“Could I start again, I would still choose psychiatry. Even its confused and illogical theories would not deter me. We cannot do any better yet. Psychiatry faces the most complex puzzle of life: how the human mind works.”
– Dr David S. Bell, Welcome to the Loony Bin
“It should be mandatory reading for medical and legal practitioners.”
– Ian Freckelton QC (2015)
Thomas Kuhn (1970) arrived at his concept of the paradigm from his interest in the history of science. Because science is so well documented in objective form, it provides the ideal resource for study of the way a group advances the thought of its members. They may believe they have discerned the truth, but in…
Pill pushing has inevitability in the best of all possible worlds. It brings good and bad. It reflects the free enterprise that built the modern world. The bonanza of effective medication that capitalism produced seen besides the insignificant output of communist Russia and its satellites gives some measure of its effectiveness. Besides drugs that have…
Humans succeed so well at using causes to achieve desired effects that David Hume’s assertion in 1739 still seems preposterous. He held that we cannot know the connection between cause and effect. We overlook the way we gain what knowledge we have. Success at particular efforts does not bring with it the knowledge of the…
No other branch of medicine generates so many critics from within its ranks. The devotion of psychiatrists to their craft impels them. They wrestle daily with its failings or wince as they cope with those of their colleagues. They address our most complex organ with our weakest tools of reason. Diagnosis has no practical value unless…
We feel the masters of our thoughts. We have no awareness of the automatic processing that makes perception meaningful and thought possible. Nor does self-awareness bring home how much our ideas come from others. We use the knowledge and skills acquired by ancestors over millennia. Drummed into our heads from infancy, the ideas of our…
To become effective, psychiatry has to give away descriptive diagnosis (see Elephantanopia series). It has to find causes. Far easier said than done. The causes of mental disorder are more elusive than those of physical illness. The March 2012 issue of the British Journal of Psychiatry touches on some complexities that make the task so…
As dubious benefits, undesirable effects and high costs dampen the enthusiasm for psychotropic drugs, psychiatrists return to psychotherapy, discovering anew the power of the mind to deal with its own disorders. Altered attitudes can redirect seemingly intractable thought. In the new millennium psychiatrists and psychologists repack old methods in new packages. Rather like meditation, mindfulness…
Asked his recipe for long life, my wife’s father would respond “Keep breathing.” He kept to his advice into his tenth decade. But even the best things in life taken to excess brings their penalties. Overbreathing brings about the greatest degree of avoidable distress and unnecessary complaint in modern communities. Overbreathing can evoke complaints that…
We are the creatures of our times, and they are a’changing. The first turning of the saeculum (see the group mind) following World War II generated a wave of drug addiction. In those halcyon days throughout the western world a multitude, not just addicts, took to psychedelics and stimulants with a messianic fervour, mixing them…
The Ancient Greeks made great strides in knowledge using mind exercises alone. The analysis of the irreducible units of matter brought Democritus to a remarkably modern understanding of atoms and energy. Aristotle sought the atom, so to speak, of thought. He called it class, which he defined as a collection of objects possessing common attributes. Despite concerns…
The brain conserves its resources by consigning the great bulk of its routine operations to automatic processing beyond conscious awareness. The automatic use of preset responses makes the brain action relatively effortless. The brain reserves most of its neuronal activity for the resource-greedy serial processing of consciously directed thought. Our language recognises the resemblance of the…
The most serious criticism I have of the President, who declared a war on drugs, is that he gave a gratuitous opening to those, who with equally asinine simplicity, assert it a failure. Restrained by wiser counsel, perhaps reflecting on a long tradition of similar endeavour, the religious leaders of the world do not declare…
The natural concern of doctors for those who suffer has its downside. When they cannot distinguish fake from fact or self-defeating from resolvable conduct, empathy governs their reason. Objective criteria should guide diagnosis. Doctors (and judges for that matter) distinguish exaggerated, imagined and false complaint from the genuine at no better than chance level. We…
Schizophrenia produces the epitome of madness. It generates wild ideas of contact with the metaphysical and supernatural, compelling hallucinations and utter strangeness, which made it seem to pre-modern societies divine or satanic possession. It deranges meme production (see “The Atoms of Thought“) and their creative source, language (see “The Split Mind” in Chap.2 of “Welcome…
Thomas Kuhn (1970) arrived at his concept of the paradigm from his interest in the history of science. Because science is so well documented in objective form, it provides the ideal resource for study of the way a group advances the thought of its members. They may believe they have discerned the truth, but in…
Our minds pose a mystery. We perceive what goes on around us very well. In striking contrast to that magnificent awareness we perceive nothing of how our brains manage it. Electrical recording demonstrates that we have no awareness of the considerable brain action that brings it to consciousness. Zoltan Torey calls it the experiential riddle…
All animal life achieves centrally organised awareness. Each species specialises during evolution in some way to perceive better its environment. Birds excel at vision and dogs at smell. The vulture manages both. Humans turned inwards to achieve self-awareness. Zoltan Torey (link here) explains its linkage to language, that other unique human ability. The capacity for language…
