Bringing sanity to psychiatry

Paul McHugh, 87, is a psychiatrist and professor at Baltimore’s Johns Hopkins School of Medicine. 

Dr. McHugh is best known as psychiatry’s most outspoken critic and skeptic of the “crazes” that periodically overtake his specialty.  In her recent "Weekend Interview" with McHugh, Wall Street Journal contributor Abigail Shrier observed, “either he’s crazy, or all the other psychiatrists are.”

He’s not crazy. 

Shrier writes that psychiatry “has fallen under the sway of a dizzying number of crazes.” Fads such as ADHD, anorexia nervosa, and recovered memory, devoid of “organizing principles” intrinsic to every medical discipline, destroy lives, displace centuries-old moral and societal customs, and lead to gross miscarriages of justice.  For example, McHugh’s expert testimony has exonerated several defendants’ wrongfully accused of child abuse.

McHugh argues that practitioners often employ what he calls “DSM checklist psychiatry” -- matching up symptoms from the Statistical Manual of Mental Disorders (DSM-5) with the goal of achieving diagnosis -- rather than inquiring deeply into the sources and nature of an affliction.

In the 1980s, Dr. McHugh became a leading opponent of so-called recovered-memory therapy   

He argues that recovered memories are iatrogenic -- a Greek word meaning “brought on by the healer” -- implanted by the therapeutic process that purports to discover them.

Twenty-five years ago, a psychology practice in an affluent Philadelphia suburb wrought havoc in the lives of many local families through its controversial “detachment” theory and fostering recovered memories of parental abuse.

Pennsylvania’s Bureau of Professional and Occupational Affairs eventually intervened to revoke the cofounders’ credentials and their “dangerous and unprofessional counseling techniques.”

I knew the mother and father who were crushed by their daughter’s “recovered memory” of sexual abuse. Their daughter in turn was victimized by the purveyors of this psychiatric craze.  Although her mother courageously led the fight to debunk the accusations and their source, the pain, scars, and distrust were indelible.                 

Post-Traumatic Stress Disorder (PTSD) is another example of iatrogenesis.  In the United States PTSD is treated as a chronic disease with “chronic invalids” on permanent disability at taxpayer expense.

McHugh points out that Israel Defense Forces veterans are taken out of battle temporarily and counseled that their condition is not permanent.  After a few weeks’ rest, they’re returned to their units. 

Similarly, the attorneys’ general of several states cynically blaming drug companies for the opioid crisis should instead target child psychiatrists for treating adolescence as a pathology and psychiatric drugs its cure.

When a generation of teens and children as young as eight are routinely prescribed Adderall and  Ritalin for painful or uncomfortable feelings (now all newly discovered “diseases” such as ADHD, depression, and anxiety), we shouldn’t be surprised when as young adults they turn to opioids to cope with the stresses of adulthood too terrible to face drug free.

The world needs more Paul McHughs to bring sanity to a profession teeming with crazes.

Paul McHugh, 87, is a psychiatrist and professor at Baltimore’s Johns Hopkins School of Medicine. 

Dr. McHugh is best known as psychiatry’s most outspoken critic and skeptic of the “crazes” that periodically overtake his specialty.  In her recent "Weekend Interview" with McHugh, Wall Street Journal contributor Abigail Shrier observed, “either he’s crazy, or all the other psychiatrists are.”

He’s not crazy. 

Shrier writes that psychiatry “has fallen under the sway of a dizzying number of crazes.” Fads such as ADHD, anorexia nervosa, and recovered memory, devoid of “organizing principles” intrinsic to every medical discipline, destroy lives, displace centuries-old moral and societal customs, and lead to gross miscarriages of justice.  For example, McHugh’s expert testimony has exonerated several defendants’ wrongfully accused of child abuse.

McHugh argues that practitioners often employ what he calls “DSM checklist psychiatry” -- matching up symptoms from the Statistical Manual of Mental Disorders (DSM-5) with the goal of achieving diagnosis -- rather than inquiring deeply into the sources and nature of an affliction.

In the 1980s, Dr. McHugh became a leading opponent of so-called recovered-memory therapy   

He argues that recovered memories are iatrogenic -- a Greek word meaning “brought on by the healer” -- implanted by the therapeutic process that purports to discover them.

Twenty-five years ago, a psychology practice in an affluent Philadelphia suburb wrought havoc in the lives of many local families through its controversial “detachment” theory and fostering recovered memories of parental abuse.

Pennsylvania’s Bureau of Professional and Occupational Affairs eventually intervened to revoke the cofounders’ credentials and their “dangerous and unprofessional counseling techniques.”

I knew the mother and father who were crushed by their daughter’s “recovered memory” of sexual abuse. Their daughter in turn was victimized by the purveyors of this psychiatric craze.  Although her mother courageously led the fight to debunk the accusations and their source, the pain, scars, and distrust were indelible.                 

Post-Traumatic Stress Disorder (PTSD) is another example of iatrogenesis.  In the United States PTSD is treated as a chronic disease with “chronic invalids” on permanent disability at taxpayer expense.

McHugh points out that Israel Defense Forces veterans are taken out of battle temporarily and counseled that their condition is not permanent.  After a few weeks’ rest, they’re returned to their units. 

Similarly, the attorneys’ general of several states cynically blaming drug companies for the opioid crisis should instead target child psychiatrists for treating adolescence as a pathology and psychiatric drugs its cure.

When a generation of teens and children as young as eight are routinely prescribed Adderall and  Ritalin for painful or uncomfortable feelings (now all newly discovered “diseases” such as ADHD, depression, and anxiety), we shouldn’t be surprised when as young adults they turn to opioids to cope with the stresses of adulthood too terrible to face drug free.

The world needs more Paul McHughs to bring sanity to a profession teeming with crazes.