Frederick Goodwin - Why the NY Times is Wrong

Hi, CtryGirl. Great comments. A few quick replies:

 

You definitely cannot read or listen or watch the news "on faith." Part of this has to do with the fact reporters are trying to pin down moving targets in the dark. The facts are constantly shifting, so is the broader context. Then there are the nuances. I greatly admire the incredible skills of journalists, who are charged with making sense out of impossibly complex and messy situations on the fly, then explaining it to the public.

 

But even the best ones do get it completely wrong at times. I mean really really wrong.

 

Then there are the biases. We all have them. You, me, everyone. There is good scientific evidence to show that our brains screen out facts that don't jibe with our beliefs, even if the facts are right and our beliefs are wrong. Likewise, our brains will accept facts that correspond with our beliefs. This applies to journalists as well as readers.

 

To see this principle in action, simply look back at past relationships, where we've all been guilty of deceiving ourselves.

 

Also, we tend to interpret facts based on our own past experience.

 

The great journalists recognize all this and do their very best to compensate, plus work very hard to inform and enlighten the public. The worst ones also recognizes this, but instead cynically pander to the biases of their audience.

 

I could go on and on, but you get the point.

 

Also, you raised a great point: The media constantly portrays us in a bad light. If they are constantly portraying us as murderers and other undesirables, well maybe we shouldn't believe them when they trash the doctors who work to improve our lives.

 

To continue this point: The NY Times has been running a series of articles that illustrate the ignorance of its reporters. They know nothing about our illness, nothing, totally nothing. But then they will uncover an example of a drug company behaving badly, a treatment gone tragically wrong, or a researcher who did something stupid. Then they will mix these "facts" with some completely unrelated facts to raise misleading innuendos.

 

In this context, the Times is as sleazy a newspaper as any supermarket tabloid.

 

So when the Times broke the Goodwin story, I knew something wasn't right in the state of Denmark.

 

Unfortunately, because it's the Times that broke the story, readers will assume it had to be true.

 

The Times recklessly and unethically smeared a good man. For this, they probably will get a Pulitizer Prize.

 

 

Nicely written piece -- and responses, John.

 

Sadly, the Gray Lady lost me somewhat with the Janet Miller fiasco. We all saw what self-described "pointy elbows" and unvarnished career opportunism did to editorial staff's judgment.

 

And, it lost me more definitively with Gardiner Harris' continued coverage of bi-polar.

 

Newsrooms are full of skeptical people -- and typically that serves the public --  but it seems they are irrationally skeptical about the possibility of their own (and other people's) mental disorders. In a profession where fast-twitch wiring is practically a prerequisite, maybe they just see conditions such as bi-polar disorder as status quo.

 

I run into the same attitudes among journalists when it comes to Attention-Deficit/Hyperactivity Disorder. Perhaps in seeking a fresh angle, they leap on the feel-good propagandists' platforms that tragically minimize the challenges of ADHD ("it's not a disorder...it's a GIFT!"), thus preventing the public not only from recognizing its tougher manifestations but knowing there are good treatments available.  What kind of big ol' control-freak Muggle meanie would medicate away Gifts???  If your boss or partner thinks you have a problem, find a new boss or partner that appreciates your gifts!

 

Thanks for bringing your reporting chops to this task, John.

 

Gina Pera, journalist-advocate

Is It You, Me, or Adult A.D.D.?

http://www.ADHDRollerCoaster.org

 

 

Hi, Gina. Absolutely, on all counts.

I am in total agreement, John. I have been absolutely shocked at the blatant biases of the New York Times' Gardiner Harris, for example, who seems to buy into the old psychoanalytic idea that these disorders don't manifest until teenage years, at least. They truly believe that babies are born with the "blank slate," and it's all environmental. The idea that a toddler could have the same bi-polar disorder-related genetic/neuroanatomical issues as an adult -- but expressed as "developmentally appropriate -- is beyond their ken.

 

As a former journalist, I'm left sickened by such reporters' blatant ignorance AND their pandering to the likes of Chuck Grassley.  They don't even dare to question that he might have less than altruistic "save the children" motives. Scientologists and politicians...strange bedfellows indeed.

 

If newspapers are dying, it's due to schlock like this as well as greedy publishers and owners.  I guess the two are related. 

Thanks, John. I absolutely agree. The NY Times and its mindless antipsychiatry style or reporting doesn't hold up under the facts. So nice to meet up with someone who sees through their BS.

