Robert Whitaker Keynote - The Disease Model Has Failed - Now What?
- Thread starter PageofME
- Start date
Robert Whitaker, health journalist, author and founder of the Mad in America online platform, gave an address at the annual convention of German psychotherapists in Berlin in June 2026. Since so many users here are interested in neuropsychiatric models, I thought you might be interested in why more and more people who have worked within that model of psychiatric care for decades—as well as many patients—think that this framework has already failed.
Utsikt
Senior Member (Voting Rights)
What do you mean by this? And models of which diseases?
I'm just over 10 minutes into the 50 minute talk and it's been an interesting listen so far.
Whittaker is talking about psychiatric diseases, noting how simplistic stories about what things like depression are were built on assuming the problem was the opposite of what the drugs given to treat them were known to do.
Whittaker is talking about psychiatric diseases, noting how simplistic stories about what things like depression are were built on assuming the problem was the opposite of what the drugs given to treat them were known to do.
Jonathan Edwards
Senior Member (Voting Rights)
What model?
'Neuropsychiatric' is normally used just as a category of disease - something with a biological structural or biochemical basis that affects thought.
Jonathan Edwards
Senior Member (Voting Rights)
As far as I can see he is just confusing two different things. Psychiatric diagnostic categories to date have been rubbish. Anyone knows that. Understanding of mechanism has been minimal. The drugs do not work well. That is presumably just a reflection of our lack of understanding of mechanisms. And any medical student who has thought a bit deeply realises that pigeonholing everything into 'diseases' is going to be at best a crude approximation and at worst very misleading.
That does not alter the fact that there are a few neuropsychiatric problems that we do understand quite well, like getting drunk or narcolepsy and that it continues to make sense to look for mechanisms where we are so far struggling.
That does not alter the fact that there are a few neuropsychiatric problems that we do understand quite well, like getting drunk or narcolepsy and that it continues to make sense to look for mechanisms where we are so far struggling.
MSEsperanza
Senior Member (Voting Rights)
@PageofME could you provide a source for this/ a link to the convention?
Not able to watch the video at the moment but would not be surprised if psychotherapists liked a critique on psychiatry that did not address shortcomings in their own field of psychotherapeutic theory and care or maybe implicitly even validated it as being better.
Wikipedia page about Robert Whitaker see this link.
Last edited:
Jonathan Edwards
Senior Member (Voting Rights)
Yes, his main platform seems to be that antipsychotic drugs are rubbish.
We all know that.
And also that anti-depressants are rubbish.
Well, that's not quite true, he says they should both be used much less and for shorter periods of time, and that they can result in worse outcomes.
And the other point he makes is that researchers and many clinicians have indeed known all that for a long time. But that actually many other people haven't. And, that's not ethical, the public should have been given a better understanding of the evidence relating to these drugs.
I think these drugs probably have been overused. For goodness sake, clinical guidelines have suggested using all sorts of anti-depressants as a treatment for ME/CFS, including the SSRIs. Even in the last few years I've argued against that idea in NZ ME/CFS guidelines, because the only doctor treating ME/CFS in this country thought they were a good idea.
Last edited:
Liie
Senior Member (Voting Rights)
I got this though which I find interesting:
Robert Whitaker and Mad in America criticise BPS from the opposite position compared to us: We want our condition to be treated as being biomedical and we protest being psychologised by BPS; they protest mental illness being biomedicalised by BPS.
Robert Whitaker and Mad in America criticise BPS from the opposite position compared to us: We want our condition to be treated as being biomedical and we protest being psychologised by BPS; they protest mental illness being biomedicalised by BPS.
Jonathan Edwards
Senior Member (Voting Rights)
But is also not ethical to give the impression that drugs should not be used at all and that schizophrenia can be cured without them. I son't see pubic education benefitting from polemic.
I didn't hear him say either of those things.
I think he talked about a clinic where maybe a third of people didn't use drugs, most people only used them for a short time as needed and 20% were on them long term, I think it was a schizophrenia clinic. ? I'd have to listen again, but he certainly was not saying the drugs should never be used at all.
MSEsperanza
Senior Member (Voting Rights)
Jonathan Edwards
Senior Member (Voting Rights)
But a lot of people will hear that.
The bit I listened to had a lot of sweeping statements in it.
Personally, I was more severely harmed by psychodynamic psychotherapy than by the neuropsychiatric model and drugs (for psychiatric condtions long before I caught ME/CFS). (It was easier for me to understand that it was crap and trust my expereriences and judgement here and leave that model behind). For many others it's just the opposite—and the research focusing on that group is Whitaker's main topic. At the same time, I guess German psychiatrists and psychotherapists are probably the only group of professionals worldwide right now with at least some self-reflection and self-criticism around psychotherapy. They are actually taking in research results that point to an efficacy and safety far lower than the wider public thinks.
Last edited:
There is a good chance this causes a lot of trouble in the coming years because of what's happening in the US. It's unfortunate that there is accurate criticism to be made here, largely an own-goal because of decades of downplaying all concerns, seemingly largely based on conviction about a "nocebo" effect from merely acknowledging common adverse reactions. There have been so many problems with the overuse of SSRIs that it's very likely to be successful, and it's frankly hard to say if it would truly be a net negative. The abuse has been that extreme.
Exact same problem happening with vaccines, although the problem is far worse with SSRIs. All of this could have been avoided by just being honest, but the belief in pla/nocebo continues to overrule reason. It's maddening how much could be improved if honesty was non-negotiable, if telling the truth was always required, and not just the truth, but candor, going above and beyond to make sure there is no misunderstanding. Instead we have the exact opposite of that as a standard.
Impunity remains the true root of all evil, money only seems like it because it often buys it, but it's being entirely immune from consequences that make people do horrible things, even with good intentions.
