Let me ask you a purely academic question: Hello?
— Dean Blehert

Wednesday, December 28, 2005

Tom Cruise -- Who Does He Think He Is -- 3

I've pointed out that Tom Cruise's attack on psychiatry and psychiatric drugs made him a target for mainstream media, and that the reasons for this all come down to "Show me the money!"

The networks (and most other media) need drug company business.

The other "reasons" why it is so easy to see Tom Cruise as an "extremist" (despite the fact that he said nothing more extreme than the truth) come under the following heads:

1. He's not a doctor.

2. He's an actor. And, worse, he's a star! (Popularity doesn't go down well with critics.)

3. He's enthusiastic.

4. He must be wrong, because "all these people" say so, and besides, would we be drugging millions of kids on Ritalin; would tens of people be taking anti-depressants; would all these sincere voices on NPR talk about "clinical depression" and "the latest medications" if there was no science to psychiatry?

I'll take these points up in separate daily installments. Today I'll discuss "He's not a doctor."
True, as far as I know, Tom Cruise is not a doctor. Its also true that psychiatry is currently considered a medical specialty, so that a psychiatrist must be a medical doctor. (Note: This is not true for psychologists, nor, at least in most states and nations, for psychoanalysts.)

When these facts are used to debunk Cruise, the following assumptions are being made:

1. That a non-doctor (or non-psychiatrist) can't understand these matters.

2. That medicine (curing illnesses, surgery, obstetrics, etc.) is scientific and useful.

3. That if medicine is scientific and useful, then psychiatry, being a branch of medicine, just also
be scientific and useful.

4. That Tom Cruise's objections to psychiatry are just the rantings of a non-expert extremist, whereas all the real experts (with medical degrees) know he's wrong.

Point 1: A non-doctor can't understand these matters:

First of all, just the fact that Cruise has no financial or career interest in psychiatry – is, in other words, an outsider, gives his viewpoint reliability. The people defending psychiatry have a vested interest (money, career, prestige) in making psychiatry look good. Cruise has no such vested interest. As far as I can determine, no one is paying him to attack psychiatry. No one is paying his church to attack psychiatry. And, as should be obvious to anyone who has followed the news, Tom Cruise's action in speaking out about psychiatry did not win him much favor with the media. Celebrities depend upon the media to keep them in the public eye. Tom actually, on the air, told a media big-shot that he was glib. (This is something most of us know. But no one ever tells them this on their own shows. No one but Tom Cruise.)

Second: Why would you think that a medical degree would give someone more knowledge of your mind than you have? What evidence exists that psychiatrists know anything about the mind? In the days of talk therapy (now a dying subject for most psychiatrists, who simply prescribe drugs), psychiatry was simply a bunch of theories (each psychiatrist had his own), but was still called a science. Studies of results from psychotherapy all came up with the startling discovery that one "therapy" was about as good as any other, and that all of them got about the same percentage of positive results as were gotten by African witch doctors. And all of these approaches were LESS successful than talking to a good friend about your troubles.

Third: Much of the mystique of science is jargon and complexity. And much of that is designed to make it appear that there's something inscrutable and profound there that normal mortals can't comprehend. And this is as true of pseudo-science as of science. Textbooks of Nazi eugenics theory are as complex and scientific-sounding as textbooks of modern psychiatry. So are textbooks of phrenology, palmistry and most other practices that claim to be science. So, yes, it is difficult to penetrate areas of science or alleged science if you don't have an education in those areas, but most of the education needed consists of learning the definitions of the terminology. This is particularly true in the field of psychiatry, since there's little "practice" to it these days beyond acting knowledgeable and writing prescriptions.

Tom Cruise – though you might not expect it, since he is, himself, so plain-spoken -- happens to be expert in the area of terminology. The media didn't mention, for example, that Tom has sponsored and established and endowed several literacy centers where kids with "learning problems" are tutored, and made literate – not by drugging them into stillness, but by teaching them to use dictionaries and look up words and master the definitions and practice using the words in sentences; by getting them to demonstrate concepts they find difficult to understand and, by other means, to break through the walls of terminology. It works.

