Cracked: Why Psychiatry is Doing More Harm Than Good

by James Davies

Controversial and powerful – a shocking indictment of the pseudo-science at the heart of modern psychiatry.

One in four people in the UK and US will develop a mental disorder in any given year. That’s what psychiatry tells us. But many – even most – will not actually be mentally ill. Thanks to pseudo-science and corporate greed, psychiatry is letting us down.

Why is psychiatry such big business? Why are so many psychiatric drugs prescribed – 47 million antidepressant prescriptions in the UK alone each year – and why, without solid scientific justification, has the number of mental disorders risen from 106 in 1952 to 374 today?

The everyday sufferings and setbacks of life are now ‘medicalised’ into illnesses that require treatment – usually with highly profitable drugs. Psychological therapist James Davies uses his insider knowledge to illustrate for a general readership how psychiatry has put riches and medical status above patients’ well-being.

The charge sheet is damning: negative drug trials routinely buried; antidepressants that work no better than placebos; research regularly manipulated to produce positive results; doctors, seduced by huge pharmaceutical rewards, creating more disorders and prescribing more pills; and ethical, scientific and treatment flaws unscrupulously concealed by mass-marketing.

Cracked reveals for the first time the true human cost of an industry that, in the name of helping others, has actually been helping itself.

Genres: Psychology, Nonfiction, Mental Health, Science, Psychiatry, Medicine, Health

336 pages, Paperback

First published January 1, 2013

About the author

Librarian Note: There is more than one author with this name in the Goodreads database.

Reviews

[Charlene · Rating 2 out of 5]

I usually love books about how messed up the DSM, Big Pharma, and the social sciences are, but this book was terrible and here is why:

This author chose a great subject, faults in the mental health industry, and set out to find as many examples to support his argument as possible. The problem was not that he lacked compelling information. On the contrary, he included some very solid and very damning evidence that highlighted serious corruption -- payoffs from pharma to doctors so they would needlessly prescribe drugs; DSM shenanigans that have been written about well and often; a rich history of "treatments" that did more harm than good (and how do we know we are not doing that same harmful behavior now); how "experts" have a large say in creating policy, informing treatment and medical practice, and informing law and morality; how capitalism and not science drives psychiatry, the file drawer effect where only positive results are published, and the lack of transparency in psychiatry and Big Pharma. All of these inclusions were valid and worth sharing with the public. Bravo for that.

However, the lack of balance on any issue bordered on absurd. He was nothing short of a zealot who cherrypicked every anecdotal piece of information he could get his hands on, threw it in a book along side of aforementioned arguments, and went on to spout his constant mantra about how pain is natural.

If I were to write this review the way he wrote this book, I would not have included one thing he did right. I would only point out everything he did wrong and then i would go through other people's reviews and include what they didn't like about his book, and then I would just throw a bunch of opinions in for good measure. This author didn't discuss any of the advances, real advances, that helped people who were genuinely suffering. (He *really* loves suffering and highly recommends it in every instance). For example, where was the discussion on schizophrenia and CBT? What about the advances in anti-psychotic drugs to treat schizophrenia, along with a better understanding of how dopamine is related to catatonic states? What about the advances made in PTSD once researchers found out that social support was a key determining factor in developing the disorder? These are a mere spattering of some subjects he could have chosen to include. There are many advances to pick from but this author was not interested in providing his reader with the latest advances *and* the problems that plague psychiatry. This guy ended up sounding much more like a scientologist or conspiracy theorist that a researcher or journalist, which was extremely off-putting.

Making matters worse, his discussion of epigenetics was abysmal. He clearly had a limited understanding of how genes work and how epigenetic modifications of genes work, which is a shame because there is an interesting discussion to be had about how epigenetics (methylation of chromatin and RNA snippets) contribute to expression of various genes. Not all genes are the same. Some are more fixed and some are more vulnerable to epigenetic/external modification. Also, it isn't yet well understood how epigenetics affects many mental health issues. Researchers are just beginning to parse all of that. His discussion was far too simplified. The same is true for his entire discussion of the biological basis for behavior. I tried to look up his education but didn't readily find anything. If he was educated in the sciences, it must have been a long time ago. I was stunned by how bad his biological basis of behavior section was.

I surely cannot recommend this book. To read books that take down psychiatry, I would instead read something more like the following:

- Sybil Exposed by Debbie Nathan (excellent takedown of fads in psychiatry/ how therapy can make things worse)
- The Book of Woe, Gary Greenberg (in depth review of problems with the DSM)
- The Memory Illusion by Julia Shaw (there are a few problems with a couple of the studies Shaw included, but it was far better researched than Cracked)

[Portal in the Pages · Rating 1 out of 5]

Poison

[George · Rating 1 out of 5]

I am astonished and somewhat disheartened that the reviews section for this piece shows little critical thought of the content.
I will accept his grim indictment of the current state of the pharmaceutical industry (indeed, many reviewers are mentioning Ben Goldacre who has pointed this all out before)
I think most of this stems from an outdated Cartesian Dualist approach mislabelled as 'critical' Psychiatry rather than the medical model.
I wonder how extensive Mr. Davies' literature search was; if he needs evidence of the biological root of schizophrenia look at the life work of Professor Eve Johnstone.
Add to this the neglect to mention a variety of drugs used to psychiatric treatment (TCAs, anxiolytics, MAOIs, BZDs etc.), the implication that ALL conditions described in the DSM & ICD are treated with drugs, that students aren't aware of these issues and blindly accept what is told, comparing the healthier pharmacologically naive individuals with the obviously more unwell who need drugs, the hypocrisy of pointing out flaws in the research of others whilst making them oneself (cherrypicking), ignoring nocebo effects outright, the childish rhetoric in describing his opponents, and what is before you but a biased diatribe.
Who does he think he is helping? Just by telling a person suffering from psychosis that they do not have a problem does not make them better.

On a final note: http://summaries.cochrane.org/CD00795...
http://www.cochrane.org/podcasts/issu...

If it's good enough for a Cochrane review, its good enough for me.


Conflicting Interests: Student Associate of RCPsych

[Pernille · Rating 3 out of 5]

First of all, let me say that I completely agree that overmedicalisation is a big problem. Okay, now for the real review.

I find it worrying that a practising psychological therapist in the NHS knew so little about mental illness, diagnosis and treatment (!) as he claimed at the outset of writing this book. I learnt all about the problems with the diagnostic system (most prominently, the DSM) and how antidepressant medications work (or don't) during my undergraduate degree in psychology, and so what bothers me the most is that the picture he paints is one of a completely clueless psychological and psychiatric profession - which is plainly not true. And yes, it is correct that there are very few (if any) biomarkers for mental illness, but that does not mean they are not real illnesses. I would like to remind (or inform) James Davies that Alzheimer's disease does not yet have a biomarker, nor do any of the other dementias at present. Does he not think they are real illnesses either? This is why we keep doing research. Furthermore, his keenness throughout the book to keep referring to mental illness as 'perfectly normal human reactions' made me quite sad, because who is he to trivialise the suffering of people who are quite literally crippled by depression, social anxiety, schizophrenia? While I completely agree that the grief of losing a loved one and similar reactions should not be thought of as illness, and while I agree that medication should never be the first option (especially in children), I find his argument hopelessly one-sided. The points he is raising are extremely important and equally, we should be critical with regards to how psychiatry, psychology and medicine works. But reporting only one side of the story is not helping anyone, it just creates a basic mistrust in the psychological and psychiatric profession which is unwarranted. He is painting a picture of psychiatrists as pure, money-minded evil and completely fails to see the complex picture of treatment that psychiatry can form part of. Psychiatrists go to work every day wanting to help alleviate people's suffering. They chose that profession wanting to make a difference. His claim that "the only ones who have ever benefitted from psychiatric drugs are the drug companies" is not just biased, but very ill-informed.

