…according to a recent study. Well, maybe not. But if I said that there was a study to show that, you’d probably believe me, right? The fact is that I don’t have any idea how many Americans have an internal feeling of emptiness, but whatever the true number is, it sure as hell is not going to make the front page of the papers, unlike an article like “Bacon Found to Increase Risk of Colon Cancer by 30%”, which for a number of reasons that I won’t go into here conveys little of value to the average reader.

I have been reading a website called “Guide to Psychology” by Raymond Lloyd Richmond, Ph.D., as well books like Shame and Guilt, Masters of Disguise, and it occurs to me that there are not hundreds of emotions, only a few really, like shame, guilt, anger, fear and love, and that “my shame” is not really all that different from yours. And Dr. Richmond says that most of his clients complain of feeling like “mush” inside, which is typically the result of an inability to be honest about their feelings. And those who have feelings that they have trouble being honest about? Usually have to do with childhood and various failures of parenting, and the development of illusions that were necessary to survive in childhood but which now cause a psychic drag.

A furore has erupted following The Scientist magazine’s revelations that Phoni Pharmaceuticals paid an undisclosed sum to scientific vanity publisher Elsleazier to produce several volumes of a publication that had the look of a peer-reviewed medical journal but which contained only reprinted or summarized articles, most of which presented data favourable to Phoni products. The journal appeared to act solely as a marketing tool with no disclosure of company sponsorship.

The Australian Journal of Boneheads and Joint Medicine, which was published by Extracta Moneya, a division of Dutch scientific publishing juggernaut Greed-Elsleazier, also contained little in the way of advertisements apart from ads for Formonimax, a Phoni drug for osteoporosis, and Viletoxx, Phoni’s controversial pain-killer.

In a statement provided last week to The Scientist, an eminent Australian physician and long-time member of the World Association of Medical Editors reviewed four issues of the journal that were published from 2003-2004.

“An average reader, such as a doctor, could easily mistake the publication for a genuine peer reviewed medical journal”, he said. “Only close inspection of the journals, along with knowledge of medical journals and publishing conventions, enabled me to determine that the Journal was not, in fact, a peer reviewed medical journal, but instead a marketing publication for Phoni.”

“They’ve done a heck of good job, and it was only when I noticed that some of the names of the so-called “honorary editorial board” appeared to be made up that I became suspicious,” the reviewer admitted.

“Professor Phil. I. Daftwhoofing appears to be an anagram of “Ripping Off Fools Who Read This,” for example. Similarly, Dr. Leon Theophuleet is an anagram of “Pulled The Other One”. And “Gill Ripcheap” seems to be an anagram of Rich Pillager, who I believe is Phoni’s Head of Global Marketing…”

A spokesperson for Elsleazier, however, told The Scientist, “All of our journals are thoroughly peer-reviewed prior to publication, by our accountants. Our company would never publish a journal unless it was guaranteed to make us lots of money. After all, our publications are well-known for the standards they deliver – standards of living for our publishing executives, that is…”

Disclosure of Phoni’s funding of the journal was not mentioned anywhere in the copies of issues obtained by The Scientist. Elsleazier acknowledged that Phoni had sponsored the publication, but did not disclose the amount the drug company paid.

The spokesperson added that Elsleazier had no plans to look further into the matter. “The high prices of subscriptions to our journals are a guarantee of their quality,” he said. “After all, everyone recognises the quality of Australian scientific publications, in the same way that American diplomacy journals or Nigerian accountancy and banking magazines are regarded…”

One of the genuine members of the Australian Journal of Boneheads and Joint Medicine’s “Honorary Editorial Board,” Dr. Táké Bakhandar, a rheumatologist in Australia, said he was delighted to serve on the board, however. Dr. Bakhandar has been on Phoni’s Asian Pacific and international advisory boards since the mid 1990s, as well as the advisory boards of other pharmaceutical companies, including Pfizer and Amgen.

“You get involved in a whole bunch of things at this level,” he said, adding that he had put his name on “quite a few advertorials” for pharmaceutical companies in the past 10 years. “I’m delighted to be able to promote the life-enhancing products of the pharmaceutical industry,” Dr. Bakhandar said.

His colleague and fellow member of the Australian Journal of Boneheads and Joint Medicine’s Honorary Editorial Board, Dr. Pádme Baksheesh, agreed. “My own observations conclusively show that there is a direct relationship between the number of products I plug for pharmaceutical companies, and the degree to which my life is enhanced,” he said.

Rich Pillager, Head of Global Marketing for Phoni Pharm. Inc. was also unrepentant.

“The Australian Journal of Boneheads and Joint Medicine” is an important tool in Phoni’s CME (Continuing Medical Education) programme,” he said.

“After all, we’ve been putting out advertorials for years. Everyone remembers our series of children’s books that were designed to promote the use of Phoni’s SSRI Saloadatat in children, for example,” Pillager notes, referring to the controversial “Mr. Bipolar” book based on the UK “Mr. Men” franchise.

“Our competitors have been doing exactly the same thing, only we’re aiming our latest fairy tales at the adult market. I can’t see what the problem is,” he frothed rabidly.

