By Fred A. Baughman Jr., MD, Fellow, American Academy of Neurology

In the April, 2003 Neurology Today, the newspaper of the American Academy (AAN) of Neurology, came a strange call “Seeking papers on (the) Merger of Neurology and Psychiatry” from The Irwin Foundation, who this life-long neurologist has never heard of. This “call,” given space in Neurology Today by the AAN (and thus, credibility) went on to describe the Irwin Foundation as “a nonprofit psychiatric education and research foundation based in Ohio (that) is sponsoring a competition on the best scholarly paper on this topic: “Neurology and psychiatry should merge, since both share neuroscience as their foundational science.” “…contact Michael A. Schwartz, MD, Medical Director, The Irwin Foundation, 34650 Cedar Road, Gates Mills, OH 44040.” Nor had I ever heard of Dr. Schwartz.

When I graduated medical school, there was no such thing as a psychiatric disease. There was conjecture, as through the ages, that schizophrenia might be an organic brain disease, but that was conjecture only—members of the NYU (my alma mater), Department of Psychiatry did not represent to us that any psychiatric diagnosis was an actual disease, due to a brain abnormality, nor were any encountered during the teaching of pathology—the study of all diseases of the brain and body that took up most of our second year of medical school. Nor was their anything but the indelible organic vs. functional divide between neurology, the specialty I was soon to elect, and train in, and psychiatry, which, having no “hard” science basis, held no particular appeal for me. In fact, then, as now, the most fundamental part of psychiatric diagnosis was to rule out, that is, be certain that no organic disease existed in patients being referred to a psychiatrists. Not only was this the duty of the non-psychiatric physician doing the referring, it was the duty of the psychiatrist accepting such patients in referral to be sure that sufficient care and consultation had been undertaken to confidently rule out all possibilities of organic disease. And this had to be assured by all involved for the simple reason, stated above, (1) that no psychiatric diagnosis, then or now is known to be an organic disease of the brain or body, and (2) that psychiatrists do not undertake organic diagnosis as do all other physicians, and, as is the medico-legal duty of all other physicians. Rather, assured upon referral that all of their patients have had organic disease ruled out, psychiatrists set about performing psychiatric diagnosis which consists of nothing more or less than the arbitrary classification of subjective symptoms, which consisting of nothing but symptoms, never of physical signs/abnormalities/diseases, is unlike all else in medicine. The only organic diseases psychiatrists encounter—recognized or not-- are those that have been missed (gone unrecognized) by non-psychiatric diagnosticians, and, of course, by the psychiatrist, as well, or those induced by, the physical treatments employed by the psychiatrists—drugs, ECT, psychosurgery, etc. Again, there is no such thing as psychiatric diseases. All brain symptoms found to have an organic basis are found in the literature and textbooks of neurology. As a neurologist it is my duty, first and foremost, to determine and know when organic disease is present and when it is not. In particular it is my duty and that of all neurologists (and this is known by the AAN and by all in the leadership of academic neurology) to know when organic disease of the brain/nervous system is present and when it is not. It is common knowledge that psychiatry long ago sold out to the pharmaceutical industry and that they, long ago—not as science, but as a marketing ploy, began to call all emotional and behavioral symptoms “disorders”/ “diseases”/”chemical imbalances” of the brain—all, needing a “chemical balancer,” a pill.

I encountered their first such lies in the proceedings of a 1970 Congressional hearing on the “treatment”/drugging of schoolchildren. Dr. John E. Peters, psychiatrist, of the University of Arkansas proclaimed:

“It is not known exactly the underlying organic condition, or psychological condition, behind MBD (minimal brain damage/dysfunction). We feel it has to do with some dysfunction of the brain, and we have to go mainly by analogy between children who have known brain damage and the behavior in children who do not have known brain damage, but do have identical behavior. So by deduction, we assume that there has to be some dysfunction of the brain…If the child is to a degree hyperactive, that he cannot function in the class he is in, whether it is a regular or a special one, then we will use medication.”

