Annotated Links

By Neuroskeptic | April 19, 2009 5:47 pm

Sydney Spiesel writes about the myriad claimed treatments for autism in Slate. He’s skeptical

If there is any illness for which 100 treatments are available, you can be sure that none of them works.

True. But he doesn’t do a great job of addressing why parents swear by such ineffective treatments. His answer is the “Hawthorne Effect”. I think there’s rather more to it than that. For one thing, Spiesel does not consider the possibility that a treatment might have no effect at all – not even a non-specific “placebo effect” – and still become popular.

But that happens. A PLoS ONE paper, From Traditional Medicine to Witchcraft, tries to explain why. Although it features some maths and lots of graphs, the argument is summed up in a sentence

Superstitious treatments and maladaptive practices can spread because their very ineffectiveness results in sick individuals demonstrating the practice for longer than efficacious treatments, leading to more salient demonstration and more converts

In other words, the less well a treatment works, the longer it gets used, and therefore, the more likely it is for other people to see it being used and adopt it. Of course this only holds under when people are completely unable to tell whether treatments used by others work or not. This may be a valid assumption.

Psychology Today interviews rebellious British psychiatrist David Healy about his new book, Mania, which I really need to read. Healy notes that bipolar disorder became a fashionable diagnosis starting in the mid 1990s. A while back I plotted a graph showing how often bipolar disorder was mentioned in the British media. It became much more popular after about 2000 – which sort of makes sense.

Healy’s one of the few people who manages to be deeply skeptical of much about modern psychiatric diagnosis and treatment while avoiding Tom Cruiseist anti-psychiatry. His last book was a homage to ECT, ferchrisakes. A lot of people felt actively betrayed by that. But if you still doubt Healy’s intellect, his use in the interview of a Buffy metaphor to explain the history of “mood stabilizing drugs” should set you straight. Genius.

  • Anonymous

    Thanks for posting this; I’d never heard of Healy before but the interview is fascinating and I will most certainly be checking out ‘Mania’. I have an infinite amount of respect for academic writers who can (successfully) integrate popular culture into their answers. I still think that SJ Gould’s ‘Phyletic Size Decrease in Hershey Bars’ is the pinnacle, but this is pretty good!

    I think that there is very interesting research to be done in this area at the minute with the increasing diagnosis of disorders such as Chronic Fatigue, and Irritable Bowel which seem to currently have no known biological foundation. The one thing I would add to Healy’s analysis is an examination of the role of patient groups. If anyone read the interview that Simon Wessely gave in New Scientist a couple of weeks back, and the responses that it got from said patient groups, then you got a Grade A demonstration of this.

    Further, I do have a lot of time for the antipsychiatrists (as do others it seems, I tutor and they are in the A-Level psychology syllabus now!) and so it is nice to see the literature continuing. If nothing else, someone like Szasz is so obviously influenced by his libertarian political philosophy. I firmly believe that, when examining social entities as psychologists and psychiatrists necessarily and unavoidably do, it is impossible to escape this influence and what Szasz does explicitly the rest of us do implicitly. This may not be the biggest problem in the world, but it does no harm for us to be reminded every so often.


  • Neuroskeptic

    Re: Szasz, maybe… and I think you do have a point about politics being relevant whether explicit or implicit. But I’ve always found him to be too conspiratorial for my taste. Which is one thing Healy isn’t. Also, Healy doesn’t deny the existence of psychiatric illness, which Szasz does (or at least comes dangerously close to doing), which for me is an acid test of whether you’re worth listening to or not.

    Elliot Valenstein is another person I’m a fan on, for the same reason…



No brain. No gain.

About Neuroskeptic

Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.


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