Mosher vs. Goodwin

We recommend the article in the October 1999 issue of Psychology Today by renowned psychiatrist Loren Mosher, in which Dr Mosher explains why he resigned from the American Psychiatric Association. Dr Mosher will be a keynote speaker at the annual NARPA Rights Conference, to be held in Louisville, KY, November 18-21, 1999.

PSYCHOLOGY TODAY provided several psychiatrists "rebuttal" space following the article. Dr. Mosher has responded to the "rebuttal" of former NIMH chief Frederick K. Goodwin, M.D. Here is Dr. Mosher's reply to Fred Goodwin, former chief of NIMH.

Loren R. Mosher, M.D.
2616 Angell Ave.
San Diego, CA. 92122

7 Sept. 1999

Frederick K. Goodwin, M.D., Dept. of Psychiatry
George Washington University Medical Center
2150 Pennsylvania Ave., 8th floor
Washington, D.C. 20037

Dear Fred:

Thank you for taking the time to write a rebuttal to my article in Sept./Oct. issue of Psychology Today. The content of your response was,of course, completely predictable. I have no quarrel with the free expression of differing points of view. Unfortunately, however, it contains four errors of fact that I can not let you purvey to an unsuspecting readership without correction.

  1. In the second paragraph you assert that I am arguing, in general,that itis "a choice between medications and psychological treatment" and then go on to cite my description of the methods used in the Soteria Project in supportof this false dichotomization. As is clear from the next paragraph you have no understanding of the nature of that experiment. My position about medications has been very consistent over many years: They do "work", but atwhat price in terms of unwanted effects and serious short and long term toxicities? They have also had the effect of relegating all psychosocial treatments for disturbed and disturbing persons to an adjunctive role. This is good to be sure psychiatrists maintain their power but at the same time it prevents us from learning what a pure psychological treatment can do.
  2. The third paragraph reveals either a remarkable level of ignorance or arrogance. Had you exercised the intellectual integrity I expect from someone of your stature you would have read at least one of the 38 publications from the Soteria Project. Had you done so you would know that it was an NIMH funded two year follow-up, random assignment, treatment study of persons newly identified as having schizophrenia -- not "simply an interesting description". I know that scientific invalidation is ac ommonly used technique for disregarding results that are not in keeping with the prevailing zeitgeist. This is a blatant use of it.
  3. In the fourth paragraph on page 42 you assert that the neuroleptics were responsible for the emptying out of mental hospitals. Again, a modicum of scholarship on your part would reality test this not uncommon delusion among biopsychiatrists like yourself. It has been shown time and time again that it is administrative policy that controls the census of mental hospitals. To edify you just a bit: In the U.S most deinstitutionalization occurred after1972, as a consequence of the availability of SSI, long after the anti-psychotic drugs were used universally in state hospitals.
  4. In the same paragraph you say that because of these medications "only the tiniest fraction of the mentally ill require involuntary hospitalization". This may be true in the ivory tower where you work but out in the trenches it just doesn't wash. For example: In the San Diego public system 65% of adults and 85% of youth are admitted to hospital involuntarily. I do not believe this county is an aberration-certainly not in California. This may constitute a tiny fraction to you but maybe you and I took different statistics courses. Because you and I have been colleagues for so long it saddens me that you no longer seem to be concerned about truth. It also frightens me because of your power and prestige. Who are relatively powerless patients to trust? It appears you are a good example of the kind of psychiatrist that embodies what the APA stands for-and resulted in my resignation. Since your Psychology Today response contains so many examples of your ignorance I must presume you have not read my original letter of resignation from APA. I am enclosing a copy FYI.


Loren R. Mosher M.D.
Director, Soteria Associates
Clinical Professor of Psychiatry, UCSD
Adjunct Professor of Psychiatry, USUHS
Cc: Dr. Hyman

P.S. What is your annual income from various drug company fees, lectureships, honoraria and consultations?

Thanks to Support Coalition International, which forwarded this letter.