Why “Middle-Grounders” May Be As Dangerous As APA Presidents

I just can’t take seriously anyone who presumes that the middle ground is always the voice of reason and the path to truth and justice. Thus, for quite some time, I’ve thought that it not worth my time to react to psychotherapist Gary Greenberg, psychiatrist Allen Frances, and others who try to convince me of their intellectual superiority by virtue of their being above the fray—specifically, above the battle between the American Psychiatric Association (APA) and its allies vs. those of us who conclude that psychiatry (with its consistent record of false proclamations and lies) is an illegitimate and dangerous authority not to be compromised with.

Obviously, the middle ground can be the correct location for arbitrating some disputes between human beings, but it should be equally obvious that the middle ground is not always the place where truth and justice reside. In the 1850s, was the middle ground between pro-slavery and abolitionist opponents the sacred ground?

With regard to the APA and establishment psychiatry, I doubt that future historians will conclude that truth and justice reside on the middle ground between psychiatrist Jeffrey Lieberman, former president of the APA, and journalist Robert Whitaker, who Lieberman has diagnosed as a “menace to society.”

In my 2015 CounterPunch piece, Who’s the Real “Menace to Society”? Journalist or Leading Psychiatrist? I noted that Whitaker exposed how Lieberman (along with other prominent psychiatrists), in the 1980s and 1990s, had conducted studies in which patients diagnosed with schizophrenia were given a psychostimulant drug with the experiment expectation that this drug would be “psychotogenic” (induce symptoms of psychosis), and this deterioration in fact did occur. I pointed out that the Nuremberg Code of research ethics, established after the horrific human experiments by doctors in Nazi Germany, states that medical experiments on human subjects “should be so conducted as to avoid all unnecessary physical and mental suffering and injury.”

Yet, the APA made Lieberman their president in 2013, which should tell any journalist what’s most important to understand about the APA.

In the past, I have simply ignored the above-the-fray/middle grounders, but I now see my ignoring them as a mistake. I now see that they, in their own way, can be as or even more dangerous as are APA presidents. I have to thank Gary Greenberg’s recent book review in the Atlantic for my reconsideration. Greenberg’s above-the-fray/middle-ground criteria of truth and justice has awakened me from my slumber. It’s difficult to remain napping when a guy pulls down his pants and takes a giant dump on, by association, my friends and myself.

In Greenberg’s review of historian Anne Harrington’s book Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness, he tells us that Harrington, a fellow above-the-fray/middle-ground author, is committed to restraint. Greenberg tells us, “By presenting a just-the-facts narrative of the attempt to find biological sources of mental suffering, particularly in the brain, she hopes to get the ‘fraught’ enterprise of psychiatry back on the path to progress.” Greenberg quotes Harrington: “Heroic origin stories and polemical counterstories may give us momentary emotional satisfaction” but, for her, this “tunnel vision, mutual recrimination, and stalemate” is not useful. Greenberg then spells out his wholehearted agreement:

“Harrington is right to sigh over what has too often proved to be a yelling match between equally deaf opponents—members of an ambitious profession convinced that psychiatry is making strides toward understanding mental illness, and critics who believe it is at best a misguided attempt to help suffering people and at worst a pseudoscience enabling social control at the expense of human dignity. Indeed, since the sides first squared off, more than half a century ago, they seem to have learned little from each other.”

First, I can only hope that Greenberg is not mocking the idea that psychiatry is a “pseudoscience enabling social control at the expense of human dignity,” a view shared by Erich Fromm, Thomas Szasz, Michel Foucault. R.D. Laing, and Erving Goffman—not exactly a bunch of hysterics. Second, this “match” is not simply an intellectual dispute but a human rights fight; and when the APA listed homosexuality as a mental illness, “yelling” at the APA was actually one effective tactic used by gay activists to abolish this DSM insult to their sexual orientation.

I learned about elitist notions of “reasonableness” and intellectual superiority from school critic Jonathan Kozol, who exposed the negative consequences of elitist schooling. Kozol had attended a prestigious prep school and Harvard, where he gained a healthy contempt for the socialization at these institutions, which he describes in The Night is Dark and I am Far From Home (1975):

“They learn to round off honest judgments, based upon conviction, to consensus-viewpoints, based solely on convenience, and to call the final product ‘reason.’ Above all, they learn how to tone down, cushion and absorb each serious form of realistic confrontation. . . ‘Isn’t that a bit too strong. . . Aren’t we overstating?’ Always the notion that in every case ‘a greater truth’ resides some place in the middle.”

Obviously, the middle ground is not always where truth and justice reside. U.S. history does not tell us that the truth and justice resided between Henry Kissinger and Seymour Hersh or between Joseph McCarthy and Edward R. Murrow, and I doubt that future historians will conclude that truth and justice resided between Jeffrey Lieberman and Robert Whitaker.

Greenberg’s put downs of the sort of psychiatry criticism that appear in Mad in America are odd because, in addition to having a book trashing the DSM, in the past he has espoused many of the same positions as do MIA authors.

Greenberg gives us a clue as to why he might have become the kind of above-the-fray/middle grounder who the mainstream media likes to publish when he revealed in an interview with the Sun, “My involvement with the Unabomber was in part an attempt to make a name for myself by writing about someone famous.” At least Greenberg is honest about his commitment to self-promotion, which apparently also includes dumping on everyone who is not named Gary Greenberg.