Phew. All of that being said, I found this book very enjoyable exactly because it was so thought-provoking. It was well-written and seemingly well-researched, but I do hope that people reading this book will also see it with a critical eye and not take it all at face value.

[Rosie · Rating 1 out of 5]

The most frustrating book I have read in a long time. I am interested in the sociology of mental illness, and believe that critical approaches to psychiatry and the medicalisation of conditions have a place in modern treatment of mental illness.

But this book is not written with patients in mind; it has not been written with people affected by mental illness and leaves lay readers feeling optionless and powerless by the end of the book. It is incredibly insensitive to the suffering endured by people with a mental illness through not only living with their condition but also accessing support for it.

For anyone interested in the sociology of psychiatry and other themes raised in this book, I recommend instead:

- The Happiness Industry by William Davies
- Bad Pharma by Ben Goldacre
- Madness and Civilization by Michel Foucault

[Peter Geyer · Rating 5 out of 5]

I've read a bit around this topic over many years and wondered at first whether I really needed to have this book to read, in that the general issues: credibility of the DSM, big pharma, the increasing use of medication for dealing with the expanding label of depression and so on, are fairly well established, not that there's been much change as a response to the evidence and perspectives presented.

I found this book to be quite different in approach, style and presentation. James Davies is an academic social anthropologist and qualified psychotherapist and his method is to interview and communicate with key players in the issues at hand, probably what you would do as an anthropologist, and present the issues and ideas in a clear and simple manner. In fact, the book is clearly aimed at what might be called the "lay reader" – in the past at any rate. In this, Davies is extremely successful. The excerpts from interviews are in plain speech, as is his prose. He takes you around with him on his journeys , mostly in the US and UK and this method enables an insight into what was going on. A comment on the back of the book says this is "a potent polemic" but there are no ad hominem statements or personal attacks, even when he writes about academic psychiatrists who might appear to the person in the street (or in this room) to be on the take.

The book begins with a discussion of the DSM and its plausibility. Davies speaks with Robert Spitzer (a key figure in earlier versions) and others about the meaning and purpose of this diagnostic text and establishes that the categories within were not arrived at by research, but what seems to be a consensus of practitioners. Later he talks with a prominent critic of the current DSM (5) with Allen Frances, who expresses his view that many normal behaviours are now being pathologised. I've read Frances' book Saving Normal, on this topic, and it appears in both instances that, for all the valid points he makes, Frances is unable to put himself outside the thought of his profession.

Perhaps this is because of an inability to theorise or philosophise, intuit perhaps. Towards the end of the book Davies examines the education of psychotherapists and finds that alternative perspectives to the biological model followed by psychiatrists (the medical model, essentially) aren't broached or discussed, and trainee psychotherapists may not necessarily want to know about them. A somewhat robust interview with the president of the Royal Society of Psychiatrists demonstrates this lack of interest in theoretical issues, even for obviously intelligent people. The main idea is to do and help; whether the tools are appropriate seems not an issue similar, on my reading to those involved with the DSM.

The RSP president argues that the current methods enable them to get mental health funding. The DSM people that they expect users, somewhat Biblically, to make their own interpretations rather than taking the DSM literally. The latter seems a general issue in anything to do with personality and social policy – people using questionnaires and methods literally; not finding out who the person/s are before making decisions about them. You can add your own here.

A core component of the biological model these days is the notion of "chemical imbalance" which presumes a kind of fluid equilibrium, somewhat like a spirit level. Davies uses the term "theory" to describe this view and demonstrates there's no evidence for this presumption, which appears to be a dogma (My doctor believes it).

This is important on a number of levels, because the claim of medication (my doctor's term) or drugs (mine, which I use for diabetes pills) is crucial to the claims of the various anti-depressants. Davies points out that published research shows that effectiveness of these products isn't all that much different from a placebo, which invites an interesting discussion on how people might be "cured" and that these drugs can have dangerous side-effects. He also points to the selective publication of research in that unfavourable studies are excluded. None of this is new, really, but it's very well presented.

A particularly interesting chapter is about a young psychiatrist who is targeted by a drug company to be trained and spruik their wares and also an exposition of the relevant sales strategies and methods. One might say that these are legitimate methods designed to sell a product (although I have my doubts) without dealing with whether they actually work.

I also liked the chapter "Psychiatric Imperialism" which deals with the ways Western methods are imposed, or insinuated< into other cultures. Davies shows how symptoms like anorexia and self-harm can manifest in cultures where the practices were previously unknown; depression, which seems to mean almost anything these days, is a prime example. He tells us that drug companies hire anthropologists these days to gain information on a particular culture so they can market their products.

On a personal level, I have to say that I encountered this particular issue in the early 1970s, where I was given the relevant medication for "anxiety" which made it almost impossible for me to function. The doctor who prescribed these, who I respected and still do, also said quite directly, in Scottish English "you don't like your job, do ya?" thus bringing that issue into full consciousness. When I left that employment to be a full-time student, I knew that I wouldn't need the medication anymore, and so it was. One of the points Davies makes is that the social aspects causing distress, hyperactivity etc are discounted by the medical model, even the neurological model and how research into genes is presented.

It's probably a quiet but persistent book, very comprehensive, and probably a go-to if you want to be informed because of the way it's written. There are notes with references, which adds to credibility.

[Cav · Rating 5 out of 5]

"Today, psychiatry’s power and influence is far from abating – it’s growing at a remarkable rate. And in this book I will show you why this is, paradoxically, a very bad thing for our mental health. To substantiate this claim, my method will be simple. I will investigate three medical mysteries: why has psychiatry become the fastest-growing medical specialism when it still has the poorest curative success? Why are psychiatric drugs now more widely prescribed than almost any other medical drugs in history, despite their dubious efficacy? And why does psychiatry, without solid scientific justification, keep expanding the number of mental disorders it believes to exist – from 106 in 1952 to 374 today?
What is going on?"

Cracked: The Unhappy Truth about Psychiatry was an excellent look into the shaky science behind psychiatry. The author lays out the thesis of the book with the above quote.

Author James Davies obtained his PhD in medical and social anthropology from the University of Oxford. He is also a qualified psychotherapist (having worked in the NHS), and a senior lecturer in social anthropology and psychology at the University of Roehampton, London. He has delivered lectures at many universities, including Harvard, Brown, CUNY, Oxford and London, and has written articles about psychiatry for the New Scientist, Therapy Today and the Harvard Divinity Bulletin.

James Davies:


Davies' writing here is excellent. He writes with an easy and engaging style that easily holds the reader's attention. And despite fielding some technical subject matter, Davies presents this content in a manner that will be accessible to even the scientifically illiterate layperson. Points to the author here for this effective communication.

