Monday, February 19, 2007

Querulous Paranoia, bullies and the British Psychological Society

querulous paranoiaFollowing my last posting on the abuse of science and of an individual - Lisa Blakemore Brown - by the British Psychological Society, I thought it appropriate to launch into a more general rant about the abuse of psychiatric diagnosis to suppress scientific discussion. For collated posts on the case of Lisa Blakemore Brown see here.

King's College London claim to know whether individuals are mentally "normal". See this fascinating study - Am I normal? - from King's College. Norms were reported for the 21-item PDI psychometric test for delusional ideation. Although the deluded sample of schizotypal inpatients scored significantly higher than "normal" individuals, the range of scores overlapped considerably, with 11 percent of healthy adults scoring higher than the mean of the deluded group.

Other silly research reported from King's College London suggests that "one in three people in the UK regularly suffers paranoid or suspicious fears" based on the King's College definition of paranoia that runs along the lines of "Paranoid thinking is the suspicion that other people intend to do us harm." According to this wonderful research (and the accompanying book "Overcoming Paranoid and Suspicious Thoughts"):
  • 40 per cent of people regularly worry that negative comments are being made about them
  • 27 per cent think that people deliberately try to irritate them
  • 20 per cent worry about being observed or followed
  • 10 per cent think that someone has it in for them
  • 5 per cent worry that there's a conspiracy to harm them.
Watch for the promotion of drug therapy any time soon (perhaps by the Mental Health Research Network - see last post - also coordinated by King's College London).

But what if people really do "intend to do us (or society) harm"? Paranoia (as incorrectly defined above) is a normal human defense mechanism designed to protect us against harm. So is fear. Protective mechanisms can be influenced by disease. But it is necessary to know the normal range of human response to bullying, and to confirm that paranoid "delusions" are in fact false before diagnosing mental illness. Sadly the British Psychological Society appear unconcerned about reality in their assertions of paranoia (read). Psychiatric labelling (such as querulous paranoia) can be a potent form of abuse. Querulous paranoia is the disease of asking too many difficult questions.

The British Psychological Society appear to endorse tests for paranoia along the lines of those discussed by Dr Rita Pal when she faced accusations of mental illness after pointing to deaths on a geriatric ward and the subsequent cover-up. After causing the target some considerable stress by obfuscating and ignoring concerns, a test along the lines of the one below can sometimes prove diagnostically helpful.

BPS stress textLook at the picture of two dolphins jumping out of the water in tandem. Research has shown that the more differences you notice between the two dolphins, the more paranoid you are. This is attributed to the concentration on minute details, distress and preoccupation induced by those in power pretending not to hear what you are saying. It also serves as an excellent test to divert attention from fiddled research involving drugs.

Such highly useful tests to detect, treat and remove the "mentally ill" from the population derives from the same highly developed system of scientific psychology and psychiatry that gave us Teenscreen (imposed screening tests in the USA to detect, drug and sometimes kill normal children - Link), hidden information about the antipsychotic drug Zyprexa, and the despicable attempts to hide away information about suicide in antidepressant drug trials [Link] [Link].

It is both notable and shameful that the neither the General Medical Council nor the British Psychological Society have uttered a peep about these scandals. They have instead colluded to hide away concerns about the science upon which we as doctors rely [Link] [Link]. The UK drugs regulator, the MHRA has colluded with industry attempts to pervert science, and has failed to address many important matters brought to their attention [Link] [Link] [Link]. Instead they bully and abuse those who raise concerns, while never dealing plausibly with the concerns raised. Our patients and the public suffer in the process - but these professional bodies have little interest in honest science, honest debate or the welfare of patients.

The British Psychological Society need to do some serious explaining.

For some good essays on brilliance and madness see The Icarus Project.

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Am I Normal? More on the case of Lisa Blakemore Brown

Am I NormalMany bloggers have been writing about the case of Lisa Blakemore Brown and the shameful attempt by the British Psychological Society to have her pronounced "mentally disturbed" and "unfit to practice" (1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22). My collated postings on this topic are here.

The psychiatric transcript of LBB's "trial" has now appeared online here. I will be analyzing this part of her "trial" in detail over the next few days. What happened to Blakemore Brown must never happen to any other commentator on science. The BPS approach to debate is absolutely wrong and against the public interest.

Worse still, the BPS have shrouded the issue in secrecy [Link]. They have allowed the nature of the "charges" to be misrepresented in public while refusing to allow Blakemore Brown to i) discuss her own case, ii) present her case at an international meeting, or iii) publish the transcripts of her trial. The BPS have threatened legal proceedings if Blakemore Brown breaks their "copyright" on what they have done to her.