On October 12, 1970, Congressman, Cornelius Gallagher 3 wrote HEW Secretary, Elliott Richardson:

“I have received letters highly critical of the focus of the medical side of minimal brain dysfunction (the reigning designation at the time), which is, incidentally, one of at least thirty-eight names attached to this condition…Such a high incidence in the population--as high as thirty percent in ghetto areas…may not be pathological at all…”

Neither, as we are all aware, has MBD, ADD, or ADHD—by whatever acronym--been validated as a disease/abnormality or the brain or body. Nor has any single, solitary, psychiatric diagnosis/disorder/condition.

We know what psychiatry says what it does…it is paid to say such things. But why has the neurology—my specialty, my organization--joined psychiatry in such a clear, total, perversion of science and medical practice? Will the answer be found, as for psychiatry, not at all in science, but by examining their bank accounts and scrutinizing their business ties?

PSYCHIATRY CLAIMS PSYCHIATRIC DIAGNOSES/DISORDERS = DISEASES

Among my first encounters with psychiatry’s attempts to validate it’s diagnoses as diseases, came in a “Talk Back” column in Clinical Psychiatric News, a mainstream psychiatric publication with mainstream psychiatrists it’ s editors. Under the title: “ WHO TEACHES PSYCHIATRISTS TO BELIEVE THEY TREAT REAL DISEASES?” I wrote:

Ladies and Gentlemen,

As a neurologist/child neurologist, and a reader of Clinical Psychiatric News, I never ceased to be amazed at the phenomena of ‘biological psychiatry ’.

I presume the editor of the Talk Back column Clinical Psychiatric News, July, 2000, page 13 chose the question to be posed: ‘Should psychiatry and neurology be combined into one specialty, since both deal with the brain? Why? Why not?”

“…since both deal with the brain?” Since when? There are blanket claims of disease and of ‘dealing with the brain,’ but, to date, psychiatry’s biological research has come up empty, nada, and these remain nothing more than claims. A review of the joint history of psychiatry and neurology seems in order.

From The American Academy of Neurology: The First 50 Years, 1948-1998 Edited by Maynard M. Cohen, MD, The American Academy of Neurology, St. Paul, MI, we read of the birth of neurology as a new specialty, separate from psychiatry and from the erst-while, combined specialty of ‘neuro-psychiatry.’

The close of the Second World War ushered in an era of unparalleled therapeutic advances. Penicillin…soon became accessible to the nation’s physicians, and a string of new antibiotics followed…with the earlier introduction of diphenylhydantoin, a more effective therapeutic armamentarium was soon developed. … Prevailing wisdom suggested neurologists were obliged to practice psychiatry to make a living. …The American Board of Psychiatry and Neurology certified only in both specialties simultaneously—separate designations did not exist before 1948. Medical schools were without formal divisions or departments of neurology for the most part…. The end of hostilities in Europe brought a flood of residency applicants…New neurology programs were established and existing ones enlarged. On 23, June, 1948…a nucleus of 52 charter members chaired by Abe Baker approved formation of the American Academy of Neurology…Those “whose chief interest is directed toward the field of organic neurology or whose clinical practice is limited chiefly to neurology” were eligible for fellow status …The need for neurologic services, both academically and for patient care, became generally recognized after the Academy was founded…Among other items of importance during his presidency (Robert A. Fishman, AAN President, 1975-77) was consideration of separation of neurology from psychiatry in the American Boards. Neurology was closer to medicine, Fishman reasoned, and had only a superficial relationship to psychiatry. …The response favored maintaining the status quo by a margin of two to one. The prevailing feeling seemed to resist leaving a larger organization and taking on a new administrative function. …separate councils were created for each of the two specialties.

What this tells us is that prior to 1948 and the birth of the independent specialties of psychiatry and neurology, the two fields were married out of economic necessity, there having been too little to do in neurology to make a living at it alone. It was never that there was a common scientific basis. Then, as now, neurology dealt with the organic, biologic, brain and with its actual diseases. In that psychiatry dealt only with emotional and behavioral problems in persons with no objective organic, biologic abnormalities, the divide—then as now, was absolute.