Psychiatry does not operate in a manner similar to any other field of medicine. Namely, diagnoses are granted based solely on symptomatic presentation, and not on objective biological testing. Davies writes:

"...In other words, unlike in other areas of medicine where a doctor can conduct a blood or urine test to determine whether they have reached the correct diagnosis, in Psychiatry’s early breakdown and the rise of the DSM psychiatry no such methods exist. And they don’t exist, as Pardes also intimated, because psychiatry has yet to identify any clear biological causes for most of the disorders in the DSM (this is a pivotal point that I’ll talk about more fully in coming chapters). So the only method available to psychiatrists is what we could call the ‘matching method’: match the symptoms the patient reports to the relevant diagnosis in the book.
These facts, although at first glance appearing innocuous, are crucial for understanding why psychiatry, in the 1970s, fell into serious crisis. They help us explain why psychiatrists were not only guilty of branding sane people as insane (as the Rosenhan experiment revealed), but also guilty of regularly failing to agree on what diagnosis to assign a given patient (as the ‘diagnostic reliability’ experiments showed). Psychiatry was making these errors because it possessed no objective way of testing whether a person was mentally disordered, and if so, precisely what disorder they were suffering from. Without such objective tests, the diagnosis that a psychiatrist would assign could be influenced by their subjective preferences, and as different psychiatrists were swayed by different subjective factors, it was understandable that they regularly disagreed about what diagnosis to give. This is why these early experiments were so dramatic for the profession: they produced for the first time clear evidence that psychiatric diagnosis was at best imprecise, and at worst a kind of professional guesswork. And so without any objective way of testing the validity of a diagnosis, psychiatry was in peril of falling far behind the diagnostic achievements of other branches of medicine..."

This means there is a reliability problem in the field, which casts serious doubts on the entire DSM-structured paradigm. Indeed, the problems within the field of psychiatry often see the same patients receiving differing and possibly conflicting diagnoses at an alarmingly high rate:

"According to a study published in the journal Psychiatry in 2007, for instance, which asked a group of psychiatrists whether they thought psychiatric diagnosis was now reliable, a full 86 per cent said that reliability was still poor.9 It was not only their clinical experience that led them to this conclusion, but also presumably their familiarity with existing research, including work undertaken by Spitzer himself to find out whether his reforms had worked. Its conclusions were not reassuring. For example, you’ll remember that I said before Spitzer’s DSM-III two psychiatrists would give different diagnoses to the same patient 32 per cent to 42 per cent of the time. Well, Spitzer found that after his reforms psychiatrists were now disagreeing around 33 to 46 per cent of the time – results indicating the very opposite of diagnostic improvement.* And these disappointing figures are consistent with other more recent studies also implying that reliability is still poor. For example, another study published in 2006 showed that reliability actually has not improved in 30 years..."

SSRIs are also covered in the book. Davies heavily critiques these controversial class of medications. Aside from being blunt instruments with alarming rates of horrible side effects, Davies writes that they are often not much more effective at reducing symptoms of depression than placebo, and less effective than psychotherapies, like Cognitive behavioral therapy (CBT):

"What we expected to find’, said Kirsch lowering his teacup, ‘was that people who took the antidepressant would do far better than those taking the placebo, the sugar pill. We couldn’t have been more wrong.’ And if you look at the graph below you’ll see exactly what Kirsch means.3

The first thing you’ll notice is that all the groups actually get better on the scale of improvement, even those who had received no treatment at all. This is because many incidences of depression spontaneously reduce by themselves after time without being actively treated. You’ll also see that both psychotherapy and drug groups get significantly better. But, oddly, so does the placebo group. More bizarre still, the difference in improvement between placebo and antidepressant groups is only about 0.4 points, which was a strikingly small amount. ‘This result genuinely surprised us’, said Kirsch leaning forward intently, ‘because the difference between placebos and antidepressants was far smaller than anything we had read about or anticipated..."

Cracked also tackles the "chemical imbalance theory" central to much of modern psychiatry:

"In recent years such disproving research has begun to erode the profession’s faith in the chemical imbalance theory. This has led increasing numbers of prominent figures in the mental health profession to declare their defection publicly. To pique your interest in this sea -change, here are a few quotations I’ve managed to gather:
‘Many neuroscientists no longer consider a chemical imbalance theory of depression and anxiety to be valid.’ (Dr David D. Burns, Professor of Psychiatry, Stanford University)
‘Chemical imbalance is sort of last-century thinking. It’s much more complicated than that.’ (Dr Joseph Coyle, Professor of Neuroscience at Harvard Medical School)
‘After decades of trying to prove [the chemical imbalance theory], researchers have still come up empty-handed.’
(Marcia Angell, former editor of the New England Journal of Medicine)
‘Despite pseudoscientific terms like “chemical imbalance”, nobody really knows what causes mental illness. There’s no blood test or brain scan for major depression.’ (Dr Darshak Sanghavi, clinical fellow at Harvard Medical School)
‘We do not know the aetiology of really any of the mental disorders at the present time.’ Dr Carl Regier, previous Director of Research at the American Psychiatric Association)
‘Research has yet to identify specific biological causes of any of these [mental] disorders.’ (US Congressional Report entitled: ‘The biology of mental disorders, new developments in neuroscience’)
‘The results of decades of neurotransmitter-depletion studies point to one inescapable conclusion, low levels of serotonin, norepinephrine or dopamine do not cause depression.’
(Professor Irving Kirsch, Harvard Medical School)
‘We still don’t know the relationship between biology and the mental disorders.’ (Carol Bernstein, previous president of the American Psychiatric Association)
‘Patients have been diagnosed with chemical imbalances, despite that no test exists to support such a claim, and that there is no real conception of what a correct chemical balance would look like.’ (Dr David Kaiser, Psychiatric Times)
‘As a scientific venture, the theory that low serotonin causes depression appears to be on the verge of collapse. This is as it should be; the nature of science is ultimately to be selfcorrecting.
Ideas must yield before evidence.’ (Dr Jonathan Rottenberg, Psychology Today)
‘A simplistic biological reductionism has increasingly ruled the psychiatric roost … [we have] learned to attribute mental illness to faulty brain biochemistry, defects of dopamine, or a shortage of serotonin. It is biobabble as deeply misleading and unscientific as the psychobabble it replaced.’ (Andrew Skull, Professor of History of Psychiatry, Princeton University, in The Lancet)

There is no point piling up more quotations. By now you get the picture: the public defections continue to mount because, after nearly 50 years of investigation into the chemical imbalance theory, there is not one piece of convincing evidence that the theory is actually correct..."

Davies also writes about the conflicts of interest that have become endemic to the field recently. Namely, a large number of medical professionals, universities, and medical associations collect bountiful fees from large pharmaceutical companies; in the form of pro-drug speaking fees, donations, consultancy work, and other assorted compensations and incentives for prescribing and advocating for these controversial medications.

The evidence presented here by Davies is fairly danming. The numerous side effects of many of these medications, coupled with their questionable efficacy will leave many readers wondering what to do if they experience some of the symptoms of common disorders; like anxiety and/or depression. While some of these medications have their uses and offer some people a level of comfort (placebo or otherwise); their usage should be heavily weighed on a cost/benefit analysis.
Many of the symptoms of mental conditions that are now pathologized; such as anxiety and depression - can be effectively moderated with a combination of non-pharmaceutical interventions; like Cognitive Behavioral Therapy, as well as a holistic approach that includes a healthy balanced diet, regular vigorous exercise, adequate and quality sleep time to maintain a circadian rhythm, and ensuring vitamin D levels are not deficient.