Psychiatrists bemoan the deficiencies of their diagnostic labels while ignoring the cause, they use the wrong method, descriptive diagnosis (see Psychiatry). It identifies the symptoms that occur together as implying that they have a common cause. The reasoning survives because most people hold to this basic error. They defy the logic that effects do not…
In the opening editorial of its bicentennial volume, the British Journal of Psychiatry plainly sighted the elephant in the room in terms that left no doubt it had always been there. In discussing psychiatry’s failings the author blamed the descriptive approach for diagnoses, “which almost certainly do not map simply onto underlying brain function and…
As we blog on, the British Journal of Psychiatry redeems itself. Its second issue for 2012 provides in editorial and original research papers a peek into a future that puts aside descriptive diagnosis for solutions that connect mental states to causes. The first general population study of the most readily evident cause of mental disorder,…
I put aside for the time being major horrors such as Nazi Germany or English soccer crowds on the rampage to begin with a minor example of errant group mind. In my home town in November 2012 the local newspaper brought to attention that one of its university colleges subjects its new members to humiliating initiation…
Ten years ago Robert Whitaker lambasted psychiatry in a best seller of the year, “Mad in America”. He reviewed a history of chaining lunatics, lobotomies, sterilisation and the Nazi solution of eugenics. He brought the sorry tale to its culmination in the current “story fashioned by drug companies” (p.158), which leads psychiatrists to find “the image of…
In 1954 the first antipsychotic drug, chlorpromazine, appeared. It calmed the acutely disturbed psychotic patient remarkably well. In the decade that followed chemists produced variations, which did much the same, but all had side-effects. They induce a dullness of mind and sleepiness that some dislike so much they prefer to remain mentally ill. All dislike…
A mountain of anomalies and a canyon of pitfalls have not dissuaded psychiatrists from taking the descriptive approach to diagnosis. They simply ignore them. Others see promise of advance in more of the same approach. They propose dimensional measures of the symptoms. They compound the error of backward reasoning. Again major depressive disorder says it…
I learned psychiatry in a mental hospital, which had its spectacular moments of irrational chaos, but the loony bin I analyse in my book, “Welcome”, is this world that contains us all. As a psychiatrist I had no difficulty recognising the insanity of mental illness. Nor would you, whatever your experience. But have you reflected on the…
The simplest view of mental disorder divides it in three: “mad, sad or bad”. The mad have psychoses that disable. Fortunately, only a few go mad. Many more suffer. Here belong the depressed, the anxious and the obsessive, in most cases enduring the sad interludes that net everybody in a lifetime. The bad make others…
The vagaries of demand, particularly the amount of effort needed for self-initiated thought, explain the human weaknesses that Hitler mocked and exploited (see Self-awareness). Daniel Kahnemann (2011) in his book “Thinking, Fast and Slow” analyses the dualistic processing he terms “System 1” (automatically produced thought) and “System 2” (analytic serial processing). They represent two alternative…
The ready availability of automatic brain action explains the blindness and stupidity of the masses that Hitler exploited (see self-awareness). Most daily brain action proceeds automatically to foregone conclusions. All animals manage the massive sensory input economically with automatic integration at an unconscious level to arrive at conscious perception. Similarly, all brains transform the conscious…
By declaring that I think, therefore I am, Descartes recognised a key element of human brain action, its remarkable capacity for self-awareness, a subtle component of human consciousness that received little attention until recently. Zoltan Torey (2009) argues that it accompanied the evolution of that other key superiority of human brain action, language. Because language is…
A form of dualism, the bipolar opposites of consciously directable mental function versus the brain’s unconscious automatic operations, governs brain action (see Descartes). ‘I think, therefore I am” gives consciously directed thought deserved preeminence. The many different ways that brains bring to awareness thought and action differentiates animal life. Most species have concentrated on a specific range…
In this blog the Resource entitled Simulation of Illness addresses the most common hazard to diagnosis, the faking of complaint. In hysteria and malingering the simulation of complaints give the false impression of illness. A succesful fake brings gain. The malingerer fakes deliberately, but in a manner that usually makes detection impossible. If detected, the gain sought…
René Descartes captured the essence of human life with cogito, ergo sum (I think, therefore I am). Still 400 years later it remains a gritty summary of the mental action that distinguishes the human. It epitomises the level of self-awareness that gave homo the apprehension and yearning for knowledge of existence beyond the self. Before…
Long after Ivan Illich (1977) denounced professional expansionism it continues unchecked. Governments struggle to contain the prohibitive cost of health services, but do nothing about its most blatant waste, the recurrent epidemics of pseudo-illness. Illich invented the term iatrogenesis, doctor-generated complaint. In its most expensive form and in different disguises it sweeps across communities in epidemics…
Dr David Samuel Bell passed away peacefully on 2 April 2025 at the age of 94.
This website serves as the official archive of Dr David Samuel Bell’s writings, ideas and educational resources. It is maintained by his family to preserve his legacy and ensure that his work remains available to future generations of clinicians, legal professionals, researchers and members of the public interested in psychiatry, forensic science and the law.
His autobiographical book, Welcome to the Loony Bin: 55 Years Inside Psychiatry and the Law, remains available through this website.