We also learn that their remains a joint American Board of Psychiatry and Neurology, not because of a common scientific basis, but as a matter of administrative efficiency. Neurology, “seemed to resist leaving a larger organization and taking on a new administrative function.”

The only thing different today, just as in the subject Talk Back column is that psychiatrists talk, to themselves, their patients, and the public-at-large as if they routinely dealt with the brain, not the mind, and with actual diseases--those things we all (psychiatrists too) learned in medical school were diagnosed only by demonstrating an objective, confirmatory, physical or chemical abnormality. Only their lexicon has changed; it has become that of the rest of organic medicine when no proof whatsoever exists that a single psychiatric condition, disorder has a single, solitary, confirmatory, physical or chemical abnormality or marker. The reasons for this must be sought. Twenty-five years of doing ‘biological’ research on physically non-specific entities, has yielded not a thing, and that of course, is exactly what was to have been anticipated. Why would US psychiatry (mainly) spend billions looking for organic/biologic/neurological dimensions to entities known to be nothing more or less than the range of emotions and behaviors in biologically whole, normal individuals? Why indeed?

Surely the Talk Back editors, likely from academic psychiatry, understand the eternal schism between psychology, psychiatry and all of biology. Why pose the question as though it were a legitimate question. They lead off with “I think, therefore I am,” as if this could possibly be true in the physical sciences, which all of the medical specialties are with the exception of psychiatry.

Respondent, Dr. Gene Wright, a child psychiatrist from Santa Rosa, CA, had it right: “Brains and minds are not the same thing at all,” he said, choosing not to ignore the science he learned in becoming a general physician, as all of us do, before electing a specialty. Sadly his voice gets no amplification from within the establishment, committed to the illusion of biology. Dr. Wright continues: “Saying that psychiatry ‘deals with the brain’ is a reductionistic half-truth that obscures the most important contributions that our specialty has to offer society.”

As much as I admire your response, Dr. Wright, it is not even a half-truth. The children, patients said to have psychiatric ‘disorders’/ ‘diseases’ are, in fact neurologically, biologically and physically normal until the brain-altering medication or medications prescribed for them begin to circulate throughout their bodies and brains.

Dr. Mario Testani of the University of Rochester (NY) posits: “Psychiatry’s unique domain is the mind—biopsychosocially defined…We have unfortunately taken mind-body dualism to far, ignoring the mind.” It is words such a ‘biopsychosocial,’ ‘neuropsychiatry,’ ‘neurobiological,’ ‘psychobiology,’ etc. that have blurred the line for the non-scientist, but only the non-scientist. Scientists, including scientific physicians are aware that it is only the patient in whom organic disease has been ruled out—excluded (by finding no objective abnormality), who is a candidate for mental health, psychologic, psychiatric, referral. Further they, and the psychiatrist as well know that the qualifying ruling out of organic disease is done by non-psychiatric physicians prior to the scheduling the psychiatric appointment. Dr. Testani’s and anyone’s saying something is biopsychosocial or neuropsychiatric or psychobiological, does not give psychiatry or sociology a neurological or a biological component. That only comes with objective evidence. And again all we have is their neurobiological lexicon—no science, no proof.

A Dr. Ronald Rubin of Appleton, WI is particularly deluded, urging that neurology and psychiatry be combined because the mind and the brain are the same entity. Where did his medical school preparation in things normal and abnormal, go? One hopes he knew the difference between the separate fields of neurology and psychiatry when he chose to enter psychiatry.

Dr. Joel Hassman, a psychiatrist, importantly, pointed out that in neurology, the patient requires a physical exam. In psychiatry, however, touching patients risks violating boundaries, even when the physicians intent is fully ethical. Each field, on its own merit is a full complement of knowledge, he said.