In fact, although not mentioned by the author here; regular vigorous exercise can be as (or more) effective in reducing depressive episodes as pharmaceutical intervention, without any of the accompanying side effects. Exercise regulates hormones and neurotransmitters, reduces inflammation, increases BDNF; among many other benefits and harm reductions.

The Ph.D. biochemist Rhonda Patrick (among others) has done some great research into the myriad health benefits associated with diet and exercise. Her work can be found on her FoundMyFitness page; where she takes a data-driven look into many fitness-related topics; like Autophagy, BDNF, Caloric restriction, Depression, Vitamin D, and much more. The site has links to many videos, literature, and podcats appearances.

*****************

Cracked: The Unhappy Truth about Psychiatry was a very comprehensive look into the widespread dysfunctionality that plagues the field of psychiatry. With the ever-increasing number of people being prescribed brain-altering psychoactive and controversial medications like SSRIs, it is also an extremely important and timely book.
With only 5 ratings and 1 review here; I am really surprised to see that this book has not garnered more traction. It certainly deserves it.
5 stars for this one.

[Nastja · Rating 2 out of 5]

First of all, I do agree that overdiagnosing and overmedicalisation are problems that should be taken into account. However, I really didn't like the extreme approach in this book, as well as the awfully subjective examples (like interviews, "my neighbor once said" or "this person thinks that his son was misdiagnosed" type of shit) and far-fetched conclusions. I don't think there's a point in blaming the DSM and its creators for causing a wave of overdiagnosing - it's the specialists who are not doing their job correctly or considering the context of problems) and the problem lies with the education and moral principles and the system. The whole part where the author blames the DSM is just so unnecessary - the DSM is already out there and I still think it's better than nothing - the probability of misdiagnosing would be a lot greater if not for the DSM.

As soon as the author started talking about real experiments and academic findings, the book got a lot more interesting and objective. I found some interesting points and research concerning, for example, the efficacy of antidepressants and improvement rates. There the author just basically stated some facts and findings. But mostly the book was not comprised of research and facts. I found that many of the references were quotes from research papers referencing other research papers, so he didn't even bother with using the original papers and quotes - gives a lot of chances to interpret the results the way he (or the guys he referenced) wanted to.

I was really bothered by the fact that the author tried to leave the impression that he had found The Truth, and the reader should be shocked by his findings. Phrases like "I tried to conceal my shock" or "you will be shocked by these findings" really triggered me. Just give me the facts and I'll decide for myself if I find them shocking or not. Don't try to manipulate your readers, please.

I also didn't really find any plausible evidence for the author's statement that drugs have horrible side effects - his examples were all symptoms of the diseases the drugs are meant to treat, so how does he know they're caused by the drugs, but not by the illness that is basically left untreated if, as he suggests, the drugs aren't actually effective in curing the person?

So, overall, the book left me triggered and enraged in a lot of places, because it just wasn't based on real evidence and/or was making very far-fetched conclusions or statements based on subjective experiences and beliefs. There were some points that should be considered, like, for example, the fact that a big part of (drug) research is funded by drug companies, or that the biological explanations of mental illnesses are just theories, or that drugs may not be effective, or that we should concentrate a lot more on the context of the symptoms and reach out for other methods of help as well, but... The book is just annoying and far from objective. I'd say it's even dangerous to read such a thing if you haven't studied psychology or psychiatry or don't have a very critical mind. An ordinary reader could make very unhealthy conclusions based on this book.

[Nat · Rating 4 out of 5]

Really interesting book looking at the unscientific nature of psychiatric diagnosis, stressing the significant economic links between the pharmaceutical industry and psychiatry, as well as highlighting significant meta-analyses which called into question the efficacy of anti-depressants. The book particularly challenges the biological model which seeks to explain every emotional or mental ailment in terms of chemical imbalances which require drugs to solve. Instead, Davies posits a more human approach that places community and mans social and spiritual needs at the forefront rather than seeing everything as a problem that only medication can solve.

[Emily · Rating 1 out of 5]

Not a well-written book. Lacking in evidence base but overflowing with hyperbole and sensationalism. Some interesting questions and ideas were raised, but sadly not explored to meaningful depths. To be read critically.

[Karan · Rating 4 out of 5]

Being a young medic who will very soon find himself in the chair making referrals to psychiatry and psychotherapy, I considered myself having a deep personal stake in reading what Davies had to say. And I am glad that Davies puts forth his case so convincingly. Being a medical trainee who devoured every moment of soaking every word of psychology at A-Levels where utterly disparate models of human behaviour could co-exist in a curriculum, I went on to get completely disillusioned after reading psychiatry with its all-explained-through biology model taught during medical school.

My experiences thereafter and this book (years after I decided not to pursue further training in it) helped rest my serious instinctual ambivalence during those days at the insane (no pun intended) amount of certain-sounding behaviour and mental state labels being dished out to the marginally unhinged or adamantly regressed individuals. The doling out of tangible and expected physical remedies in the form of drug prescriptions to fix the "ailment" seemed like the logical and neat next step and gave psychiatry the veneer of just-like-any-other medical specialty in our broad medical curriculum, when it was quite the opposite. The biopsychiatric model underpinning the assumptions and expectations with its baroque world of neurotransmitters, affective chemicals and receptors have, thanks to decades of strong pharmaceutical and intellectual lobbying, found their way into university and post-graduate curriculums sans any ambiguity, making it seem like an outcrop of neurology and narratives like that by James Davies here (or at a more popular level, Jon Ronson's Psychopath Test and/or Louis Theroux even-handed recent documentary work) are extremely important to help gullible young trainees have an open, critical mind if planning to practise taking care of patients classed as mentally ill.

I remember being incredulous at medical school whenever faced with reams of best-of-five spot-the-right-diagnosis answers trying to learn how to spot a schizoid personality from a vignette that is not quite schizoaffective or outright schizophrenic. It's (no pun intended) mental. Thanks Mr Davies for letting me know that these incessant, forever morphing and budding "categories" of mental "disorder" were basically dubious, consensus-driven language exercises, and not the solid, objective clinical entities they seemed to be. Being interested in human behaviour, I remember deciding that I had no talent or patience to cram the linguistic chicanery and psychobabble that was helping drive the engine of context-free diagnoses, medication and hospitalisation of people that undersold and grossly mislabeled the patient's social and interpersonal adjustment issues and/or legitimate-but-exagerrated reactions.

