1968…

Posted on Saturday 17 November 2012

In The Creation of Psychopharmacology, Dr. David Healy describes an interesting historical landmark – 1968. If you were alive in 1968, you remember that year like it was yesterday – the TET Offensive in Viet Nam, the Civil Rights Act, the MLK and RFK assasinations, the riots at the Democratic Convention in Chicago, the tanks rolling into Prague ending the Prague Spring, President Nixon’s election, and then spending your holidays watching the Astronauts orbiting on the far side of the moon. If something could possibly change, it changed in 1968. Psychiatry even got into the game, releasing the DSM-II – the version with the psychodynamic descriptions of the neuroses.
But that’s not the landmark Dr. Healy was talking about:
It was simultaneously the year of the DSM-II, the beginning of the antipsychiatry movement and a change in the theoretical leanings inside of psychiatry,  and the start of a hiatus in the introduction of any major drugs – a dry spell that lasted for two decades.

I’m not postulating anything mysterious like synchronicity, maybe something more like the adage, "history repeats itself," but it sure sounds a lot like our ever-so-recent history. We’re about to have us a controversial DSM released. The field is still reeling from the scandals and a year of record setting suits against the pharmaceutical industry. The Sunshine Act and ProPublica are targeting Conflict of Interest. The pharmaceutical industry has abandoned CNS drug development en masses, closing its labs. And the move for reform of the Clinical Trial process is accelerating [the TEST ACT, the BMJ, the Cochrane group, etc]. We are at the beginning of an end, or perhaps the end of a beginning – very like the state of play in 1968. And like that era with Managed Care cutting its teeth, we have ObamaCare tossed into the mix.

While there had been a lot that bothered me in psychiatry along the way during my time in grade, I stayed out of the business of the specialty itself – occupying myself with my own work with patients and the literature that pertained. But after retiring, the public disgraces in academic psychiatry and the surprising corruption of our scientific literature [and practices] grabbed my attention, and I joined the growing throng of public complaint. But over this last year, like many, I’m feeling the winds of change beginning to gust. I wasn’t around for the 1968 version, at least not in psychiatry, only its aftermath. And this time around, the only thing I know for sure is that the time we’re in right now won’t just be a sentence or two in some future history book. It’ll have its own chapter…

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