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Big Pharma, Book Review, Cracked: Why Psychiatry Is Doing More Harm Than Good, James Davies, Medicine, Psychiatry, Soapbox
Wool Pulled Justifiable Rage Disorder
Why has the prescription of antidepressant medicine roughly tripled in less than 20 years? Is it that we are indeed becoming sicker, that we are all becoming more and more stressed and psychologically unwell, is it merely that doctors and psychiatrists are much more skilled at diagnosing psychiatric conditions than they used to be, or is it that we are now medicalising (drugging) what is normal about the variety of day to day human experiences, which at times can be sorrowful, challenging or confusing?
This briiliantly clear, cogently argued, shocking and timely book by psychotherapist and anthropologist James Davies rendered me almost incoherent with rage, exposing as it did something which many of us have been aware of, but maybe have not had the tools or ability to follow to a conclusion. James Davies has those tools and abilities; he thoughtfully, knowledgeably, skilfully connects all the dots together, uncovering the horrendous duplicity, collusion and sheer unscientific snake oil peddling visited upon us by Big Pharma, in the field of mental health.
I can’t urge the reading of this book strongly enough. Anyone who cares about what it 
means to be a fully human being, and especially anyone involved in any way in the caring professions needs to be aware of what Davies lays clear about the mental health industry. For industry it surely is.
With a carefully constructed series of explanations, revelations and arguments Davies delivers telling knock out punches to the House of Trick Cards of current mainstream psychiatry. The major punches involve
1) The increasing categorisation of VIRTUALLY ANY EMOTIONAL STATE so that it falls within a category of disorder – thus opening the way to the development of chemical coshes. This categorisation – the ‘Bible’ used to denote syndromes, the DSM (currently DSM 5), is NOT the result of huge studies and research itself, yet it gets used as if it were the result of close scientific analyses. The result of the sort of sordid, limiting tickboxy thinking, turning us all into robots who can be managed out of our normal human pain is the crass thinking that says, for example, if after a bereavement, sleep appetite and general mood are affected for more than 2 weeks, anti-depressants may be helpfully prescribed. Crazy, insidious, crass. We have become so afraid of our suffering that the answer becomes ‘cosh it, flat line what it is to be in any way human’
2) Trials – various meta analysis studies have shown that antidepressants are BARELY more effective, in mild to moderate depression, to placebo. Drug companies have disquietingly low bars to climb over, in order to ‘prove’ their products effectiveness. Davies uncovers the secrecy, the UNPUBLISHED drug trials that go against the findings Big Pharma wants and the manipulation of results. More than this, how drug companies positively USE that most powerful of tools – PLACEBO ITSELF to manipulate their own results higher – for example, the colour, the name, the advertising of the pharmaceutical – many of the effects that might be assumed to be the result of the chemistry of the drug ‘better than placebo’ – are in fact DUE to the use of placebo!
3) There has been a change in thinking from the 60s and 70s, where psychiatric drugs were seen as altering mood (in the same way as any mind altering drug, including alcohol and street drugs alter moods) A shift occurred to thinking of psychiatric drugs as ‘curative’. This might not seem an important shift – however it goes along with the idea that much uncomfortable, difficult human emotion is now being seen as potentially aberrant and classifiable as a ‘disease’ – as in the DSM – shyness becomes ‘social phobia’.
Medical naming encourages thinking about human beings in all their complexity as broken, and needing mending – and opens the door to the over-prescription. In fact, as one astute expert (among the many) Davies consults, points out tersely, this thinking of these drugs as ‘cures’ is erroneous, as unlike most physiological disease there just is no hard evidence to support the biology of a lot of what is now being treated as ‘disease’ through these medications – which alter mood. They do not ‘cure’ shyness, (or, lets medicalise it as social phobia) any more than a glass of wine ‘cures’ shyness – both change ways of perceiving the world, that is all.
4) Who bites the hand that feeds? There is a huge cover-up, smoke and mirrors going on in the world of funding ‘research’ into psychiatric medicine whether in academic institutions, or with clinicians. And, gentle reader, there is even less transparency over this in the UK than there is in the States, where under the Obama administration, spearheaded by a particularly truth-and-justice campaigning Senator, Senator Grassley, some efforts to bring the Pharma hyena under the spotlight are beginning to bear fruit. But not here, where there is murk a plenty. Perhaps though, the fact that fully 56% of the panel member luminaries involved in writing the DSM-IV bible had 1 or more financial associations with the pharmaceutical industry, should begin to rip the wool from over our eyes. And, for those writing/creating the diagnostic categories, which would of course be primarily treated by pharmaceuticals, – 88% of DSM-IV panel members had drug company financial ties.from Big Pharma. And things don’t have appeared to have changed for the better in terms of ‘arms length’ involvement with the writing of the now current DSM-V.
I am not saying (nor is Davies) that all these senior clinicians and medical academicians are corrupt, merely that neutrality becomes hard to achieve when your income is dependent on a particular company who are hoping your findings will support the excellence of their product, and even to demonstrate a need for their product
I received this book as an ARC – of course, given what I have said in point 4, you may feel that my judgement is compromised. I would argue that a lowly amateur reviewer lucky enough to get offered bookie freebies through third parties does not in any way equate to some stars of the psychiatric industry who receive millions for the sterling work they do in supporting the claims of specific drugs and manufacturers. A look at some of my reviews on Amazon will show that if I think a particular book is poor I will indeed say so.
This one though gets my gold standard bookie trial award. Properly researched, properly cited, free from duplicitous cover-up. Unlike the industry is exposes.It deserves to be a best seller – indeed, needs to be so – its material is provocative, prescient, and vital to know.
I have one cavil – my ARC was a digital copy, from the publisher via NetGalley. Now I don’t know if this will be any different than the standard digitise prepared for sale, but the digitisation on my ARC was poor – a lot of the useful charts and graphs do not appear and footnotes get chopped and inexplicably appear in the middle of other pages. If I were buying this book, I would definitely choose hard, over digitised, copy.
Available now in the UK, paper and digital; not in the USA in paper until August but available as digital
Cracked: Why Psychiatry Is Doing More Harm Than Good UK
Cracked: Why Psychiatry Is Doing More Harm Than Good USA
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