If Blakemore-Brown did do anything seriously wrong in terms of patient care, then charges should be examined in detail, and criticism should be transparent - but we have seen no evidence of this in her "trial". These procedures have been likened to a Salem Witch Trial and threaten to shut down all debate. I don't have to agree with her in order to be repelled by what is happening. This is not how debates about policy or science should work.

Blakemore Brown appears as sane as the next person working in this controversial area. Having spoken extensively with her, her colleagues and some of her patients, it would be hard to describe her as having a paranoid illness. Even harder since those of us who have investigated the facts of her case know that all of her so called "paranoid delusions" appear to have a solid foundation in fact. The British Psychological Society don't appear to be too concerned about facts. Blakemore Brown claimed that:
  1. there were successful attempts to hack into her computer.
  2. named parties in communication with the BPS had admitted to computer hacking.
  3. documents had been stolen from her home (by an individual known to the BPS).
  4. this individual had altered the address of her bank account.
  5. a patient had been coached to make an earlier "complaint" by a patient "support group".
  6. this support group subsequently received a large injection of funding from a pharmaceutical company.
  7. some E-mail and written correspondence had been forged.
  8. the BPS lied that they had not been approached repeatedly by a third party to report that a patient had been coached to complain.
  9. the BPS transmitted correspondence of dubious provenance (supposedly written by herself) to a psychiatrist for "review" without checking whether she had in fact written it.
  10. critical background regarding the source of the correspondence and the stated intentions of the individual who provided it was not conveyed to the assessing psychiatrist.
  11. the BPS had continued with their procedures taking no cognisance of the fact that her daughter was desperately ill.
  12. the "panel" judging her mental state was composed of an accountant, a physiotherapist, and Dr Pat Frankish.
  13. the medical assessor to the panel (qualified in medicine in 1953, was a Consultant Psychiatrist at King's College Hospital), is author of these books on Christianity and psychiatry and has accused her of "grandiosity" (presumably of a non-religious type). This is on the basis of her involvement in parliamentary reports - unfortunately senior parliamentarians have declined to agree with this interesting assessment (see letter from Lord Earl Howe)
  14. that the Psychiatrist chosen to assess her mental state and paranoia from her E-mail syntax (including falsified E-mails) is Deputy Director of the UK Mental Health Research Network which aims to provide "a better environment for pharma industry-sponsored research in the UK" [Link].
  15. that the psychiatrist "forgot" to include this appointment on his supplied CV
  16. that a number of anonymous and named parties had conducted a deliberate and protracted campaign (between 2002 and 2006) to induce a "flame war" on an Internet bulletin board to defame her -- and that she knew the identity of at least one of the anonymous posters (that bulletin board is there for all to see - as is an archive of an earlier postings - but the BPS have not thought to ask for it).
  17. that one of those parties defaming her anonymously was in communication with the British Psychological Society.
Unfortunately for Blakemore Brown, she also claimed (amongst many other excellent writings) that thimerosal in vaccines might not be such a great idea. Furthermore she claimed that some prominent paediatricians might have misled the scientific community in terms of the strength of science relating to the diagnosis of M√ľnchhausen's Syndrome by Proxy (MSbP) and supposed murders and injury of children by their mothers. I have no idea at all about this aspect of science. I have no idea whether there is any credible scientific evidence to indicate the specificity and sensitivity of indices for diagnosis of MSbP. I have no idea whether vaccines are always helpful. Lisa Blakemore Brown may well be wrong - but I am starting to wonder why those in power feel the need to stifle debate in this most controversial and scientifically blurry area of medicine.
There are of course never conspiracies to discredit those who forward unpopular, embarrassing or potentially costly scientific viewpoints. Those who believe in conspiracies must be mentally ill. See the next posting on querulous paranoia, and more about the Mental Health Research Network.

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Tuesday, February 13, 2007

Suppression of dissent - the British Psychological Society turns off the lights

British Psychological Society in troubleWhat exactly is the role of the British Psychological Society (the representative body for psychology and psychologists in the UK)? Bloggers have been writing about the apparent attempt by the BPS to discredit the respected psychologist Lisa Blakemore-Brown and to have her officially pronounced "mentally disturbed" and "unfit to practice" (1,2,3,4,5,6,7,8, 9,10,11,12,13,14,15,16,17,18).