Hi, Jon. Thanks for pointing me to the link. A few points:

 

The commentary on that site refers to an expert food fight re the FDA antidepressant-suicide hearing that took place in 2004. In my email Newsletter, I extensively reported on the FDA antidepressant-suicide black box warning controversy that spanned from 2003 through 2005. A lot of evidence came to light on the appalling behavior of drug companies, GSK especially, which I duly reported.

 

Long before the FDA investigation, I featured considerable commentary by David Healy MD in my Newsletter and on my website, whose studies pointed to a suicidality link in antidepressants and who has been extremely courageous in breaking ranks with his profession by pointing out how the drug companies market cooked data as science.

 

I also gave major coverage to wrongful death lawsuits against the likes of Lilly and GSK, plus studies and reports that showed how the FDA never should have approved Serzone (since taken off the market), plus why the FDA is basically a toothless watchdog, plus how failed clinical trials don't get reported, etc etc. It is not a pretty picture.

 

As expected, these expert commentators made submissions at the FDA public hearings in 2004. I featured what they said.

 

I also featured the testimony of families, whose kids either committed suicide or wound up in the criminal justice system soon after taking an antidepressant.

 

And of course, I also featured the FDA's own data, which pointed to a suicide link, which the FDA had been reluctant to further investigate until public pressure forced its hand.

 

But - the issue was - and is - extremely complicated. Many experts interpreted the same data very differently. Plus other experts presented their own findings. Plus others - including groups such as DBSA and NAMI who represent patients and family members - were very concerned that a black box suicide warning would scare off patients who could benefit from an antidepressant. I featured their submissions, as well.

 

Dr Goodwin was part of a panel that represented a group making its own submission to the FDA. As I recall, the panel focussed on the issue of suicidality. The FDA data defined suicidality very widely. Dr Goodwin and his panel argued for a much narrower definition. With a much narrower definition, the FDA's data would have come out a lot different.

 

Dr Goodwin made the same point on The Infinite Mind. Suicidality is a very emotive word, one likely to scare off many of the very people who could use an antidepressant.

 

But the issue here is not whether Dr Goodwin is right or wrong. We can debate his views and associations another time.

 

The issue is what the NY Times did to a decent man. Please: Let's keep our comments focussed on that.

 

 

 

 

 

 

Actually, I am concerned with the facts.  I do think, and I think my essay shows it, that he did not present a fair and balanced view of the SSRI/suicide controversy.  We need to ask why this was the case?  Given the conflicts (whether they were declared or not) listeners will surely wonder if this was one of the reasons for the one-sided show.  I have suggested to NPR that they redo the show with some professionals who take a more critical view.  This seems logical, but NPR will not do this. I sent my essy to NPR a long time ago and they are showing no signs of retracting the false information presented on the show. Maybe Goodwin and the other guests should come forth and correct the false statements made in the show 

Hi, Jonathan. NPR cannot redo the show, because NPR does not produce Infinite Mind. The producer, Bill Lichtenstein, has that responsibility, and he is not doing any more shows due to running out of funding.

 

Re suicidality - I don't dispute your views. In fact, I welcome them. The suicidality issue is by no means resolved. Dr Goodwin's show contributed to the debate - and he did make his points in good faith. But we do need dissenting views. Hopefully, someone with influence can round up the likes of David Healy and yourself and others and produce a rebuttal that NPR may want to air.

 

If not, I suggest a podcast.

 

Please be assured I'm interested in the topic, and I encourage you to keep posting here.

John, This is where you confuse me.  You say that there were no suicides in the trials.  In my essay I wrote about the mistatements like this in the show I point and even go so far as to reproduce tables that show there were suicides in the trials.  You also mention that I and others should do some podcasts.  But your suggestion just highlights the problem with the media. In a nutshell, "Experts" who are biased and apparently don't understand the SSRI - suicide issue get a national forum on NPR, meanwhile the facts get a podcast out in cyberspace.

 

As far as NPR doing another show, they could at least start with correcting some of the simple statements made by the guests that were just flat out wrong.

Hi Kerry. Thanks for your interest. Here's the complete statement:

 

Statement of Frederick K. Goodwin M. D. regarding the 11-21-08 New York Times article by Gardiner Harris and the follow up editorial of Nov 29

Mr. Harris’ article is filled with misstatements of fact, and incorrect implications; which also characterize the brief mention of me in the Nov 29 editorial.

Let me first note that I spent nearly an hour on the phone with Mr. Harris, and followed this up with a detailed email providing easily verifiable factual information. While he did quote a few things I said, most of the important information I provided was left out of the story.

