I think David Dobbs is going to be amused to learn that the Discovery Institute thinks he has just demolished Darwinism by way of psychiatry. But in an article that is delusional even by the standards of that bastion of lunacy, the DI argues that the collapse of evolution is just around the corner. Again. Like always.

Here’s how David Dobbs decided the demise of Darwinism: he wrote a positive review of a book critical of the impending release of DSM-5, The Book of Woe: The DSM and the Unmaking of Psychiatry. Such a small thing, the tiniest pebble that will lead to an avalanche of destruction and the total demolition of the edifice of modern science.

Or not. The book is critical of one component of the understanding of the mind, and it’s no surprise…hasn’t every edition of the DSM led to the gnashing of garments and the wailing of teeth, or something? As Dobbs points out, there really are fundamental flaws in how psychiatry handles mental illness.

The DSM, Greenberg concludes, “dresses up symptoms as diseases that are not real and then claims to have named and described the true varieties of our suffering”. Technically, the APA concurs, admitting sotto voce (for instance, in planning documents and public discussions for earlier versions of the DSM) that many psychiatric diagnoses are constructs of convenience rather than descriptions of biological ailments. This originates in an explicit decision the APA made, during the creation of DSM-III, to base diagnoses not on aetiology but on recognizable clusters of symptoms that seem problematic. The APA did so recognizing that this would mean stressing consistency among clinicians in recognizing symptom clusters rather than any other marker of a condition’s origins.

A slippery deal, but essential. For by formalizing this scheme, psychiatry can claim medical legitimacy and accompanying insurance coverage and pay rates so that it can help people. Unfortunately, writes Greenberg, this scheme has led everyone, psychiatrists included, to talk about and treat DSM’s conceptual constructs as if they are biological illnesses — a habit that has bred troubles ranging from overconfidence to incestuous liaisons with Big Pharma.

Yet neither Greenberg or Dobbs are predicting the annihilation of psychiatry. Rather, they seem to be discussing serious problems that need to be corrected so the discipline can advance.

As Greenberg writes, the DSM, and psychiatry with it, increasingly “casts its subjects into dry, data-driven stories, freed from the vagaries of hope and desire, of prejudice and ignorance and fear, and anchored instead in the laws of nature”. Yet when psychiatry works, it often works less at a biological than at a humanistic, narrative level, by helping the sufferer to reframe the story of his life and of his place in the world into one that includes a sense of agency, strength and social connection. This is doubtless why a combination of drugs and talk therapy generally works better than just drugs. It also helps to explain why schizophrenia, as described in Ethan Watters’ Crazy Like Us: The Globalization of the American Psyche (Free Press, 2010) and in work by Tanya Luhrmann, is much less disabling in cultures — or even treatment regimes — that cast its eccentricities more as variations in human nature than as biological dysfunction.

For more than 100 years, psychiatry has been getting by on pseudo-scientific explanations and confident nods while it waited for the day, always just around the corner, in which it could be a strictly biological undertaking. Part of the DSM-5’s long delay occurred because, a decade ago, APA leaders actually thought that advances in neuroscience would allow them write a brain-based DSM. Yet, as former APA front liner Michael First, a psychiatrist at Columbia University in New York, confirms on Greenberg’s last page, the discipline remains in its infancy.

So…it works, but our understanding of how it works is in its infancy. That’s not the act of carving its tombstone, but merely issuing its first grade report card (“little Psych is very creative, but needs focus and discipline.”)

That doesn’t fit into the creationist trope, though, so they had to…reinterpret what was said (“little Psych is about to die, deservedly!”) This is a really old line: the Discovery Institute has a hard-on for psychiatry that rivals Scientology’s. Some years ago they were fond of citing the troika of 19th century failed philosophers: Marx, Freud, and Darwin. They predicted that because Communism was already dead and Freud was an old discredited pervert, Darwin was next. It was highly irrational ‘logic’, and smacked more of superstition than reason, but it was a big deal for them. They’ve also been arguing for years for dualism — there is a supernatural soul or spirit in the brain — and anything that tries to find natural causes for the mind is anathema to them.

So Dobbs, published in Nature, and Greenberg, author of a very serious book, are dragooned into the service of intelligent design, their conclusions twisted to support the dogma of the day, and are now cited as not just pointing out the problems with past assertions or the politics that distort the publication of a major reference work, but as a science in crisis, on its deathbed, about to be pushing up daisies.

I agree with Greenberg, Dobbs, and the Discovery Institute (Erk! My heart!) that psychiatry is rife with conceptual problems and a serious absence of sound natural causes for the phenomena they describe. But I’m not about to write it off completely, and I certainly do not understand this massive bounding leap of illogic.

The things being said about psychiatry now, though, on the eve of publication of its latest upgrade, the DSM-5, are revealing it to be a science in crisis — if it ever was a science at all. As we list the problems, ponder whether many of the same criticisms could be leveled against Darwinism.