Tom knows a lot about it: He grew up nearly illiterate and was considered to be afflicted with ADHD (Attention Deficit Hyperactivity Disorder). But his mother did not allow him to be drugged. Eventually, after years of struggle with the need to read scripts, etc., he encountered a technology of study (the one used in his literacy centers), which, when he applied it, disintegrated his allegedly incurable ADHD. (Psychiatrists claim it's a permanent condition, which can only be held at bay by a lifetime on drugs.)

Tom has successfully applied that knowledge to handle the "study difficulties" of thousands of "learning disabled" children. (He's worked with them personally or others, using the same technology in his literacy centers, have worked with them.) He's donated hundreds of thousands of dollars to set up these centers, and they do get results. (Odd that in all the media blitzing he received, no one mentioned these literacy centers.)

So, though not a doctor, Tom IS an expert in the area of learning disorders and does get results (results that the psychiatrists cannot get with their drugs for learning disorders, which do NOT improve student grades on tests or abilities).

More to the point, Tom knows how to read and understand what he's reading. You don't have to be a doctor to understand medical literature IF you have the right dictionaries and know how to look up words. Since I've done the same thing, I'll give you some idea what you find out, if you start looking into the science of psychiatry:

A. You find out that the way so-called "mental illnesses" become official "illnesses" is not via scientific research. Mental illnesses are voted into existence by a show of hands among members of an APA committee. Once they are voted into existence, because psychiatrists are doctors, the newly approved "illnesses" are presumed to be medical illnesses, are covered by insurance and Medicare and Mediaid, and are used by drug companies to sell new drugs. You also find out that this is NOT the way other medical illnesses are designated illnesses.

Both medical illnesses and psychiatric illnesses begin as observed symptoms. For example, doctors observe that some people react very badly to sugar. Psychiatrists observe that some people are very sad.

The next step for the medical doctor (non-psychiatrist) is to find out what is causing the condition. The researchers try to find if these people with sugar intolerance (and other symptoms) have something in common that explains their symptoms and that can perhaps be handled to cure the symptoms. The medical researchers may find that there are several different causes for these symptoms (as a headache may be from a brain tumor or a salt deficiency or a head injury or "stress" or a virus, etc.) and that you have to find out which cause applies if you want to treat the symptoms successfully. For example, if a headache is caused by a salt deficiency, taking salt tablets handles it, but if it's caused by a brain tumor, salt won't handle it – and if it's salt deficiency, brain surgery is an awfully extreme treatment.

For the sugar intolerance, doctors find that most of these people have a shortage of insulin, and that, if they are given insulin and avoid sugar, they get better. That's over-simplified: There are various forms of diabetes. There are probably other, more basic causes (Why is the person not manufacturing enough insulin?), etc. But the basic point is, in standard medicine, you don't label a group of symptoms an illness or disease until you isolate it from other similar sets of symptoms by finding a unique cause for each sub-set of symptoms and then a handling for that cause.

So medical doctors proceed from noticing symptoms to finding an etiology (that's one of those medical terms: It means finding a cause) and developing diagnostic tools that enable them to differentiate which cause applies to the symptoms being investigated. For example, a patient comes in with symptoms A, B and C. There are 2 known diseases (X and Y) that show symptoms A, B and C, and they require different treatments, so one must first determine if this patient has X or Y. People with X will also have symptom D. People with Y will not have D. So the doctor checks for symptom D, finds it, and knows his patient almost certainly has disease X, so he treats the patient for disease X.

This is, ideally, what medical science does. It is not and has never been what psychiatry does. The psychiatrists, having observed the symptoms (sadness), come up with a bunch of ideas about what may be causing this sadness.

For example, the fad (and it is no more than a fad, not based on research) in the past 20 years or so has been to say that the cause is "a chemical imbalance in the brain." No actual research has ever shown that such an imbalance exists or even defined what a correct "chemical balance" is for the brain. Nor is it considered that there can be many different things that cause sadness, each of which has it's own unique handling.