Some of the article’s misstatements have been covered in other media reports (e.g., NPR, 11-26-08). I’ll focus on the most egregious misstatements and omissions.
First, his story implied that I am and always have been the host of The Infinite Mind. In fact, from April ‘05 through January ‘08 the producer replaced me with another psychiatrist with no ties to drug companies, while I served as guest host for shows unrelated to pharmacological treatment issues. Furthermore the show ended well before Sen. Grassley’s report or the Times story and had nothing to do with them. The show simply ran out of money.

Mr. Harris’ story also implied that I had been a speaker for Paxil, a GlaxoSmithKline product, since 2000. I never spoke for Paxil. Starting in 2001, I spoke about mood disorders and Wellbutrin (now generic) and in January ‘04 began giving talks dealing with lithium. Incidentally, I used this as an opportunity to remind psychiatrists about lithium, a forgotten drug, forgotten because it’s been generic for decades and doesn’t make enough money to justify promotion by drug companies. I referred Mr. Harris to my 2007 book (with KR Jamison) Manic Depressive Illness 2nd edition, where my dismay at the fact that many young psychiatrists don’t use lithium is clearly expressed. Later, as Lamictal joined lithium as the only other FDA approved mood stabilizer, my talks included the FDA indications for both. 

More egregious is Harris’ Paxil narrative. The article implied that I asserted on the air that “there is no credible scientific evidence linking antidepressants to violence and suicide” because of my ties to drug companies. Note he did not question the accuracy of the statement because he could not. Both I and the show’s producer (who wrote the script) stand by the scientific accuracy of what the script said. A major focus of the show was the FDA’s “black box” warning about a relationship between antidepressants and “suicidality.”  But suicidality as defined by FDA encompasses everything from suicide attempts to any “self harm,” much of the latter having no relationship whatsoever to actual suicide. The concern expressed by me and the guests that the producer had selected was that this “black box” warning might be scaring many doctors away from using these drugs when they were needed for fear of being sued (suicide being the number one reason why psychiatrists are sued). Doctors should be warned about the distressing symptoms that young patients can sometimes feel on these drugs, but many (not all) experts in the field believe that a less charged word would have been better.  I made all this clear to Mr. Harris. 

I also pointed Mr. Harris to my long-standing, easily accessible record of being quite critical about the overuse of SSRI antidepressants, especially in young people. I referred him to Manic Depressive Illness and gave him references to two recent journal articles I co-authored, all of which expressed major reservations about the overuse of SSRIs. I further pointed out that I had never spoken on behalf of Paxil. All of this information was ignored. Instead, the above quote from the show was paired with the fact that Glaxo has been accused of suppressing data. A careful reading of the article shows that these are unconnected facts, but a casual reader will be left with the impression that I was somehow involved in suppressing data on Paxil.

The article also implied that I was trying to promote Lamictal by pushing the diagnosis of bipolar disorder in kids. I pointed out to Mr. Harris that Lamictal hasn’t yet been properly studied in that age group. The show in question, as I recall, did discuss mood stabilizers that have been studied in kids, especially lithium and divalproex, both now generic drugs and no longer “promoted” by anyone. (For that matter, I also pointed out that Paxil had been generic for some time and is therefore no longer promoted.)
Finally, the article states that my involvement with pharmaceutical companies was “undisclosed.” Again, Mr. Harris simply ignored much of what I told him--that there is ample evidence in the public record disclosing my work with drug companies; it's never been a secret. It's extensively acknowledged in papers that I have published, in my book, and in all of my continuing medical education (CME) activities.

I also explained that The Infinite Mind producers were aware of my connections to pharmaceutical companies. While he did quote me in the article to this effect, he failed to cite an important, easily verifiable fact: Mr. Lichtenstein recruited another psychiatrist without any ties to industry to be the host starting in 2005, and serving through January 2008. This action was taken to deal with Mr. Lichtenstein's concern that my industry ties could become a problem for the program. Given this fact, Mr. Harris’ report that Mr. Lichtenstein knew nothing of my activities on behalf of drug companies is clearly not accurate. It is true that Mr. Lichtenstein may not have known all the details, but he was generally aware of my activities.

Sincerely,

 

Frederick K. Goodwin, MD

Hi, JFR. My two blogs on the topic and my numerous comments unequivocally show that Dr Goodwin has a long track record of publicly speaking out against reckless prescribing of antidepressants, especially to bipolar populations.

 

The NY Times failed to point this out.

 

The Infinite Mind discussed antidepressants in an entirely different context. Had Dr Goodwin or his producer expanded the context or included a dissenter on the panel we wouldn't be having this conversation now. 

 

 

 

 

 

 

 

 

So you are saying that it was an oversight on the doctor and the shows producers not to have an opposing view.