I had the opportunity to shadow three different psychiatrists for a few weeks each, and my uncertainties about the shaky ground that drives much of the formalism in current psychiatry became more clear. I saw some fantastically humane work at rehabilitation and care of the sectioned and institutionalised patients by two of these three consultants but their clinical practice, deeply appreciative and incorporating other models of management of mental health, was driven by an agency, character and intelligence all their own. This was in stark contrast to one consultant who was a thoroughbred conservative practitioner sold and stuck in biopsychiatric reductionism. While the former two intimidated me with the level of engagement they applied in their everyday practice with the patients and their families, partners and carers; the latter's objective-sounding management plans withd rug-dose titrations filled to brim with specialty-honed jargon on subjective moods and fancies almost asked to be spoofed. I was privately aghast at the gulf between clinicians, and my uncertainties weren't helped by the state of most patients, majority of whom were seen roaming in drug-addled stupor with not much to look forward to. Earlier this year, I came across Nathan Filer's Shock of the Fall that captured the almost-surreal free floating tedium brilliantly. And I couldn't quite recover from the tragicomedy of patients' playing-up symptoms to expectations in the ward rounds, or a few of the more serious cases finding the incentive to keep staying locked-and-cared-for in mental institutions: anyday a convenient and comfortable alternative to a trial and outright incarceration after committing heinous crimes, just by playing the role of a psychotic/depressed patient.

While reading Davies' book, I wonder if all these alternate critical narratives have enough force to stop the mainstream pharmaceutical-driven biopsychiatric juggernaut. I fear that the mountain of literature, the DSMs and the ICDs with their solidified hard-print certain categories are likely to be shunned en-masse. I fear that they will continue to produce earnest but myopic prescribing clinicians who have veered into the specialty without an appetite for its contradictions and, have tutored themselves by internalising the vocabulary of specialty's now standard bio-medical and legal large prints for examinations and tickbox patient management. I also fear for all those referring and non-interested non-specialists in primary and secondary care who have only had to revisit clinical cases in books and person perfunctorily and only have the biopsychiatric framework with the attached pharmaceutical armaterium to digest, remember and act upon. I genuinely fear how far this stone has rolled down the hill.

Regardless, I am grateful for the little re-education I have received thanks to author's mission. Inspite of knowing about his professional credentials (and the attached stakes, interest conflicts etc) I believe in his thesis and found myself completely aligned to his plea for a desperate need to rethink models of suffering for modern Western mortals before its too late. I have knocked a star off because of some indignance that veers into sensationalism, and while I understand the disgust at the deceits practiced by the pharmaceutical industry, the chief arguments and alternate models has have had a presence within the specialty before Davies came and enlightened us less-informed mortals (you wouldn't know this from the way he writes sometimes). There is no doubt that a bottoms-up shakedown to change the pill-driven management of a principal majority of patients is the need of the hour, and in the larger culture, the necessity to have a completely different kind of discourse about moods, internal monologues, grief, loss and motivations is paramount. In an increasingly atomised, consumerist, digitally overloaded Western reality stretching from school classrooms on home turf to Army Corps in middle-east, as civilsation's rejects find themselves at the threshold of the medical fraternity, I hope we are collectively able to do less harm to them in the future. Cracked is by turns accessible, incendiary, impassioned, silo-demolishing read. Highly recommended!

[Abbie · Rating 5 out of 5]

Super interesting read exposing some of the unscientific portrayals and dark financial gains of psychiatry… It’s hard for me to even summarize the book, so you might just have to read it for yourself. ;)

I will say.. One concept that stood out to me was the difference between the disease-centered model and the drug-centered model. James Davies quotes Dr. Joanna Moncrieff as she explains the difference, “In the disease-centred model, people are assumed to have a mental disease, a problem in their brain. And drugs are thought to be effective because they rectify or reverse that underlying brain problem in some way… But the drug-centred model… rather emphasises that drugs are drugs; they are chemical substances that are foreign to the human body but which affect the way people think and feel. They have psychoactive properties, just like recreational drugs do, which alter the way the body functions at a physiological level.” (103)

I found this explanation helpful as I’ve process through the idea that the that chemical imbalance theory has yet to be proved. (“After nearly 50 years of investigation into the chemical imbalance theory, there is not one piece of convincing evidence that the theory is actually correct” (129).) If this theory were true, then chemical imbalances could be cured by intaking the right amount of chemicals (via medication). Davies’ view instead is that pills “don’t cure us - they simply change us” (99). He offers, they are “just providing a temporary and superficial distraction” (100).

Still processing all of this, but the discussion has been helpful!

[Lindaanne · Rating 5 out of 5]

We are constantly barraged with TV and print ads sponsored by Big Pharma urging us to just take a pill (or many of them) to take care of anxiety, depression, stress, existential angst or what have you. The truth is that these meds can have serious long-term side effects, and patients are often not told about them because doctors have a financial interest in prescribing them. BIG CONFLICT OF INTEREST. On a personal note one of my cousins was rendered nearly comatose by massive doses of psych drugs prescribed to "treat" a minor depressive episode that did not warrant such massive doses. (This was revealed after my cousin went to another doctor who treated him conservatively). The drugs resulted in diabetes and a facial tic that linger to this day. James Davies goes into all of this and more. The book is well researched, full of meaningful statistics and well written. Even if you're skeptical about the premise of this book I think it's worth reading just to get a different perspective.

[Lloyd Downey · Rating 5 out of 5]