That makes no sense. The 18th century assertion by spermists that the spermatozoon contained a tiny homunculus has been disproven, therefore I’m pondering whether the same criticism could be leveled against stem cell therapies. The archaic economic structure of the Ottoman Empire contributed to its collapse, therefore I’m pondering whether the same criticism could be leveled against the apocalyptic popularity of Fifty Shades of Gray. The designated hitter rule ruined American league baseball, therefore I’m pondering whether the same criticism could be leveled against the use of polysiloxanes in McDonald’s Chicken McNuggets.

A = B, therefore X = Y is not sound reasoning.

But reason won’t get in the Discovery Institute’s way, now or ever! So they compile a list of psychiatry’s shortcomings, as they gleaned from a number of criticisms they found on the internet, calling it a “failed science”, even though that’s not the impression I got from the sources they cite.

1. Long history of failure.

2. No theoretical basis grounded in biological reality.

3. Reliance on a book.

4. Conflicts of interest.

5. Lack of quality control.

6. Ignoring critics.

7. Focus on symptoms instead of causes.

8. Category errors: confusing arbitrary classification with reality.

9. Attempting to pigeonhole complex entities into simple categories.

10. Concern for consistency and consensus over empiricism.

11. Tortured attempts to fashion theories.

12. Formalizing schemes to gain legitimacy.

13. Promissory notes to do better in the future.

14. Hopes that other sciences will legitimize it.

And now the fun begins. They have cobbled up 14 reasons why psychiatry is totally wrong, so let’s make up 14 complementary reasons why evolution is totally wrong!

1. Failure to explain the Cambrian Explosion since Darwin.

2. Extrapolating natural selection far beyond the evidence.

3. Continuing to exalt Darwin and his Origin.

4. Scheming to keep criticisms of Darwin out of journals and classrooms.

5. Flimsy assertions that “it evolved,” with little rigor.

6. Refusing to hear or publish scientific critiques of Darwinism.

7. Use of homology as evidence and explanation for adaptation.

8. Inventing terms like “kin selection” and “evo-devo.”

9. Attributing the whole biosphere to undirected causes.

10. Claiming the consensus accepts evolution in every meaning of the word.

11. Applying natural selection recklessly to everything, even the universe.

12. Scheming to prevent intelligent design from gaining a hearing.

13. Always saying “more research is needed.”

14. Misappropriating genetics, computer science, and development to support it.

Uh, wait. Despite having the same number of items, the lists don’t really line up at all well — there’s virtually no correspondence between the two. Furthermore, many of those items are just plain wrong or repetitive.

1. We do have explanations for the Cambrian explosion, and good ones at that. That one is just a plug for Stephen Meyer’s hack book that’s supposed to come out next month (and I’ll write more about the reasons when it’s out.)

2. That some people overuse a powerful explanation does not imply that the phenomenon does not exist. This is the same as #5 and #11.

3. We do not exalt Darwin. We respect him as a great scientist who still got many things wrong. Also, you do not need to read the Origin to learn about evolution.

4. “Scheming”? No. Demanding rigor. Half-assed assertions of a “designer” with no evidence are not adequate. This is the same as #6 and #12.

5. This is the same as #2 and #11.

6. This is the same as #4 and #12.

7. No, I’ve never heard homology or common descent used as an explanation of adaption. Retention of non-adaptive features, sure.

8. Both kin selection and evo-devo are terms for real phenomena, one for a gene-centric explanation for altruism (for instance) and the other for a discipline that relates evolution and development.

9. This is not false. There is no evidence for teleology in evolutionary history.

10. The scientific consensus accepts the scientific meaning of the word. What else would we do? Anything else, it wouldn’t be a consensus!

11. This is the same as #2 and #5.

12. This is the same as #4 and #6.

13. But we always need more research! If we had all the answers, we’d be done with science.

14. It’s not misappropriation. Genetics does support evolution; have you ever heard of the neo-Darwinian synthesis? Computer science provides an essential contribution to modern biology; have you ever heard of bioinformatics? Development and evolution work together beautifully; have you ever heard of evo-devo? Oh, right, you have, you just believe we made it all up.

The creationists are just getting more desperate and pathetic. They didn’t even try to come up with a reasonable set of correspondences — apparently they trust their readers to be so stupid that they won’t actually read or think about the comparisons, they’ll just see 14 reasons evolution is just as wrong as psychiatry — it’s about as reasonable as saying that the 14 stations of the cross mean Catholicism is as doomed as Freudian psychoanalysis.

But then, non sequiturs are what I’ve come to expect from those awful writers at the DI.

---

Dobbs D (2013) Psychiatry: A very sad story. Nature 497:36–37 doi:10.1038/497036a