The man is a doctor. He knows about the use of SSRI's, suicidality and BP's.

Since he is a doctor, we assume he knows what he is talking about.

He knows that and the shows producers know that.

The question that needs to be asked - why put on a show with only one point of view?

 

The answer is obvious.

 

And then there are the family and friends of individuals (who were BP and on SSRIs) who had listened to the show and felt all was right with the world. Only to wake one day to discover that the individual had killed themself.

 

Will they find much comfort in your excuse "it was all just an oversight". 

 

Please listen to the tapes of his show.

 

 

 

 

 

 

 

 

Hi, JRF. You said:

 

"If you have heard the opinions that this doctor offered on his show - saying that he felt there was no proof to the fact that anti-depressants can cause bipolar with hypo-mania to commit suicide is obscene."

 

Actually, on the show, Dr Goodwin said no such thing, or anything even close to that. This forum is no place for fabrications.

 

The show focused exactly on what Dr Goodwin said it focused on: The misleading term, suicidality, which has generated a lot of public confusion. In the show, Dr Goodwin did raise the issue of adverse reactions to antidepressants, especially in young people, and proposed a better word to describe "disturbed behavior" that antidepressants may cause.

 

But he and his guests did note that in the studies the FDA relied upon to issue their black box warning, there were no suicides.

 

You may have wanted the show to be about bipolar. It was a show about clearing up public confusion over "suicidality." Dr Goodwin and his three guests were highly informative, and is definitely worth listening to. It would have been useful to have had a dissenter in the mix, but it wasn't mandatory.

 

Readers: You can listen to the show here:

http://www.lcmedia.com/mind524.htm

 

 

I came over to check out this site because I heard you were defending Dr. Goodwin and bashing Gardner Harris, who I happen to think has done terrific reporting in the MSM on mental illness, doctors on the take, pharma dirty tricks, FDA botch ups along with his peer Alex Berenson.

 

I wonder who supports this site, and look around and see NAMI, drug ads, and the like, and know I won't be here long.

 

I know too many friends from around the country who lost their spouses or children to suicide from SSRIs.  Individuals who were definitely NOT mentally ill.  One thing the black box has done has caused psychiatrists to switch children over to atypical antipsychotics for "whatever - make up a label, including the bogus pediatric bipolar disorder."  Now suicide is breaking out on the atypical side, along with diabetes and death from profound hyperglycemia and pancreatitis - all the metabolic causes that Lilly and the FDA refused to reveal.

 

I never listened to Dr. Goodwin and am glad I did not.  Though my son and the sons of friends in their twenties and thirties were killed by Zyprexa, I also almost lost my daughter, who was under the care of a HOPKINS trained psychiatrist.  He did not know why she appeared to have athetoid cerebral palsy.  A nuero. consult also didn't help.  It just happened that I turned to the page entitled lithium toxicity in his and Jamison's bipolar book.  A quick dash to the ER saved her life. So while I know nothing else about the man, and don't like what I hear, he did do me a favor, once. So thank you for that, Dr. Goodwin.  Maybe Dr. Jamison will see that the students at Hopkins will now learn the signs of lithium toxicity, even though it is a cheap generic that gets no press.

Anonymous....don't let the backdoor hit you on your way out!

 

Nobody said that medication was perfect or, certainly, that all prescribing physicians know what they are doing.  Moreover, there are some very sick people in this world...it's a sad fact of like. And not all of them can be helped by medication. We are in fact in the Stone Ages. But many people are helped, and your hyperbole doesn't elevate the discourse.

 

If your ability to critically think and process information is superceded by a website's ad for a medication or some info about NAMI, you're in desperate need of mental health treatment yourself.

Wanting the show to be about bipolar is not the point.

 

It's the use of SSRI's and the possible dangers that comes with them.

 

To me - the doctors show sounded more like an infomercial for SSRI's then anything else.

 

You have your opinions. And since you acknowledge the benefit that this doctor's has given to you it's really no use to argue this point.

 

What is important for people to understand is knowledge is the most important tool to have in dealing with mental illness. Don't make decisions based on one source.

 

Especially if the individual is reading your posts.

 

Hi, JFR. Your point that the show very much sounded like an infomercial is well-put.

 

Unfortunately, a reasoned discussion about the merits (or lack of) of the show got drowned out by the NY Times' baseless inneundos and character assassination.

 

Dr Goodwin and his guests raised a number of interesting talking points, but people should feel free to rebut these points, as well as question the associations of those making the points.

 

Certainly, any issue that affects our very lives is worth vigorous (and rigorous) debate.

