Critical Psychiatry Textbook: a new psychiatry is needed

By Peter C Gøtzsche

To pave the way for a new psychiatry, I wrote a textbook, Critical Psychiatry Textbook, which you can download for free on my website.

All over the world, a rebellion is underway against traditional, so-called biological psychiatry. The reasons are obvious. The more you treat people with psychiatric drugs, the worse for the patients, and the more people end up on disability pensions because they cannot complete an education or get a job.

Psychiatric drugs cannot cure patients and often make them sicker than they already were.

The criticism comes not only from the patients and their relatives, but also from the psychiatrists themselves. A particularly active group is the Critical Psychiatry Network in the UK, which has around 400 members from all over the world, a few of whom are not psychiatrists. We discuss animatedly by email every day, e.g. different patient stories – in anonymised form of course – and what the best treatment might be.

In the network, the general position is that you should use psychiatric drugs as little as possible and focus on psychosocial measures, above all psychotherapy. Psychotherapy has a documented effect on many different disorders, even the most severe ones such as schizophrenia, and has better long-term outcomes than medication. It is also psychotherapy the vast majority of patients want, but very few get it, even though it would be far cheaper for society than handing out diagnoses and corresponding medication.

Things go wrong very early. People who study medicine, psychology or nursing, or who embark on an education to become psychiatrists, are taught by psychiatrists who almost without exception subscribe to biological psychiatry, where the cause of mental disorders is sought in the brain, and not in the environment and the patient’s life history and where the focus is on medical treatment.

Once the students have passed their exam, it is over. Then most people firmly believe what they have been taught. And telling them that much of it is objectively wrong will get you nowhere. It is too late.

It is therefore important to demonstrate, with reference to the most reliable research available, what is wrong with what students are taught before it becomes so ingrained that it cannot be erased.

Bearing this in mind, I read the five most frequently used psychiatric textbooks by students of psychology in Denmark and wrote my own textbook.

I wrote the book in English because I want as many people as possible to get acquainted with it. I have found that textbooks in psychiatry in other languages are similarly misleading as the Danish ones.

My book describes, with detailed references and criticism of the sources used, what is wrong with the psychiatric textbooks. I uncover a wide range of misleading and erroneous information about the causes of mental disorders; if they are genetic; if they can be detected in a brain scan; if they are caused by a chemical imbalance; if the psychiatric diagnoses are reliable; and about what the beneficial and harmful effects are of psychiatric drugs, electroshock and forced medication.

Much of what is claimed in the textbooks is scientifically dishonest. I also describe many cases of fraud and serious manipulation of the data in frequently cited research.

My conclusion is that biological psychiatry has not led to anything of use, and that psychiatry as a medical specialty does more harm than good. Psychiatric drugs kill an unimaginable number of people and maim even more.

Psychiatry must therefore be radically reformed. It must be based on a humanistic approach, where the most important thing is to try to understand the person in front of you, and to help as best you can, considering this person’s circumstances, and not based on your own ideas and mistaken perceptions of what the many unscientific diagnoses and the corresponding drug overload can accomplish.