While there is something strangely interesting about Greenberg’s self-promotion strategy, middle-grounder psychiatrist Allen Frances’s approach is quite boring, as he simply stays in step with what’s most fashionable.

Frances is the former chair of the DSM-4 task force, but with the political winds blowing against the DSM-5, the politically astute Frances, in 2012, was criticizing DSM-5 before its publication. I confess to finding the sight of Frances condemning the DSM-5 quite humorous. It is as if the guy who wrote Leviticus realized that his “abominating” and “sinning” had gotten out of hand.

Frances, predictably, takes the middle-ground when it comes to diagnosis and medication. His position is that the problem is simply one of over-diagnosis and over-medication, which he sees caused by Big Pharma, not the APA. For Frances, many MIA writers are taking extreme positions and thus irrational ones. These “extreme” positions include the ideas that the entire psychiatric diagnostic process is a bad idea; and that given psychiatry’s history of ignorance, denial, and lies about theories of mental illness, drug ineffectiveness, and drug adverse effects, psychiatry as an institution has long ago lost credibility as an authority.

In the past, I have restrained myself with regard to above-the-fray/middle grounders. In 2013, I even gave Greenberg and Frances and their DSM-trashing books some ink in Salon¸ listing them along with Paula Caplan’s and Herb Kutchins and Stuart Kirk’s DSM-trashing books. I was, I’m sorry to say, too polite. I neglected to note that Caplan’s and Kutchins and Kirk’s 1990s DSM-trashing books took some career courage, while Greenberg’s and Frances’s books did not. By the time Greenberg’s and Frances’s books were published, the APA’s over-reaching imperialism in creating DSM-5 illnesses had become an embarrassment even for many mainstream shrinks.

Okay, so Greenberg took a dump on my team, and I took a dump on Greenberg and his fellow above-the-fray/middle-grounders. Turning to more important matters, let’s consider the damage created by above-the-fray/middle grounders, starting with one of the most famous ones, the New York Times.

Malcolm X biographer Manning Marable pointed out, “Malcolm X today has iconic status, in the pantheon of multicultural American heroes. But at the time of his death he was widely reviled and dismissed as an irresponsible demagogue.” Marable quotes the New York Times one day after Malcolm X’s assassination in 1965: “An extraordinary and twisted man, turning many true gifts to evil purpose. . . . Malcolm X had the ingredients for leadership, but his ruthless and fanatical belief in violence . . . set him apart from the responsible leaders of the civil rights movement and the overwhelming majority of Negroes.”

I suppose for the NYT in 1965, the “reasonable” middle ground was somewhere between Martin Luther King and the KKK, and that it was “reasonable” to term Malcolm X’s belief in the validity of African American anger and in self-defense as “violence.” That kind of NYT “reasonableness” can so frustrate nonviolent oppressed people that they consider violence.

Speaking of NYT obituaries, Robert Whitaker may have the misfortune to read a sentence that will one day show up in his NYT obit. Specifically, in her story in the New Yorker, above-the-fray/middle-grounder Rachel Aviv inserts the following parenthetic description of his Anatomy of an Epidemic: “The book has been praised for presenting a hypothesis of potential importance, and criticized for overstating evidence and adopting a crusading tone.” In Aviv’s story on “The Challenge of Going off Psychiatric Drugs,” featuring Laura Delano, the only reason for this otherwise gratuitous crack appears to be an attempt at appeasing the psychiatry establishment—since Aviv could not ignore the positive value that this book and Whitaker had on Laura.

Many of us in the MIA world who are Laura’s friends are very happy to see her receive mainstream media recognition and are pleased to see another mention of the problem of psychiatric drug withdrawal. However, the reality is that, similar to the DSM, psychiatric drug withdrawal is no longer a taboo topic—in no small part because of the hard-fought struggles of many in the MIA orbit who pushed this story out there in spite of psychiatry’s denials.

What’s most troubling is that Aviv omitted the entirety of Laura’s story, which includes not simply Laura being harmed by psychiatric drugs and the denial of the hell of drug withdrawal. Aviv omitted the vital truth that Laura was harmed by psychiatry’s pathologizing and dehumanizing, and how this resulted in Laura becoming an activist helping others so oppressed to liberate themselves from psychiatry. This major part of Laura’s story is made clear in Laura’s talks and writings, including in her pieces on this MIA site (as you might expect, this “extremist” MIA web site, despite its importance to Laura’s story, goes unmentioned in Aviv’s lengthy article).

When above-the-fray/middle-roaders jump on bandwagons and criticize only those aspects of psychiatry that have become fashionable to criticize but don’t challenge the legitimacy of psychiatry as an authority, they hurt more than they help.  They provide the false impression that psychiatry is self-correcting and progressing.

In general, above-the-fray/middle-grounders refuse to ask this important question: How much does an institution have to get wrong for that institution to lose its authority? Because above-the-fray/middle-grounders avoid that question, because they never challenge the very legitimacy of an institution to exist as an authority, these above-the-fray/middle-grounders are never a threat to institutions, even those that have long proven to be far more harmful than helpful. For their generosity to mainstream institutions, above-the-fray/middle-grounders are provided with mainstream rewards, while the rest of us are stuck with the fallout.