The psychiatrists, having thus come up with a theory (but not tested it), give sadness (up until then considered a part of the human condition) a name (clinical depression) and vote it into their manual (DSM: Diagnostic and Statistical Manual) as a mental illness. They make it sound scientific by talking about degrees of depression, by listing a bunch of symptoms (difficulty sleeping, for example) and by giving percentages of people suffering from this newly invented illness. The percentages are based on – nothing. They never site any source for these statistics. The main idea is to persuade lots of people that they are mentally ill so that psychiatrists and drug companies can sell them drugs.

(Having thus labeled hundreds of millions of people mentally ill -- anyone who is sad or anxious or overweight or just about anything -- they argue that opponents to this labeling are just trying to stigmatize the mentally ill, who should be happy to know that they just have an illness, like any other illness. Thus the stigmatizers represent themselves as defending those they stigmatize against being stigmatized! Would you rather consider that you are feeling bad about yourself or that you have a permanent "brain imbalance" for which you must be drugged for the rest of your life?)

The drug companies then advertise a drug that handles this new illness. They couldn't very well drug you just to get you high on a stimulant (that would be like getting drunk to forget one's troubles), but they can give a stimulant a fancy name and tell you that it handles "clinical depression."

Then, AFTER THE FACT, the drug company researchers look to see what chemical effect their drug has in rat brains, discover that one effect noticeable is that their anti-depressant increases the amount of a chemical called serotonin in the brains (of rats). This then is much publicized as the cause of depression: Not enough serotonin.

Aha! This makes it sound like science has been at work to discover the etiology of depression. But the time sequence is backwards. MANY things may allay depression: Getting drunk or taking heroin or taking a walk or straightening out one's life or being confronted with an emergency that demands instant action or getting a better job or taking a hit of cocaine (which is pretty close to what Ritalin is, the drug we give to millions of kids to make them sit still in school), etc. So one could as logically note that a few cocktails cheer up many people, then say that they suffered from an alcohol deficiency.

Thus, for all the scientific and medical jargon, the use of words like "syndrome" and "dysfunction", the fake statistics, etc., when you take the trouble to look up the words and read the manuals and textbooks, you don't have to be a doctor to discover that you're wading chin-deep in bullshit.

The process of psychiatric research has been entirely a public relations campaign on behalf of the drug companies: Creating the rationale for getting more and more people on drugs by defining more and more conditions as mental illnesses. The science is so non-existent that an illness may be pulled from the manual if it is unpopular. For example, homosexuality was listed as a mental illness until this became so politically incorrect that it was voted out of the manual. Meanwhile, it "turns out" that being anxious or fat or religious or annoyed by psychiatry are all mental illnesses. Having difficulty with math in school is a mental illness. Disliking peanut butter getting stuck to the roof of your mouth is a mental illness. (You think I'm kidding? Read DSM, edition 4.)

The point is, you don't have to be a doctor to see what's going on here. Forgetting that Tom is a bright guy (you don't make hundreds of millions and direct and produce blockbuster movies without some intelligence; plus, as I mentioned, Tom is an expert on learning disorders), lets say he's "just an actor." But please reread "The Emperor's New Clothes." The Emperor is stark naked. His high officials all flatter him, agree that his new outfit is lovely. The "media" all applaud (not wanting to risk the Emperor's wrath). Who speaks out? A small child who doesn't understand that this is the Emperor, who must not be displeased. A small child cries out, "Look! The Emperor is naked!" Sudden shocked silence. Then everyone begins to shush the child, tell him, "Quiet, you silly child, you don't understand a thing!" But a few people begin to chuckle, then more, then waves of laughter.

It sometimes takes a child to state the obvious. ("Out of the mouths of babes...".) I don't think Tom Cruise is a child. But clearly he's not part of the Emperor's entourage nor one of his media lackeys nor part of the over-awed crowed. And that's what it takes to tell us the truth. That, and a lack of interest in being a slave.

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