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 ...
1 comment:
And here's Whitaker's response:
http://www.madinamerica.com/2012/05/e-fuller-torreys-review-of-anatomy-of-an-epidemic-what-does-it-reveal-about-the-rationale-for-forced-treatment/
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