SIX-TO-ONE GETS THE JOB DONE: COMMENTS ON THE REVIEWS

Behavior and Social Issues, Fall 2006 by Wyatt, W Joseph, Midkiff, Donna M

We are pleased to note that six of the seven responses to our article were marked by approval, and/or thoughtful contemplation, regarding our central theses-that the research said to support biological causation of mental disorders is relatively weak, and that the claims of drug effectiveness are often overstated.

Richard F. Rakos (2006) put forth an interesting hypothesis-a belief in agency (free will) may be genetically determined because it has survival value. A sense of autonomy may function as a powerful primary reinforcer. As Rakos put it, this belief seems unshaken by logic or evidence, an observation with which it is difficult to disagree.

On reflection, however, one must account for the fact that humans are quite often eager to abandon agency, such as when they engage in inappropriate, illegal, unethical or otherwise maladaptive behavior. On such occasions humans are often quick to blame external factors ("The dog ate my homework"), rather than themselves. Perhaps what is born into us is a gene for adoption of any position that is self-serving.

Rakos has thoughtfully analyzed the human tendency to attribute free will in doses that correspond to functional level. The developmentally disabled are seen as more appropriate targets for behavioral techniques because they are seen as possessing less free will than those who function at a higher level.

Rakos takes note of the powerful influence of the pharmaceutical industry and asks what is to become of behavior analysis in a society that is moving closer to Brave New World than to Waiden Two. He suggests that the nonscientific manner in which syndromes are selected for inclusion in the DSM is not widely known, and adds that now may be a good time for behavior analysts to work toward a new system of diagnostic classification based upon functionally-defined problems. We agree, but remain somewhat pessimistic due to the enormous power of the psychiatry and pharmaceutical industries that likely will strongly resist such a move. At any rate Rakos recognizes that we have presented, "...compelling reasons for behavior analysts to incorporate political activity into our role definition."

Kurt Salzinger (2006) eloquently describes the state hospital of years gone by. We both have worked full-time in a state hospital-the first author as far back as the 1970s. Indeed, many changes have taken place. Like Rakos, Salzinger puts forth an interesting hypothesis-in this case about a possible inborn disposition of schizophrenics to respond to stimuli preponderantly in the immediate environment, to the exclusion of stimuli that are more removed. We see no reason why that could not be the case, and the hypothesis awaits confirmation. We tend to disagree, however, with Professor Salzinger's assertion that evidence for the biological model is much more compelling today than it has been in the past. He cites the genome project and the, "...possibility of real breakthroughs..." Certainly the possibility is there, but up to now the breakthroughs appear to be less the products of the scientific enterprise than the culmination of the economic interests of the medical and pharmaceutical industries.

It is suggested by Salzinger that we should view the biological model as a friend that will make our procedures more powerful. Upon reading that we were put in mind of Skinner's frequently stated desire to see behavior analysis become a part of the science of biology-a thoroughly natural science. In that context we agree wholeheartedly with Salzinger.

Christopher G. Mitchell (2006) felt challenged to review the acceptance of biological causation that he had acquired over the years. Thus, we have succeeded in one of our goals. We have created a dialogue. Interestingly, in contrast to Professor Rakos who considers that the biological model imbues the individual with a heightened sense of autonomy, Dr. Mitchell holds the opposite view, that the biological model disempowers patients in their efforts to change. We lean toward Mitchell's position, but recognize the intriguing and thoughtful discussion made by Rakos, as well.

Mitchell focused at some length on the adverse side effects of psychotropic medications. Indeed, these are significant, and at times underplayed in drug company advertisements. We agree with Mitchell's conclusion that vast sums of money and battles for territorial dominance leave our patients with the most to lose.

Judy Blumenthal (2006) nicely reviews the historic efforts to understand behavior, including supernatural "explanations." This is refreshing. We find it a healthy exercise when, upon learning of some new causal hypothesis, to ask whether it is substantially different from the witchcraft, zombies or multiple personalities to which Blumenthal pointed. Too often the answer is no, although slick drug company advertisements, as well as organized psychiatry's position statements, frequently possess the language and trappings of science and, as a result, have accrued greater face validity than have explanations which invoke witches and zombies.