It has taken me a while to get around to writing this review because I felt that I needed time to do it justice. In many ways this is a scary book and I feel that I might need to read something that puts the other side of the story to really feel that I have a reasonable grasp of the issues.
Essentially, my take on this book is that the author points a dammning finger at the psychiatric profession and the drug companies that support them. James Davies is a qualified psychotherapist and has worked with the British NHS. He has a Phd in medical and social anthropology (whatever that actually is). Well I actually googled his thesis and found an interesting interview with him (see: https://www.psychologytoday.com/us/bl...) and this is what he has to say about his thesis:
"In other words, trainings are places where persons are socialised to uphold the values and beliefs of the particular tradition into which they are being initiated. What is good for the ‘patient’ is often less important than what will ensure the longevity of the therapeutic tribe upon which one’s status and livelihood will come to depend. So I tried to expose anthropologically the tacit institutional devices used in training to transform persons into celebrants and defenders of the tradition (often in ways, and unbeknown to practitioners themselves, that are at the expense of the ‘patient’)".
In this book "Cracked", Davies argues along the following lines:
1. The DSM (Diagnostic and Statistical Manual of Mental Disorders) is the book listing all the psychiatric disorders that psychiatrists believe to exist. It began as a modest 130 page version in 1952 and is now 886 pages long. It is, effectively, the bible of psychiatrists.
2. However, Davies investigated how the disorders found their way into the DSM and it seems that they are there because of a vote by a committee (and not necessarily a unanimous vote). There appears to be no (or almost no) objective biological tests that can be used to identify any particular mental illness.
3. The DSM has gone through a number of editions and each time numbers of "new" mental illnesses have been added to the book (82 new illnesses from DSM3 to DSM4). So what are all these "new" mental illnesses.
4. One has to question the validity of the DSM when (by a relatively close vote of the US Psychiatric Society) homosexuality was removed from the DSM as a psychiatric illness. And one must also question the validity of ADHD diagnostics when in Canada there was an explosion of diagnosis of kids with ADHD and it was found that it was highly correlated with the month of the year. What had happened was the kids in the one class could be over a year different in actual age and the younger kids had lower attention spans.
5. So the illnesses defined in the DSM are deeply suspect and the criteria used to define them are deeply suspect but worse, the DSM has led to a situation where the drug companies have medicalised the illnesses and produced drugs to treat these "illnesses".
6. The theory is that the psychiatric illness is caused by some sort of imbalance in brain chemistry and the drugs will correct this imbalance. However, the imbalance has never been shown to exist. Even in the case of depression the evidence is pretty clear ...as the following citation indicates:
"Patients have been diagnosed with chemical imbalances, despite the fact that no test exists to support such a claim, and that there is no real conception of what a correct chemical balance would look like ". Dr David Kaiser, Psychiatric Times). So, according to Davies, after nearly 50 years of investigation into the chemical imbalance theory, there is not one piece of convincing evidence that the theory is correct.
7. However, that has not stopped the prescription of drugs to "correct" these imbalance.
8. Davies shows that there is an unholy alliance between the drug companies and the psychiatric industry. Drug companies have cherry picked their results (only publishing the favourable results). They have ignored the placebo effect
which seems to show that there is no real benefit from most of the drugs over a placebo. They have compromised academic researchers by funding psychiatric departments, research, publications, conferences etc and withholding funds from non-conformers. They have marketed the same drug for different psychiatric illnesses...Prozac for example packaged-up for treating a pre-mestrual "Illness". (Which other societies regard as just a normal condition). And they have marketed various drugs with all the skills and techniques of modern consumer marketing without regard to either effectiveness (especially over the long term) or side effects.
9. The drug revolution saved psychiatry from the legacy of embarrassing failures: shock therapy, lobotomies, putting patients into comas etc. After all Psychiatrists in the 70's -90's were now the only professionals who had legal authority to assign psychiatric diagnoses and prescribe psychiatric drugs. So long as these remained in their hands their authority and distinctiveness was assured. Furthermore they now had a powerful new ally in the drug companies.
10. Davies seems to side with the view that some form of suffering is natural for humans and the best way to treat it is through social measures or simply managing it. He suggests a path forward for the profession which has four steps:
a0. Psychiatry needs to develop greater modesty about what it can actually hope to achieve
b) there needs to be more thorough regulation an transparency regarding psychiatry's financial ties to the pharmaceutical industry
c) The training of future psychiatrists must install greater awareness of psychiatry's scientific failings and current excesses as well as how to manage patients outside the medical model.
d). The public needs to become better informed about the current crisis in psychiatry.
I think this is a really important book. As Peter Hitchens (Mail on Sunday) put it...this "Should be read by every doctor....by everyone in politics and the media, not to mention any concerned citizen".
And as Will Self (The Guardian) put it....it is "Chilling reading".
I give it 5 stars and hope that it does get a much wider reading. Since writing the review I started searching out a bit more information on the author and found that he was one of the founders of the Council for Evidence Based Psychiatry and their web site....particularly the section on little known facts..... is really worth some attention. See: http://cepuk.org/ I also read some of the other reviews of the book and it is interesting how polarised the views are. Clearly Davies has touched a raw nerve with some people. I tend to agree that his "solution" for psychiatric problems seems to be a bit weak ....kind of "tough it out' or get some friends sort of solutions. But maybe the people who are so opposed to his views are the prescribers of the drugs that Davies says do not cure. Still see no reason to alter my rating.

[Ami · Rating 2 out of 5]

An interesting book, however let down by its vague exploration of the subject matter.

Filled with sensationalist statements and hyperbole, Davies tries to expose the darker side of psychiatry and big pharma. Although he frequently references the literature, he only very briefly mentions their findings. The structure of the book is also somewhat confusing, as it is repetitive at times. The book is littered with several spelling and grammar errors.

Cracked attempts to be a “heretical text” for the anti-psychiatry movement, but it fails to properly acknowledge the victories of modern psychiatry and provide concrete solutions to the issues it highlights. This is perfectly summed up by a quote by Professor Sue Bailey, president of the Royal College of Psychiatrists: “When you go into a profession where you want to help people, and you don’t have the tools to help them, the temptation is to medicalise them”.

A shame, as a more thorough exploration of the failings of psychiatry would have made for a very powerful book.

[Miguel Márquez · Rating 4 out of 5]

A must read for anyone still believing that pills and some bullshit based on Freud's theories is what will heal their issues.

[PJ · Rating 4 out of 5]

We r so cooked

[Sarah Clement · Rating 4 out of 5]

I've read several books that incorporate or focus on the issues in psychiatry, but this is definitely among my favourites. The book is thought provoking, easy to read, and it challenges what you think we know about psychiatry. I wouldn't say I am convinced by everything in the book, but it certainly brought to light just how far removed psychological research is from the way it is practiced with patients and understood by the public.

Davies touches on diagnostic criteria, pharmaceuticals, the biological model of psychiatry, cultural influences on how mental illness is expressed and understood, and many other topics. He illustrates his points through the use of research, narratives about particular cases, and interviews with experts. I thought he did a brilliant job of bringing several lines of inquiry together into a coherent story about the rather sad state of the field as it stands.

I think if you are just being exposed to some of the ideas - like the lack of evidence re: the biological model or the poor performance of pharmaceuticals in treating mental conditions - you will either strongly resist the ideas or find it simultaneously fascinating and terrifying. I read this after Saving Normal by Allen Frances, which is interesting because Davies is rather scathing of Frances' assessment of his role in the revision of the DSM. I think Davies is, at times, a bit dismissive of not just Frances but several others who see things differently to him, but overall the book is quite balanced.

Davies is quite clear about what we do know, what we think we know, and what we don't know; and in discussing all of these he paints a very vivid picture of how we are failing to deal with mental illness. I found his discussion of the cultural influences on what you will be diagnosed with, as well as various examples of social contagion once a new mental illness is introduced into a society, to be among the most fascinating. It's also something I haven't seen as much of in other books on the topic. Overall, I'd highly recommend this book for anyone who is interested in digging a bit deeper into where psychology is failing and how it might be put on a more promising trajectory.

[Amelia · Rating 4 out of 5]

Cracked is a searing indictment of psychiatry and its dependent relationship with the pharmaceutical industry. While a bit too tabloid sensationalist in its style at times, Cracked is a really interesting challenge to the current hegemony around mental illness and psychopharmacological treatments. From the fascinating construction by committee of mental illness taxonomy the DSM and the aggressive prescribing of SSRI anti-depressants for the mythical 'chemical imbalance in your brain', to the psychiatric imperialism necessary to sell drugs in new markets and the academic experts on the pharmaceutical industry payroll, this is a great overview of some of the problems with how we treat modern mental illness.

Particularly important I thought were the parts about the extremely lacklustre evidence base for many psychiatric treatments, and trial data manipulation by pharmaceutical companies to hide side-effects and mislead consumers. Given the enormous amount of people prescribed SSRIs (17% of the population in the UK last year) with usually very little information about them, this is definitely the kind of writing I'd like to see more of so that people can make more informed decisions about their mental healthcare. Having read about the dirty marketing tactics of big pharma, I'm also left with uncomfortable thoughts about how many mental health influencers on social media might be on pharmaceutical companies' payroll which had never crossed my mind before.

This is a great critique of how a combination of trying to construct mental illness into a solidly bio-medical category plus big business interests has shaped our approach to healthcare, and is a great read for anyone interested in mental health or critical psychology/psychiatry.

[Sophia · Rating 3 out of 5]

I wavered back and forth in the rating, between three and four, but in the end three won out.
Pros:
very important critical look at the overmedicalization, how and why it happened.
Easy to read, fluent.

