titled “Shame of a Nation.” (Page 214.) In this section of the chapter, I am writing about the history of forced treatment with neuroleptics, and how patient groups in the 1970s organized against it, arguing that it was a form of “psychiatric assault.” I noted that one of their rallying cries was, “We need love and food and understanding, not drugs.” (That quote, if I remember correctly, was taken from a sign at one of their protests.)
Dr. Torrey, I am quite certain that you can see that I am not, in that paragraph, writing about what I recommend as treatment. So, once again, here is my advice: Take what you wrote to your lawyer, have him read this passage, and ask him about the legal ramifications of your obvious dishonesty here.
In an earlier post, I noted that you used this same dishonest, straw-man tactic—misrepresenting what I wrote and then criticizing me for those “writings”—in your scathing review of Anatomy of an Epidemic, also published on the TAC website. Thus, as you meet with your attorney, ask what the law thinks about repeated libel and slander.
There are two other aspects of your latest post that need a response.
First, you write that madinamerica.com is an “antipsychiatry” website. We are not an “antipsychiatry” website. I turned madinamerica.com into a website where people with a variety of backgrounds—psychiatrists, psychologists, family members, social workers, counselors, people with lived experience, etc.—can write about our current paradigm of psychiatric care, and how it might be improved.
The site does give voice to a number of people who are sharply critical of the system, and particularly to people who have been “patients” in the system. Some of those writers are indeed “antipsychiatry.” But if our society is going to have a discussion about how we can build a better system of care, we surely need to hear from the many who feel they have been horribly abused, betrayed, and harmed by our current form of care.
More to the point, though, we also urge our bloggers to write about new treatments and programs that, one hopes, will lead to a more humane and effective paradigm of care in the future. Those writings aren’t “antipsychiatry” tomes; they are writings intent on creating a better psychiatry.
Finally, you criticized Dr. Steingard for writing on our website. In my opinion, her writings are among the most important that appear on madinamerica.com. She writes in a humble, thoughtful, informed fashion about improving psychiatric care, and she does so from the perspective of a physician who works within the system. But in your article—and ultimately this is what is so indecent about it—you try to discredit her through guilt by association.
Honestly, it made me think of the McCarthy hearings in 1954, when Army counsel Joseph Welch asked Senator Joseph McCarthy this ringing question: “Have you no sense of decency, sir?”