July/August 2004 VOICE FOR THE DEFENSE 1

Likewise, not so long ago, on the basis of their clinical experience,
psychiatrists diagnosed and treated such “disorders” as
“lack of vaginal orgasm,” “childhood masturbation disorder,”
and “hyperactive sexual desire.” (“Hyperactive” means wanting
sex too much, once called nymphomania; no one seems to
think that’s much of a problem nowadays.) But other problems,
such as “Hypoactive Sexual Desire Disorder,” have been voted
in. Nowadays, after all, people think it can’t be healthy to not
want sex, so that’s the new “disorder.”
Of course people have concerns about their love lives and
sex lives, and seek therapy for their problems. But problems are
not necessarily mental disorders. It’s an open secret that many
of these “disorders” get into the DSM solely for the purpose
of insurance compensation. Nonetheless, once in, they get the
imprimatur of SCIENCE, as if they explained
something. But these labels are not explanations:
they are descriptions. Yet many experts
confuse the two: A woman is acting crazy. Why?
Because she’s a “borderline personality.” How
do we know she’s a borderline personality?
Because she’s acting crazy. The label gives us
no new information. It’s just a fancy label for
behavior that others find strange, distressing
or annoying.
In medicine, in contrast, a diagnostic label
or the use of the word “syndrome” has a specific
meaning: a cluster of symptoms that reliably
occur together and that indicate the presence
of underlying disease. People with Werner’s
Syndrome, a disease that produces premature
aging, will turn gray in their teens, have
wrinkles in their 20’s, and diseases of the old in
their 30’s. But in psychiatry and psychology, the
word “syndrome” is generally a warning sign of
pseudoscience, as in “Munchausen Syndrome
by Proxy” (called Factitious Disorder by Proxy
in the Appendix of the DSM) or “Parental
Alienation Syndrome.” The reason that so many
psychological “syndromes” are unscientific is
that their “symptoms” are not specific to the
disorder, and the list of defining symptoms keeps growing until
anything a person does is evidence that he or she has the problem
— the “syndrome” is most likely in the mind of the observer
rather than in the disorder of the patient. That is why, once a
syndrome gets a new label, clinicians suddenly see evidence of
it everywhere, as they did with Attention Deficit/Hyperactivity
Disorder (a real problem, but now wildly overdiagnosed), PTSD
and Multiple Personality Disorder.
With this background, then, let us take a deeper look at the
differences between real science and clinical pseudoscience.
Science, The Scientific Method and Scientific
Knowledge.
“Science” refers to the procedures or methods used to gather
scientific knowledge; and it refers to a body of knowledge that
is established through scientific methods. Science involves an
attitude of questioning received wisdom, of being skeptical
of claims that lack good evidence, of not relying solely on the
claims of an authority, and most of all, of being willing to be
wrong in our predictions and beliefs. Science also relies on
the use of objective methods to gather empirical, data-based
evidence to determine whether a belief is valid or not.
Hard sciences, such as physics, biology or chemistry, are
characterized by hard facts and laws — a stable and reliable
body of facts and laws upon which further achievements are
built. Laws of planetary motion, or combinations
of elements that form more complex
substances (compounds or alloys), or medical
conditions/diseases (e.g., cancer, pregnancy,
malaria, etc.) are examples of hard facts or
laws. Most of cinical pychology does not rely
upon hard facts, or hard laws, or firm and fast
disorders, diagnoses or syndromes.
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In science, new evidence does not necessarily
cause existing theories to be junked.
When Einstein’s Theory of General Relativity
came along because Newtonian physics could
not account for events that occur near the
speed of light, Newtonian physics were not
junked; they are still used to make highly accurate
predictions of planetary motion and
other events here on earth. Remember the
comet, Shoemaker-Levy? Two weeks after it
was discovered, Newtonian physics were used
to predict that it would impact Jupiter, as well
as the date those impacts would occur. Have
you ever used an accident reconstructionist?
If so, that individual’s testimony was based
on Newtonian physics.
Hard scientific knowledge is characterized
by the range of phenomena that can be
predicted and the precision with which they can be predicted.
For example, astronomy, a hard science , can predict far into the
future when and where a solar eclipse will occur. The effects and
courses of disease and many disease agents can also be predicted
with a fair degree of accuracy. It is this principle of science
that the Department of Defense and Homeland Security have
used to estimate what it would take to re-introduce smallpox
into this country and what the effects of that re-introduction
would be.
In contrast, can any mental health professional predict who
will or will not develop a given psychological condition? Can
any mental health professional predict who will or will not
“of not
relying solely
on the claims
of an
authority, and
most of all,
of being
willing to be
wrong
in our predictions
and
beliefs.”
24 VOICE FOR THE DEFENSE July/August 2004