Scientology's criticism of psychiatry: separating fact from fiction

In my next few posts, I'll lay out my responses to some concerns that scientology expresses about psychiatry.

The first issue I'd like to address is the CoS stance that mental illnesses don't exist, because there are no lab tests or imaging studies we can use to diagnose individual patients. The CoS points out that modern medicine does not have lab tests to diagnose mental illnesses (true). The CoS then makes the illogical leap that lack of a test means lack of a disease (false).

One hundred years ago, medicine did not have lab tests for asthma, gout, or smallpox. Does this mean that those diseases didn't exist or weren't recognized one hundred years ago? No. Like these illnesses, mental illnesses do exist. We can diagnose them, treat them, and quantify how well particular treatments work, even though we don't yet have reliable blood tests for diagnosis.

The practice of medicine is more about talking to patients and examining them than it is about drawing their blood and taking x-rays. 90% of the information needed to make a diagnosis of any kind, from a torn knee ligament to bipolar disorder, can and should be gathered by thorough history and examination. Physicians may use lab tests and other diagnostic studies to obtain more information, but these studies are just part of the larger body of data needed to make a diagnosis and develop a treatment plan.

Psychiatry has solid evidence for alterations in neurologic and endocrine function that correlate with mental illnesses. Here are only a couple of examples:

1) For over thirty years, blood tests such as the cortisol suppression test have shown that depressed patients have different stress response patterns than those of non-depressed subjects.

2) We can demonstrate significant differences in the way glucose is metabolized in the brains of mentally ill patients compared to those of healthy subjects when we look at imaging studies such as functional MRI and PET scans.

Unfortunately, while these differences hold true when comparing groups of healthy controls to groups of people with mental illnesses, our tests are not yet sophisticated enough to use for diagnosis in individual patients.

Psychiatrists are looking forward to the time when we have reliable tests to enhance our clinical care. But even when those tests become available, they won't supplant the importance of history-taking and examination, and we won't need them to prove the existence of mental illness.

I Don't Hate Scientologists

I do abhor the CoS vendetta against modern mental heath treatment. I abhor the methods the CoS uses to target those who criticize it, both within and without its organization. I abhor the damage it does to people who need legitimate mental health treatment.

And I abhor the fact that the CoS has chosen my medical specialty as the one to target. Dr. Nada Stotland of the APA pointed out a couple of weeks ago that psychiatry is the only branch of medicine that has its own hate group. What if the CoS targeted another medical specialty? What if it targeted your child's pediatrician, your mother's oncologist, your diabetic friend's internist? What if it did everything it could to deny these patients appropriate medical care?

Scientologists have the right to believe whatever they wish, to follow whatever paths that seem right to them. My beef is not with individual scientologists, but with the powers that be within the bureacracy of the CoS, the people who seek to deny an entire branch of medical care to their members and to the world at large.

There is something very wrong with the tenets of the CoS as it is now. Neither its members, mental health workers, nor the rest of the world should stand for it.

A Work in Progress

I'm a psychiatrist who was curious about why scientologists protest against psychiatrists and psychologists. About a year ago, I decided to learn a little about the Church of Scientology (CoS) to have a better idea of why scientologists hate "psychs", and whether there was any room for mutual understanding.

I was really disappointed to discover that scientologists believe psychiatrists are criminals who colluded with an alien overlord (Xenu) to kill billions of people 75 million years ago. Given that their hatred is based on a shared paranoid delusion, I have lost hope that there will ever be any understanding between believers in the CoS and providers of mental health treatment.

I felt I had to start this blog because of the convergence of a few recent events. First, I was involved with members of an evangelical Christian family who were taken in by CoS internet posts. I knew that these people would not have paid attention to this disinformation if they had any idea that it was coming from an anti-Christian cult. The posts stated that antidepressants were very toxic and recommended that people should wean off their medications and take high doses of niacin instead. I thinks it's fine for people to take reasonable doses of natural supplements, and I often recommend them to my patients, but when I saw that the niacin doses recommended were high enough to cause liver damage and possibly even liver failure, I became especially concerned.

Next, I attended the 2009 meeting of the American Psychiatric Association and once again witnessed the yearly CoS protest, but this time, members of Anonymous protested against the CoS. When I returned home after the convention, there was a post on the Anonymous web site pointing out that Anonymous is doing work that psychiatrists need to be involved in. Anonymous is right! Now I'm going to do my part to expose some of the dangerous practices of the CoS.

This blog will be mostly a place to put together links to other information sites, but I'll try to highlight news pertaining the CoS and mental health care.