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Comment by breck | Hacker News Reader

Absolutely. Psuedo-science at best. Psychiatry in America is no more scientific than phrenology.

These people are charlatans, not scientists. Science only works when you can run repeated experiments in controlled conditions with fast feedback loops. Those conditions are not, and will never be, present in humans. The whole industry is a fraud. I came across a great term the other day: the Mental Health Industrial Complex.

If you want to get on the right track for how the brain actually works pickup Minsky's Society of Mind.

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> If you want to get on the right track for how the brain actually works pickup Minsky's Society of Mind.

I was with you until that last sentence. What you call the "Mental Health Industrial Complex" is the modern-day equivalent of the Catholic Church prior to the Enlightenment. The cure to the ills of Catholicism wasn't reading the Quran (Minsky's Society of Mind) instead of the Bible (the DSM). It was, as you said, turning away from dogma and towards science, rationality, and empiricism.

Like the DSM, Minsky's work presents many useful models for thinking about the mind, and I might even agree that they are more useful. However, what we really need to do is not just change our models, but acknowledge that modern clinical psychology is built more on tradition and authority than it is on the testing of such models.

I'd agree with you. My sentence was bad in that it oversells that book. That book is merely one baby step in the right direction.

As excited as I am about Minsky's hypothesis that the brain is a society of agents, your point is the more important one that the process is more important.

I also think Minsky would have agreed with you. His process seemed to be the Feynman "What I cannot create, I do not understand" approach. His thoughts on the brain were developed from building robots and multi-agent simulations and AI. Whereas the DSM says "here are the conditions, take this pill, pay us", he would say "we have no idea, let's keep building until we understand".

I mean it's true that doing scientific psychiatry is hard, and a lot of the industry is subpar (and actually the majority do not really closely use psychiatric research results, forgetting how good they are or not). But what alternative exactly do you want? To just give up? There are some parts of psychiatry that have fairly well-validated conclusions at present, and hopefully that will (albeit likely slowly) progress.

Continue neuroscience research; stop pretending psychologists and psychiatrists are more than cranks; admit the pills don't work. Basically quit pretending that this is a science. The problems are not biological that can be solved by pills, the problems lie in society, not individuals.

Yeah, that's just nonsense. There are certainly many societal ills that do not help. But your broad brush there is entirely wrong. Though I doubt any kind of legitimate discussion would sway you from it.

Many fields of medicine, such as mental health, are far closer to religion or politics than they are to science.

Science requires controlling the environment and the ability to do repeated experiments with rapid feedback. The mental health field cannot do that. It can on worms. We could build the most amazing medicine for worms (by killing trillions of them). But we cannot do that with humans.

The Mental Health Industrial Complex deserves no respect. It may turn out that psychedelic mushrooms that someone could grow for free in their yard could have saved millions of lives over the past 50 years, but that would have deprived the MHIC of tens of billions in revenue. The field is built on lies.

Dude neuroscience departments at pharma companies have been dropping like flies precisely because they are so fucking bad at finding new effective drugs for mental illness. Old shit like Prozac and Adderall doesn't do much for them financially, but most new psych drug clinical trials fail.

There's no conspiracy there, and in fact the absolute rot that pervades most of academic science is just as culpable for the incompetence part as the psychiatry side. I'm pretty sure drug companies would love to be less incompetent at making psych drugs.

And as far as therapists making money - well demand way outstrips supply and most people do combination treatment with drugs and therapy. So no shrooms would not make therapists go out of business, unless you've been deluded into thinking that's a magical cure for all mental illness (and if you really think it can cure all psychotic illnesses I have a bridge to sell you).

I don't think shrooms should be illegal but a lot of politics surrounding drug prohibition that have jack shit to do with the "mental health industrial complex". By the way therapist is generally not a very well paying job.

I genuinely find it hard to see the legitimate scientific foundation of psychiatry, and would love to be persuaded that there is one. At the moment, I see the profession as overall more harmful than beneficial to health, and it's sad to see people treated this way.

Is there substantial evidence that psychiatric treatment improves quality of life in the long term?

Can we say with any confidence that our culture and health is broadly better thanks to psychiatry than it would be without?

If there are well validated studies, I would be interested to read them. In particular, are there any long-term studies to justify the drug regimens and the recommended doses which so many people are advised, or forced, to take for decades?

Are there well-validated biomarkers that can reliably support any psychiatric diagnoses?

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