Letter Mosher to Goodwin
7
Sept. 1999
from Loren R. Mosher,
MD
to
Frederick K. Goodwin, MD
Dear
Fred:
Thank
you for taking the time to write a rebuttal to my article in Sept./Oct.
issue of Psychology Today. The content of your response was, of
course, completely predictable. I have no quarrel with the free
expression of differing points of view. Unfortunately, however,
it contains four errors of fact that I can not let you purvey to
an unsuspecting readership without correction
1.
In the second paragraph you assert that I am arguing, in
general, that it is "a choice between medications and
psychological treatment" and then go on to cite my
description of the methods used in the Soteria Project in
support of this false dichotomization. As is clear from the
next paragraph you have no understanding of the nature of
that experiment. My position about medications has been very
consistent over many years: They do "work", but at
what price in terms of unwanted effects and serious short and
long term toxicities? They have also had the effect of
relegating all psychosocial treatments for disturbed and
disturbing persons to an adjunctive role. This is good to be
sure psychiatrists maintain their power but at the same time
it prevents us from learning what a pure psychological
treatment can do.
2.
The third paragraph reveals either a remarkable level of
ignorance or arrogance. Had you exercised the intellectual
integrity I expect from someone of your stature you would
have read at least one of the 38 publications from the
Soteria Project. Had you done so you would know that it was
an NIMH funded two year follow-up, random assignment,
treatment study of persons newly identified as having
schizophrenia
-- not "simply an interesting
description". I know that scientific invalidation is a
commonly used technique for disregarding results that are not
in keeping with the prevailing zeitgeist. This is a blatant
use of it.
3.
In the fourth paragraph on page 42 you assert that the
neuroleptics were responsible for the emptying out of mental
hospitals. Again, a modicum of scholarship on your part would
reality test this not uncommon delusion among
biopsychiatrists like yourself. It has been shown time and
time again that it is administrative policy that controls the
census of mental hospitals. To edify you just a bit: In the
US most deinstitutionalization occurred after 1972, as a
consequence of the availability of SSI, long after the anti-psychotic
drugs were used universally in state hospitals.
4.
In the same paragraph you say that because of these
medications "only the tiniest fraction of the mentally
ill require involuntary hospitalization". This may be
true in the ivory tower where you work but out in the
trenches it just doesn't wash. For example: In the San Diego
public system 65% of adults and 85% of youth are admitted to
hospital involuntarily. I do not believe this county is an
aberration certainly not in California. This may constitute a
tiny fraction to you but maybe you and I took different
statistics courses.
Because
you and I have been colleagues for so long it saddens me that you
no longer seem to be concerned about truth. It also frightens me
because of your power and prestige. Who are relatively powerless
patients to trust? It appears you are a good example of the kind
of psychiatrist that embodies what the APA stands for -- and
resulted in my resignation. Since your Psychology Today response
contains so many examples of your ignorance I must presume you
have not read my original letter of resignation from APA. I am
enclosing a copy FYI.
Sincerely,
Loren R.
Mosher M.D.
Director,
Soteria Associates
Clinical Professor of Psychiatry, UCSD
Adjunct
Professor of Psychiatry, USUHS
Cc:
Dr. Hyman
P.S.
What is your annual income from various drug company fees,
lectureships, honoraria and consultations?
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