I have often pointed out to psychiatrist colleagues—those given to waxing biological, that they do not do general physical examinations, neurological examinations, laboratory, x-ray or scanning diagnostics! How, then can they possibly claim to demonstrate organic, biologic, chemical abnormalities—those necessary to diagnose actual diseases. They are trained to do no such things and they do no such things. By telling their patients (and all in their lives, as well) that they have a ‘brain disease,’ a ‘chemical imbalance’ they make a ‘patient’ out of a normal human being, they pervert science, and they knowingly, and routinely, violate that individuals informed consent rights. Everything they diagnose and prescribe henceforth is predicated upon having made a ‘patient’ of a normal human being.

Sincerely,

Fred A. Baughman Jr., MD

NEUROLOGY CLAIMS PYCHIATRIC DIAGNOSES/DISORDERS = DISEASE

It is no longer possible to deny that the American Academy of Neurology, of which I am a Fellow, has become a party to the anti-scientific, anti-Hippocratic lie that psychiatric disorders/chemical imbalances are actual diseases/objective abnormalities of the brain/body.

What follows is a letter-to-the-editor of the Neurology Today, Dr. Lewis P. Rowland, formerly Chief of Neurology, the Columbia-Presbyterian, Neurological Institute, NYC, and formerly, editor-in-chief of the journal Neurology, the scientific journal of the American Academy of Neurology.

As throughout this essay and compilation, the subject matter has to do with calling psychiatric disorders diseases when they never are, and urging the marriage of neurology and psychiatry for the marketplace purpose of furthering the lie and deception of the public.

What follows is the only letter to the editor, of mine, to Neurology Today that they consented to publish.

Should Neurology and Psychiatry be Integrated? (published in Neurology Today, August, 2002 edition)

I question why Dr. Leon Eisenberg's Viewpoint, "Is it Time to Integrate Neurology and Psychiatry," was published in Neurology Today (May 2002, page 4). Psychiatrist Dr. Eisenberg argues that "imaging studies regularly reveal striking correlations between mental events and brain activity… and that “those who deal with structural abnormalities and those who deal with behavioral abnormalities are coming closer together."

Indeed, there has been a burgeoning neurobiological vocabulary in psychiatry since the advent of psychopharmacology (1950-1960), but nary a psychiatric "disease" has been validated. All talk of things "neurobiological" and about "chemical imbalances of the brain" is about selling drugs-- "chemical balancers," which become, in fact, the first and only "chemical imbalances" in the previously normal psychiatric patient's brain.

In science, if not in the practice and business of medicine, the divide between psychiatry, on the one hand, and neurology and medicine, on the other, is wholly intact. The primary duty of neurologists remains to determine whether or not organic disease of the nervous system is present, and, if so, which one. Psychiatrists have no such duty and have no biological tests to apply because there are no biological abnormalities in psychiatry to test for. Those who for financial gain portray the physically normal as abnormal/diseased to make "patients" of them to "diagnose" and "treat" should not be allowed to pervert any aspect of the scientific practice of medicine (neurology included).

Nor did it take long before Neurology Today was back on the “psychiatric diseases” bandwagon. The claims of D.R. Weinberger of the National Institute of Mental Health needed responding to, but none--mine included--were published, or, in any way, responded to. My letter:

Editor-in-Chief, Lewis P. Rowland, MD 6/26/02

Neurology Today

American Academy of Neurology 1080 Montreal Ave. St. Paul, MN 55116-2311

Re: “Imaging for psychiatric disorders is done mainly for research, not clinical purposes”-- Daniel R Weinberger, MD, Chief of the Clinical Brain Disorders Branch , NIMH.

To the Editor,

In Neuroimaging Advances Offer New Data on Stroke Detection and the Genetics of Mental Illness by Gail McBride, Neurology Today, June, 2002, p 26-28 Daniel R Weinberger, MD, Chief of the Clinical Brain Disorders Branch of the National Institute of Mental Health, stated: “At this time, the only clinical reason to do a neuroimaging study in psychiatry is to rule out a neurological disease masquerading as a psychiatric illness.” “Dr. Weinberger explained that neuroimaging in the form of MRI, fMRI, and PET has demonstrated that most major psychiatric disease—depressive disorders and schizophrenia, for example—are associated with “subtle but objectively characterizable changes” in brain structure and function. “These changes do not establish the diagnosis but do demonstrate the involvement of the brain in these disorders,” he said.