 

A further point: The Infinite Mind disclosure issue first broke in a story in Slate Magazine in May. I have no reason to dispute Slate's account. In fact, I applaud their journalism. The reporters stuck to the facts. They made fair comment based on the facts. Perhaps because of this, the story generated little comment on the blogosphere.

 

The story only got hot when the Times distorted the facts and injected its own innuendos.

 

But again, concerning the show's content, you made a very valid point.

 

Slate article:

http://www.slate.com/id/2190775/pagenum/all/#page_start

Hi, JFR. Your point that the show very much sounded like an infomercial is well-put.

 

Unfortunately, a reasoned discussion about the merits (or lack of) of the show got drowned out by the NY Times' baseless inneundos and character assassination.

 

Dr Goodwin and his guests raised a number of interesting talking points, but people should feel free to rebut these points, as well as question the associations of those making the points.

 

Certainly, any issue that affects our very lives is worth vigorous (and rigorous) debate.

 

A further point: The Infinite Mind disclosure issue first broke in a story in Slate Magazine in May. I have no reason to dispute Slate's account. In fact, I applaud their journalism. The reporters stuck to the facts. They made fair comment based on the facts. Perhaps because of this, the story generated little comment on the blogosphere.

 

The story only got hot when the Times distorted the facts and injected its own innuendos.

 

But again, concerning the show's content, you made a very valid point.

 

Slate article:

http://www.slate.com/id/2190775/pagenum/all/#page_start

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To William Malo,

 

Thanks for citing doc Grohol’s comment on this very subject.

 

I posted a comment to his blog:

 

http://psychcentral.com/blog/archives/2008/12/04/dr-fred-goodwin-update/

 

Warmly,

Herb

VNSdepression.com

 

 

Disclosure: I am a very, very long-time support person and caregiver and lay-depression expert to my spouse and I receive absolutely no remuneration of any kind from any sources.

 

"As Philip Dawdy over at Furious Seasons noted today, John McManamy again came to Dr. Goodwin's defense, basically just quoting from Goodwin's letter and reinforcing whatever he says with little critical commentary or skepticism. At the end of the article, McManamy notes that Goodwin has written and will write a future blurb for McManamy's books - an important endorsement from one of the leading researchers in bipolar disorder. (Which, ironically, McManamy discloses, but completely misunderstands why it was just as important for Dr. Goodwin to disclose to his listeners a similar conflict whenever he was discussing drug treatments on his show.)"

 

It is interesting how we choose to support those who support us.

Hi, William. It's flattering that a blogger made me the object of his blog, but the issue isn't about me.

I wouldn't consider that particular quote to be complimentary.

And this thread is all about you.  You initiated this discourse -- your the expert.

However, your rally to defend this individual on merit alone is a rather dubious undertaking at best.

It's "interesting"?  In what sense?

 

When authors survive the sheer torture that is required in writing a good book, do you think those authors will then ask someone they don't respect to write a blurb? Just for the heck of it?

 

No.

 

When an author asks an expert to write a blurb, an endorsement, a foreword, etc. for his baby, that author is putting his or her reputation on the line, too. In having that expert's name on the book, the author is saying, "I respect this person, and I am proud to have this person's endorsement."

 

I'd say John is fortunate to have the support of someone like Goodwin -- and vice-versa.

 

Gina Pera, journalist-advocate

Is It You, Me, or Adult A.D.D.?

http://www.ADHDRollerCoaster.com

 

"I'd say John is fortunate to have the support of someone like Goodwin -- and vice-versa." 

 

My point -- such co-mingling often compromises objectivity.

It is all too easy to rally a defense for a lauded 'colleague' without a reasonable insight to what the individual might be fully capable of within a private sphere-- improprieties of another sort, unrelated to brilliant academic accomplishment -- a cautionary tale at best.

And you, an author advocate, which you have made clear, are raring to get in the mix, defending John, a fellow book-master in much the same manner -- noting the eloquence and professionalism of the subject (Goodwin).

This investigation is about a possible indiscretion at best, pandering to a provider, and it is in no way linked to his merit, although it could be an ugly matter to manage publicly -- if it is substantiated.

 

A caveat -- I initially entered into this discussion because I believe many of the experts' topics, this one particularly, to be of dubious importance to readers such as myself, who are looking more for bonding than politics.  I was irritated by what I perceived as an egotistical indifference to this readership -- could be wrong -- I'm sure I will hear how and why.

 

Hi, Gina. Agreed.

Hi, Dr Ghaemi. Many many thanks for your contibution. I'll check out your posts right now.