I have devoted considerable space on this blog to Robert Whitaker’s 2010 “Anatomy of a of an Epidemic,” which posits that mental illness is on the rise because of psychiatric medications, rather than in spite of them. In reviewing Whitaker, I read the same studies he cited in his book and came to the conclusion that Whitaker had not made his case.
Nevertheless, I pointed out that Whitaker had made a very strong “case to answer.” In other words, until someone (presumably a psychiatrist with weighty credentials) made a convincing counter-argument (preferably in a point-by-by rebuttal), Whitaker’s thesis - whatever one’s misgivings - stood as the authority.
I also stated that Whitaker had initiated a conversation that we badly need to have. Whitaker was also very clear that he wanted to have this kind of discussion.
To my dismay - and to the shame of psychiatry - that conversation never eventuated. Daniel Carlat of Tufts University in two blogs issued what was essentially a collegial light dusting, taking issue with Whitaker’s presentation of the evidence in a friendly sort of way, but hardly knocking any holes in his main arguments.
Andrew Nierenberg of Harvard purported to “rebut” and “refute” Anatomy of an Epidemic in response to a grand rounds Whitaker delivered at Mass General. The so-called rebuttal amounted to an irrational and high-volume hissy fit (one punctuated by totally unprofessional ad hominem attacks) that I could only characterize as “sick, very sick.”
A few commentators quibbled about Whitaker’s interpretation of the term, “Epidemic,” tossing in an ad hominem attack or two for good measure, but otherwise avoiding engagement.
That all changed last week with an article posted on the website of the Treatment Advocacy Center. Anatomy of a Non-Epidemic - A Review by DrTorrey, read the heading. “How Whitaker Got it Wrong,” read the subheading.
E Fuller Torrey (pictured above) has a way of getting a rise out of certain mental health advocates. Dr Torrey is the founder of the Treatment Advocacy Center (TAC), which pushes for aggressive outpatient treatment laws for those with severe mental illness. The issue is a hot-button one, and TAC and Torrey have come under considerable criticism for their position and their tactics (including from this writer).
But Torrey has paid Whitaker the ultimate compliment of intelligently and thoughtfully responding to Whitaker. Too often, in our focus on personalities, we lose sight of the issues. Advocates who should know better have elevated Whitaker to the status of cult hero who can do no wrong. This is a grave disservice to both Whitaker and the people we purport to serve.
Torrey, too, enjoys a certain cult following, particularly among first-generation NAMI parents, as well as villain status from a host of mental health advocates. We will discuss these matters in a future blog. But, for right now, let’s focus on the issues. Essentially, Torrey has shifted the whole discussion. He has convincingly answered Whitaker’s “case to answer.” This hardly means that Torrey is right and Whitaker is wrong. Indeed, a constructive synthesis would move the discussion to a new level, one that Whitaker and Torrey could easily agree upon - the need for some serious research.
In other words, if the scientific evidence is insufficient to either support Whitaker’s case or to rebut it, then let’s put some serious money into unearthing the evidence.
In future blog posts, we will explore point-by-point Dr Torrey’s responses to Whitaker. In the meantime, this disclosure: Dr Torrey wrote a very glowing back-cover blurb for my 2006 book, “Living Well with Depression and Bipolar Disorder.” The blurb states: “Very helpful for those affected by bipolar disorder and their families ... I recommend this book enthusiastically.”
I have had no other involvement with Dr Torrey and none with the Treatment Advocacy Center.
Stay tuned ...