Dr. Weinberger must submit for publication in Neurology Today, references to the proof that “neuroimaging in the form of MRI, fMRI, and PET has demonstrated that most major psychiatric disease—depressive disorders and schizophrenia, for example—are associated with “subtle but objectively characterizable changes” in brain structure and function.” If he is unable to present proof of the “subtle but objectively characterizable changes” in these psychiatric conditions, the editors of should say so and print a retraction.

Sincerely,

Fred A. Baughman Jr., MD

So far (5/19/03) no proofs to support Dr. Weinberger’s claims have been published and there has been no retraction published by the authors of Neurology Today, a publication of the American Academy of Neurology, of which I am a Fellow. This is not the only evidence that the AAN is in collusion with the APA and the pharmaceutical industry in dissemination of the lie that psychiatric diagnoses/ “disorders”/ “diseases” are actual diseases of the brain. The AAN and the Child Neurology Society (most of whose members are members of the AAN) and the American Academy of Family Practice have all been involved in the formulation and dissemination of the American Academy of Pediatric’s Guidelines for the diagnosis and treatment of ADHD, which speak of ADHD as a “neurobehavioral disorder,” leaving no doubt that they were referring to it as a brain disease, while having no medical/scientific proof to support such a claim/designation, which was to be circulated to practitioners and the public everywhere.

Next, in the February, 2003 issue, Neurology Today published “Cross-Competencies for Neurology, Psychiatry.” This article continued neurology’s “validating” of psychiatry’s “invented diseases” as real and “neurological,” while paving the way for the ultimate furthering of this illusion by recombining the two specialties. To be sure, they have no science in common, only a shared controlling sponsor—Big Pharma.

My response:

Lewis P. Rowland, Editor March 20, 2003

Neurology Today

710 W. 168th Street Neurological Institute NI-14 New York, NY 10032-2603 NeuroToday@LWW.com

Re: Cross-Competencies for Neurology, Psychiatry, Neurology Today, February, 2003, p.18.

To the Editor:

It is bad enough that psychiatry has deserted science and the Hippocratic practice of medicine to portray all mental/emotional conditions as “diseases”/ “chemical imbalances” of the brain—neurological diseases--neurology should not join them, lending them credence. Neurologist Edgar Kenton sights child neurology and child psychiatry as two examples of specialties that science is bringing together. He calls it “crossing over.”

Kenton states: “ In the broad field of learning disabilities, many children have behavioral disturbances that accompany the learning disabilities. Now that we’re able to do neuroimaging with MRI, PET, and SPECT, we can identify neurological changes not only in children with learning disabilities and associated behavioral disturbances, but more and more in adults as well.” In fact, not a single learning disability or behavioral disturbance/ disorder is a proved disease with a confirming, physical abnormality, much less, one diagnosable/ confirmable with any type of brain scan. Functional correlates and illusions of disease—yes—but proven diseases—absolutely not.

Neurology and psychiatry were formally separated in 1948; neurology to deal with organic diseases of the brain; psychiatry with emotional and behavioral problems in the physically normal. Psychiatry’s pretence that it diagnosed “diseases” / “chemical imbalances” commenced with the appearance of psychiatric drugs to sell, in the sixties and seventies. Not a single psychiatric disease has “crossed over” becoming “neurological” by virtue of science having discovered an organic basis; not even schizophrenia, and surely not a schizophrenic prodrome. But all can, and many do, develop neurological diseases/syndromes once neurotoxic “treatments” are begun. The relationship of the neurologist to the psychiatrist has always been neat and clean: the neurologist was to rule out/exclude organic disease before the presumption of “no disease” and referral to a psychiatrist or any other mental health practitioner. Further, and in keeping with their separate competencies, all apparent neurological and medical problems arising in psychiatric patients, after the start of biological treatments, are appropriately referred back to neurologists and “organic” physicians for organic diagnosis—not the province psychiatrist.

