Last week the the British Psychological Society released a very important work that I highly recommend, Understanding psychosis and schizophrenia: why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help. The Mental Elf website posted a three-part review; here are my comments (
and schizophrenia: why people sometimes hear voices, believe things
that others find strange, or appear out of touch with reality, and what
can help’. - See more at:
http://www.thementalelf.net/treatment-and-prevention/medicines/antipsychotics/understanding-psychosis-and-schizophrenia-a-critique-by-laws-langford-and-huda/#comment-448951
British Psychological Society Division of Clinical Psychology entitled ‘Understanding
psychosis and schizophrenia: why people sometimes hear voices, believe
things that others find strange, or appear out of touch with reality,
and what can help’. - See more at:
http://www.thementalelf.net/treatment-and-prevention/medicines/antipsychotics/understanding-psychosis-and-schizophrenia-a-critique-by-laws-langford-and-huda/#comment-448951
I can think of no worse
disrespect to the authors of Understanding Psychosis than the haste and
superficiality of thought driving this largely shallow critique. If this
website wanted to have a dialogue that improved the quality of care provided to
users of mental health services, this was certainly no way to get there.
Understanding Psychosis is a fine
compilation of resources and valuable analysis for building and supporting the
health, agency and options for service users/patients, their families, and the
professionals who provide mental health services. At its center is the primacy
of patient/service user agency, respect, and health.
Unlike your critique,
Understanding Psychosis provides readers with tools that serve more than symptom
alleviation, an important, but rather low, standard. We are more than
symptoms—and the solutions on offer frequently cause horrific, life-threatening
problems (mentioned only in passing here). Often referred to with that
minimizing term—“side effects”—these all-too-common results of pharmaceutical
intervention (tongue thrusting and jaw-gurning, mounting anxiety and akathesia,
the deadened sex drive, massive weight gain, somnolence, and iatrogenic
sickness) too often occupy the center of a life.
Your commentators’ remarks are disappointing
in a number of ways—for both potential users of Understanding Psychosis, and
because they fall far short of your vaunted scientific objectivity and high
evidentiary standards. (We would all have been put right from the beginning if they’d
simply written: “We don’t have any idea about most of the material in this
compilation, so don’t expect more than a glancing mention of anything except the
things that offend us.”)
The question that immediately
springs to mind is: Who and what was served by posting this incomplete,
opinion-riddled, and error-challenged critique? As Bell notes, Langford, for
example, ‘mischaracterises’ a study (oops--wrong population!) that is the
foundation of his criticism. He then spends a chunk of time on his opinion
about the drug-centered approach—which must be wrong, you see, because it doesn’t
match his experience. (And then, to defend himself on both counts, uses a
version of “Well, it *was* er, incomplete--but I had to have something so I
could pile on with the other boys!”) This, Mental Elf, represents your high
evidentiary standards?
Law’s criticisms of the CBT
research seem to be the only one of significance; I imagine they will be useful
to the authors. Note, of course, that the CBT section is a very small part of
this work.
Point-scoring (and I am, of
course, echoing some of @BipolarBlogger’s post on this topic) was the purpose
of this critique, and only that. There was little (if any) interest in being of
help to service users, other mental health professionals, and certainly not the
Understanding Psychosis authors.
If that desire had been
paramount, this site, for example, would also have engaged the participation of
a reviewer in an allied health field to comment on the document, and certainly
one or more service users. At the very least, you would have fact-checked the
post.
(It has been both alarming and
instructive to see the big, jostling crowd that has come to join in on this assault;
it has become a veritable circle-jerk, complete with gleeful howls and crowing.
When the Mental Elf, based on comments in his Twitter timeline, attempted to
procure Eleanor Langdon’s contact information to draw her into this mess, I
could not help but wonder why he would expect her to come and lie down in this
bed he’d made. That would be crazy.)
Full disclosure:
I follow and have exchanged social media messages and information with the
editor and several of the Understanding Psychosis contributors. I particularly
hold Jacqui Dillon, Anne Cooke, and Rufus May in high regard. I have also had one
expletive-filled response from Laws to a question I asked him via Twitter.