Blakemore Brown has unpopular views about autism, drug use, some powerful paediatricians, accusations of parental child abuse, some paediatric research, vaccines and the manipulation of patient "support" groups by the pharmaceutical industry. The BPS are attempting to declare her "paranoid" for believing things which are quite evidently believable to all of us who have examined the evidence in her case. Blakemore Brown appears as sane as the next person working in this controversial area.

For an example of her "controversial" writing see here: [Link].

The BPS have also allowed the nature of the "charges" to be misrepresented in public while refusing to allow her to i) discuss her own case, ii) present her case at an international meeting, or iii) publish the transcripts of her trial. The BPS have threatened legal proceedings if Blakemore Brown breaks their "copyright" on what they have done to her.

If Blakemore-Brown did do anything seriously wrong in terms of patient care, then charges should be examined in detail, and criticism should be transparent - but we have seen no evidence of this in the charges she faces. Nor has Blakemore Brown been allowed to address the misrepresentation of the charges in the only way possible - by discussing what they are.

These procedures have been likened to a 21st Century Salem Witch Trial and threaten to shut down all debate. I don't have to agree with her in order to be repelled by what is happening. This is not how debates about policy or science should work.

The BPS have reportedly spent a half a million pounds of members money and public funds on Blakemore Brown. Given our reading of the transcripts it is hard to work out how they perceive this to be in the interests of the public, their members, or scientific discussion.

Other complaints about the BPS are surfacing. The BPS have a strangely selective approach to integrity. While psychology and psychiatry are convulsed with problems of a very serious nature (see AHRP Blog, Furious Seasons, Clinical Psychology blog) the BPS has nothing at all to say about them - from the hiding of documents about the antipsychotic drug Zyprexa [Link Link] to the ongoing concerns about manipulation of information about suicide risk with SSRI antidepressants [Link]. However when Blakemore Brown asserts that that a certain pharmaceutical company is influencing a patient support group the BPS take this as diagnostic of "paranoia". Some education seems in order.

In the meantime an interesting letter appeared in the February 2007 issue of the Psychologist. I reproduce the writer's E-mailed version of it:
The BPS - value for money in the public service?
The Psychologist, February 2007


The BPS regularly refers to its duty to the public when defending itself against i) accusations of failure to support its members, ii) ostentatious advertising of members under a cloud and iii) being over-expensive.

I no longer subscribe to such a defence. Three times, spread over some years, I have sought either support or guidance on ethical matters. On none of these occasions was I offered any.

In the last instance, when I told officials that I was being repeatedly and overtly pressurised to falsify research findings for a public project, I was told that 'we don't give legal advice' and that I should consult the Code of Ethics. Apart from the fact that there is little in the Code of Ethics about corruption, other than an urging of the practitioner to behave professionally, I don't see why some guidance was not forthcoming. I was in touch with members of the BPS with responsibility for regulations and ethics; if all that is necessary is already on the web site, then I think there is a certain amount of redundancy in the organisation.

In short, I don't think members' subscriptions are benefiting the public and I think reorganisation, rethinking and refunds are in order.

Yours Sincerely

Cole Davis
Chartered Occupational Psychologist, London NW2

Now this is an organisation which spends vast amounts of money pursing bizarre charges of paranoia against Blakemore Brown yet fails to engage with serious problems that are widely discussed or presented to them.

The BPS is not the only professional body that has a problem with integrity. The General Medical Council is an interesting organisation which takes selective action against some (often Asian) doctors for doing silly things, while very serious "indiscretions" of senior members of the old-boys club are quietly ignored by powerful colleagues through a process of deceit, delay and secrecy (see my own complaint here, and further discussion here and here)

The actions of the British Psychological Society are especially reprehensible given the many mothers Blakemore Brown has helped, and that they were fully aware of the tragedies in her personal life. I end with three quotations as tribute to the courage of Lisa Blakemore Brown.

"If they can get you asking the wrong questions, they don't have to worry about the answers."
(Pynchon T, 1995 Gravity's Rainbow. ISBN 140188592)

""It's hard to get someone to believe something when their job is dependent on not believing it"
(Al Gore, An inconvenient Truth)

"The greatest evil is not now done in those sordid 'dens of crime' that Dickens loved to paint. It is not even done in concentration camps and labour camps. In those we see its final result. But it is conceived and ordered (moved, seconded, carried, and minuted) in clean, carpeted, warmed, and well-lighted offices, by quiet men with white collars and cut fingernails and smooth-shaven cheeks who do not need to raise their voices. Hence, naturally enough, my symbol for Hell is something like the bureaucracy of a police state or the offices of a thoroughly nasty business concern."
(Preface to The Screw Tape Letters, C. S. Lewis)

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