Nor does the psychiatrist’s pseudo-organic/ “chemical imbalance” orientation do anything to truly prepare them to practice neurology or any other branch organic medicine.

Sincerely,

Fred A. Baughman Jr., MD, Fellow, AAN

Leaving no doubt that all of organized neurology has joined the illusion-making that makes “chemically-imbalanced” of normals, providing endless “patients” in need of “chemical balancers”—pill, read this statement from Gerald D. Fischbach, MD, Director National Institute of Neurological Disorders and Stroke, NIH:

Gerald D. Fischbach, MD, Director 01/05/00

National Institute of Neurological Disorders and Stroke NIH Clinical Center Bethesda, MD 20892.

Dear Dr. Fischbach,

In the December 22-29, 1999 issue of JAMA, you state

Neurodegeneration is a ubiquitous phenomenon that occurs in many brain diseases, not only in the classic neurodegenerative disorders such as Parkinson disease, Alzheimer disease, and amyotrophic lateral sclerosis. Neurodegenerative disorders also contribute significantly to epilepsy, multiple sclerosis and even depression.

What proof exists that depression is a phenotype, a disease or a medical syndrome having a confirmatory physical/chemical marker or abnormality. Why did you say “…and even depression” when no such proof exists?

Sincerely,

Fred A. Baughman Jr., MD

1303 Hidden Mountain Drive El Cajon, CA 92019

cc Congressman Duncan Hunter, R-San Diego

This letter is an example of the fact that organized neurology colludes with psychiatry in representing psychiatric ‘disorders’ as ‘brain diseases’. Fischbach is Director of the National Institute of Neurological Disorders and Stroke. He never answered my letter. This is yet another institute of the NIH involved in the deception that is carried out in the economic interests of the pharmaceutical industry; of selling ‘chemical balancers ’—pills, for ‘chemical imbalances.’ The Am. Acad. of Neurology, the Child Neurology Society, and all that is US neurology play a part in enabling this deception of the American people. These two organizations had input into the Clinical Practice Guideline, published in the journal PEDIATRICS in May, 2000, speaking of ADHD as a ‘neurobehavioral disorder (inferring that the brain is abnormal).

Conclusion: All physicians (psychiatrists too) go to medical school to learn the difference between things physically abnormal—diseases, and things normal—non-diseases. Next they learn how to tell one from the other in human beings--their patients. This is every physician’s primary duty to their every patient. Before treatment is begun it is every physician’s duty to disclose, openly and honestly, to their every patient,, what is wrong with them—whether or not they have a disease and which one, and, if they do not have a disease, the exact, alternative, nature of their symptoms. This is an essential part of “informed consent” and of an honest, open formulation of the risk vs. benefit equation.

For physicians to call things behavioral/emotional/psychiatric-- “diseases,” knowing they are not (see statement of Richard Harding, President, American Psychiatric Association, Family Circle Magazine, November 20, 2001) is nothing less than a heinous betrayal. Nor is it just a betrayal of their patients, it is a betrayal of the entire public, which is prepared, daily, for their victimization, which, in time, will surely come. Secondly, it is a betrayal of every truly ethical and scientific neurologist who does not succumb to this practice “strategy” out of economic necessity. It is also a betrayal of every medical student, intern and resident who is given this new revised (for economic’s sake) science that Thomas Szasz and Alvin Pam long ago, rightly called pseudo-science.

However, the word “pseudo-science” doesn’t capture the evil. Just think: 6-7 million of our very own NORMAL (until treatment begins) children said to have the wholly fraudulent “chemical imbalance”—ADHD, on addictive, dangerous, deadly “chemical balancers”—Ritalin and amphetamines. Just think, a total of 9-10 million NORMAL children, if not with ADHD with some other contrived ( with full knowledge of psychiatry, neurology and all organized medicine) “chemical imbalance” on some other “chemical balancer”—(usually on a few or several) many of them addictive, as well--all of them dangerous and brain altering. What a heinous thing to do to anyone. But to our own children—our own NORMAL children--15- 20 percent of them--with no end in sight.