Cons:
I found it at times got too "sensational" and less rational (as a book like this should be), relying on rhetoric and emotions.
He relies heavily on interviewing "important people in the field", and while this may seem like a good way to get quick answers, it also makes it very easy to manipulate the information throguh cherry picking. It doesn't mean his point isn't true, it just means that I have no real reason to believe it is.
He seems to miss the point entirely of psychiatry, even when the words he quotes explains it. Yes, there are a ton of problems, but some things MUST be dealt with with drugs because 1. we don't at the moment have a better solution (either because the patient doesn't have the resources for better treatment, or the scientific comunity really still has no clue) 2. sometimes it really is a "biological" reason for mental distress, and therefor requires a biological solution (chemicals).

[Greta · Rating 4 out of 5]

This book should be read by anyone who thinks there's a pill that will fix your problems. Mental health professionals have tried all sorts of solutions to problems related to mental suffering, but still haven't found the answer to be in physically messing with the brain. Until money can be replaced by compassion, the real needs of the patient will continue to be sidestepped by those who stand to make a profit. There is much to be said on this topic and this book is an excellent starting point. Anyone concerned about the increasing numbers of dysfunctional people in the world should start searching for answers and this book is a good place to begin.

[Evelina · Rating 5 out of 5]

I loved this book. I have read so many similar to this, criticizing the Big Pharma and the pathologization of human emotions in the context of medicalization and funds. This book was informative, succinct, and incredibly interesting. I'd recommend this to anyone who works in the mental healthcare sector.

[Sophie Robinson · Rating 4 out of 5]

Great book detailing disturbing research into the corrupt world of pharmaceutical drugs. Be prepared to have wool taken from eyes

[Rahdika K · Rating 3 out of 5]

This book was published in 2014. Why is this significant? Because since its release, there have been significant advancements in both psychiatric research and treatment. Some of the book’s arguments, therefore, may no longer be as relevant or applicable today.

As a psychiatrist, I found it particularly challenging to read this book after spending years in medical school, only to encounter a psychotherapist claiming that psychiatry is doing more harm than good. Naturally, I was intrigued when I first picked up this book.

At first, I found the book’s premise engaging, and some of the arguments were indeed thought-provoking. For instance, the criticism of classifying grief as a disorder struck a chord with me, especially since grief is not included as a mental health disorder in the latest DSM. That point felt valid, and I found myself agreeing with it.

The author also delves into the influence of capitalism on the psychiatric field, particularly focusing on the relationship between pharmaceutical companies and healthcare providers. He claims that the close ties between the two have led to a system where medication is often over-prescribed for profit. While I understand his concerns, I feel that this argument is somewhat overstated. As clinicians, we adhere to a strict ethical code, and our prescribing practices are guided by patient needs rather than any potential financial incentive. At times, it seemed like the author was trying to paint the entire field with a negative brush, as though every clinician were compromised by corporate interests. His perspective, while not entirely ungrounded, feels a bit far-fetched at times.

One of the more troubling aspects of this book is the author’s approach to research and evidence. It often seemed like he had cherry-picked data to support his arguments, sometimes distorting or oversimplifying complex issues. For instance, his discussion on epigenetics seemed flawed. Whether the author misunderstood the science behind it or is simply dismissing the established research in favor of his own views, I found his treatment of this topic particularly problematic. It left me questioning whether the author was genuinely informed or if he believed that only his viewpoint was valid.

What I find most difficult to forgive, however, is his example of a schizophrenia case that was supposedly "cured" by reading a book and adopting a positive mindset. This claim is not only misleading but dangerously irresponsible. Schizophrenia is a complex, lifelong condition that requires proper medical intervention, and the author’s portrayal of a quick fix based on self-help advice is not just inaccurate—it borders on harmful. At times, I couldn’t help but wonder if the author was perhaps on some crack while writing this book.

Additionally, the overall tone of the book struck me as dismissive, particularly towards individuals suffering from mental health issues. While the author offers his critiques, he seems to neglect the real, lived experiences of those dealing with mental health conditions. His approach comes across as lacking empathy, which is deeply concerning for a book that aims to challenge the psychiatric establishment.

In conclusion, while this book is an entertaining
read with some thought-provoking points, I would caution readers to approach its conclusions with skepticism. The arguments presented may be compelling in some areas, but they require careful consideration and should be viewed in the context of a rapidly changing field. If you are a patient or someone seeking help for mental health issues, I recommend consulting with healthcare professionals and making decisions based on a thorough, well-rounded understanding of your options.

[Sandra · Rating 4 out of 5]

This book was really a great reading experience. There is definitely A LOT of controversy surrounding the topic but I guess that is something that made it that intriguing. I can definitely see the reason why many people would hate this book and try to lessen the credibility. It questions so many core beliefs we have about mental disorders and the industry.

The book was written in journalistic style - daring, straight forward and a bit provocative. That made it easy and entertaining to read but the book still managed not to go too overboard and keep to the facts. Still the reader should be critical to the conclusions he makes of the facts. Of course critic reader as I am, I can't be sure that all the facts are indeed correct and I don't have the time, effort and ability to check everything myself (some I have though). But the overall impression was consistent for me and in some domains resonated with my previous psychology knowledge and beliefs.

I also think that prescribing psychoactive drugs should not be the first thing to do when person seeks help with mental problems neither the only thing to do since we still don't actually know what causes mental illnesses and how they develop, neither we know how exactly the drugs influence the brain. Still I am definitely NOT anti-drugs and I don't think we should discard psychoactive drugs completely. I believe that it is possible to make great use of them in some cases. Psychiatry and psychology are still very young sciences and we don't know far enough to be able to create manuals how to get optimal results all of the time. But those are also quickly developing sciences witch means we get smarter every day.

But the book goes deeper. It does not only doubt the efficacy of psychoactive drugs but also finds that biological paradigm in treating mental disorder in general is flawed and attacks pharmaceutical companies for discarding truthfulness for profit. And the author does not cut short with just broad statements like that. He collects information from various sources and conducts interviews with a lot of people who are one way or another connected to the topics and gives their full names and direct quotes. And of course most of the important statements are referenced.

The only complaint I have is that the book lacks balance. It does not talk much of the positive side of psychiatry, only barely noticeable hints. Which is sad because the book might create the impression that all the psychiatry is shit. The author only touches the subject of potential in the end. The other reviews have also admonished the same problem and it is definitely justified. I see a big threat that the book might be interpreted as too radical and the arguments might be dismissed due that.

In conclusion, it is a valuable read for mental health specialist and students. I don't mean that you should swear by it but it definitely gives another way of thinking to generally recognized principles. It is deeply recommended to have a good background knowledge in psychology and psychiatry.

[Lady Fancifull · Rating 5 out of 5]

Wool Pulled Justifiable Rage Disorder

Why has the prescription of antidepressant medicine roughly tripled in less than 20 years? Is it that we are indeed becoming sicker, that we are all becoming more and more stressed and psychologically unwell, is it merely that doctors and psychiatrists are much more skilled at diagnosing psychiatric conditions than they used to be, or is it that we are now medicalising (drugging) what is normal about the variety of day to day human experiences, which at times can be sorrowful, challenging or confusing?

This briiliantly clear, cogently argued, shocking and timely book by psychotherapist and anthropologist James Davies rendered me almost incoherent with rage, exposing as it did something which many of us have been aware of, but maybe have not had the tools or ability to follow to a conclusion. James Davies has those tools and abilities; he thoughtfully, knowledgeably, skilfully connects all the dots together, uncovering the horrendous duplicity, collusion and sheer unscientific snake oil peddling visited upon us by Big Pharma, in the field of mental health.

I can’t urge the reading of this book strongly enough. Anyone who cares about what it means to be a fully human being, and especially anyone involved in any way in the caring professions needs to be aware of what Davies lays clear about the mental health industry. For industry it surely is.

With a carefully constructed series of explanations, revelations and arguments Davies delivers telling knock out punches to the House of Trick Cards of current mainstream psychiatry. The major punches involve

1) The increasing categorisation of VIRTUALLY ANY EMOTIONAL STATE so that it falls within a category of disorder – thus opening the way to the development of chemical coshes. This categorisation – the ‘Bible’ used to denote syndromes, the DSM (currently DSM 5, is NOT the result of huge studies and research itself, yet it gets used as if it were the result of close scientific analyses. The result of the sort of sordid, limiting tickboxy thinking, turning us all into robots who can be managed out of our normal human pain is the crass thinking that says, for example, if after a bereavement, sleep appetite and general mood are affected for more than 2 weeks, anti-depressants may be helpfully prescribed. Crazy, insidious, crass. We have become so afraid of our suffering that the answer becomes ‘cosh it, flat line what it is to be in any way human’

2) Trials – various meta analysis studies have shown that antidepressants are BARELY more effective, in mild to moderate depression, to placebo. Drug companies have disquietingly low bars to climb over, in order to ‘prove’ their products effectiveness. Davies uncovers the secrecy, the UNPUBLISHED drug trials that go against the findings Big Pharma wants and the manipulation of results. More than this, how drug companies positively USE that most powerful of tools – PLACEBO ITSELF to manipulate their own results higher – for example, the colour, the name, the advertising of the pharmaceutical – many of the effects that might be assumed to be the result of the chemistry of the drug ‘better than placebo’ – are in fact DUE to the use of placebo!

3) There has been a change in thinking from the 60s and 70s, where psychiatric drugs were seen as altering mood (in the same way as any mind altering drug, including alcohol and street drugs alter moods) A shift occurred to thinking of psychiatric drugs as ‘curative’. This might not seem an important shift – however it goes along with the idea that much uncomfortable, difficult human emotion is now being seen as potentially aberrant and classifiable as a ‘disease’ - as in the DSM – shyness becomes ‘social phobia’.
Medical naming encourages thinking about human beings in all their complexity as broken, and needing mending – and opens the door to the over-prescription. In fact, as one astute expert (among the many) Davies consults, points out tersely, this thinking of these drugs as ‘cures’ is erroneous, as unlike most physiological disease there just is no hard evidence to support the biology of a lot of what is now being treated as ‘disease’ through these medications – which alter mood. They do not ‘cure’ shyness, (or, lets medicalise it as social phobia) any more than a glass of wine ‘cures’ shyness – both change ways of perceiving the world, that is all.

4) Who bites the hand that feeds? There is a huge cover-up, smoke and mirrors going on in the world of funding ‘research’ into psychiatric medicine whether in academic institutions, or with clinicians. And, gentle reader, there is even less transparency over this in the UK than there is in the States, where under the Obama administration, spearheaded by a particularly truth-and-justice campaigning Senator, Senator Grassley, some efforts to bring the Pharma hyena under the spotlight are beginning to bear fruit. But not here, where there is murk a plenty. Perhaps though, the fact that fully 56% of the panel member luminaries involved in writing the DSM-IV bible had 1 or more financial associations with the pharmaceutical industry, should begin to rip the wool from over our eyes. And, for those writing/creating the diagnostic categories, which would or course be primarily treated by pharmaceuticals, - 88% of DSM-IV panel members had drug company financial ties.from Big Pharma. And things don’t have appeared to have changed for the better in terms of ‘arms length’ involvement with the writing of the now current DSM-V.

I am not saying (nor is Davies) that all these senior clinicians and medical academicians are corrupt, merely that neutrality becomes hard to achieve when your income is dependent on a particular company who are hoping your findings will support the excellence of their product, and even to demonstrate a need for their product



I received this book as an ARC – of course, given what I have said in point 4, you may feel that my judgement is compromised. I would argue that a lowly amateur reviewer lucky enough to get offered bookie freebies through third parties does not in any way equate to some stars of the psychiatric industry who receive millions for the sterling work they do in supporting the claims of specific drugs and manufacturers. A look at some of my reviews on Amazon will show that if I think a particular book is poor I will indeed say so.

This one though gets my gold standard bookie trial award. Properly researched, properly cited, free from duplicitous cover-up. Unlike the industry is exposes.It deserves to be a best seller – indeed, needs to be so – its material is provocative, prescient, and vital to know.

I have one cavil – my ARC was a digital copy. Now I don’t know if this will be any different than the standard digitise prepared for sale, but the digitisation on my ARC was poor – a lot of the useful charts and graphs do not appear and footnotes get chopped and inexplicably appear in the middle of other pages. If I were buying this book, I would definitely choose hard, over digitised, copy.

[Vibhor Sahay · Rating 3 out of 5]

Learned a little about the world of psychiatry and how big pharma traps us at every instance.

The following excerpt from the book will stay with me for some time:

“We are not so different from that little girl. We seek myths to settle crucial questions for which we have no clear answers, but about which we feel we need answers so that we may turn our attention to other things. This is why every society throughout time has had its multifarious myths about all aspects of life: about where we are from, about where we are going, about why we are here, and so on. Myths help soothe our anxiety about some of our most fundamental human uncertainties. Take one of the greatest uncertainties of all-what happens to us after death. This issue provokes such universal anxiety that anthropologists haven't found a single community upon this vast globe that doesn't have a myth about the afterlife. One community speaks of ethereal angels awaiting us at pearly gates, another of a cosmic mother we'll all return to after death, another of gambolling ancestors welcoming us with barrels of manioc wine. The myths are everywhere, all telling fantastically different stories, but all in effect serving the similar purpose of providing explanations for questions that if left unanswered could drive many of us to mad distraction. Myths speak to the realms of life that matter most, including 'whence comes and how goes our suffering' - a matter for which, in contemporary Western societies, we turn to psychiatrists for help.”

[Fin · Rating 3 out of 5]

3.5, ⭐⭐⭐.5/5 stars!

A shocking read! And yes, from the evidence, it is more than reasonable to judge that psychiatry is (potentially) doing more harm than good. In addition, the final chapter of this book does make a valid suggestion that could be implemented (if not already) to aid transparency for consumers of antidepressants within the industry.

However, like with all science, readers will need to enter this book with a critical mindset as Davies may have fallen foul to confirmation bias in some instances.

[Jenna · Rating 4 out of 5]

Yeah good and informative read for a layperson like myself who is not knowledgeable about medical literature or medical culture. Great stuff, though maybe as a disliker of big pharma im biased to like this book, I’ll acknowledge that for definite

[Katy · Rating 2 out of 5]

useful references and interviews, otherwise extremely sensationalist and scaremonger-y? my christmas wish is for james davies to chill out