[this was a spoof piece but unfortunately the quote
"You get involved in a whole bunch of things at this level,"
was real, and the fake journal was real as well]

For more of Pharma Giles work see his hilarious children’s book ‘The Story of Modern Medicine’.
[via pharmagossip and scientific misconduct blogs. Hat tip to Dan Abshear]

Head lice are a big problem, affecting 6 to 12 million people in the US every year. Head lice are becoming endemic amongst our children. Unfortunately the pharmacological treatments for head lice are not that great. Malathion (Ovide) is an organophosphate that kills lice by inhibiting the cholinesterase enzyme.

Malathion works well for lice, unfortunately it has the side effect of being highly flammable, so little children should stay away from fires, to keep their heads from catching on fire. 

The most commonly used prescribed medication for these problems is lindane (Kwell). Doctors apparently have not figured out yet that it doesn’t work and has been associated with some potential safety concerns. Efficacy of lindane has been decreasing over the past few decades to lindane due to the emergence of treatment resistant lice. Lindane has limited efficacy, killing only 17% of lice after a 3 hour period, and none after 10 minutes, the recommended time of exposure.

In other words, take Lindane as directed, and it will do NOTHING!

I think the actual tune ended with “comb” rather than “drugs” and I don’t remember what TV show that was from, maybe Happy Days or something. Anyhoo there has been developing the odd story of Timothy Kuklo, MD, a physician at the Army’s Walter Reed Medical Center who was performing research on a drug developed by Medtronic (a company he also worked for as a paid consultant) called Infuse that was designed to promote bone growth, on soldiers who had sustained bone injuries in combat in Iraq. Apparently he wrote an article based on “research” related to the drug claiming that over 90% of patients treated showed favorable results. After the article was published in a British medical journal, one of the supposed “authors” recognized it as an article that he knew nothing about. An internal investigation by the military found that four of the “authors” had had their signatures forged by Dr. Kuklo on the letter submitting the article, that the patients supposedly involved in the research could not be confirmed as having existed, and that the results appeared to have been fabricated.

I mean talk about bending over backwards to help out your pharma friends.

This isn’t the first time that Medtronic has made the sleaze bag page of the daily news. They made the bogus TENS unit which gave electrical stimulation to the back for treatment of back pain. When a study came out showing that it didn’t work, and when they figured out they couldn’t do anything to punish the researchers, they took the creative step of using their political influence to cut the budget of the federal agency that funded the research, as outlined in the book Hope or Hype (google it yourself, bitches). A couple of years ago it came out that Medtronic was providing kickbacks to surgeons for using one of their spinal devices off label, in the form of free trips and picking up the tab for “VIP services” at the Platinum Plus stripper club in Memphis (where the corporate headquarters of Medtronic are located) as well as paying for a fishing trip to Alaska complete with covering the tab for prostitutes for the surgeons.

I wonder if they have any devices to tickle MY spine?

Dr. Kuklo has since left the military and is an Associate Professor of Surgery at Washington University School of Medicine in St. Louis. And have they done anything to look into this matter? Nothing at all of course. In fact they still proudly list him on their website as one of their own, and identified as one of the “Best Doctors in America”. Now I don’t really like this institution, first of all for their bogus efforts relating to DSM, stating that ”familial” depression is ”real” and by implication other types of depression are not, but also for a radiologist who was paid several hundreds of thousands of dollars by Roche under dubious circumstances to help them fight off law suits related to their acne drug Accutane and its relationship to depression and suicide.

It all started that night in my office. There I was sitting in the dark, leaning back in my chair, my legs propped up on the desk. If there was one thing better than having a phone that never rang, it was having two phones that never rang.

The smoke from the cigarettes was floating around my head and the whiskey was tasting better with each swallow. On the radio Sinatra was crooning “I’ve Got The World On A String.” Yeah!

I hadn’t had a case in weeks and I was seriously thinking about getting a new line of work. Being a pharmaceutical litigation consultant just wasn’t paying the bills.

I like the good things in life. Like liquor, women, reading, chess and working alone. I’m educated enough to speak English if I’m required to. I used to work for the Big P, but was fired for insubordination, thus starting a cliche that still hasn’t run out of steam. But I’m all done with hating them. It’s all washed out of me. I hate pharmaceutical companies hard, but I don’t hate them very long. How many ex-marketing VPs are there out there that have become litigation consultants? Not many.

I needed a drink. I needed a lot of life insurance. I needed a vacation, I needed a home in the country. What I had was a coat, a hat and an overdraft.

So here I am in 2008. I’ve turned fifty and what do I have to show for it? A second floor office (that doubles as my abode since I was booted out of my apartment) above a two-bit saloon in downtown Peapack NJ that serves watered down drinks and has a neon sign that is driving me wacky. A ‘05 Lincoln Continental that I bought with my last pay check pay from the Big P in 2005. A black suit with two pair of pants, and a broken computer from one of the many working overs it’s taken since I became a Hard Boiled Blogger.

Yeah, I’ve got the world on a string all right…

Then came the knock at the door.

I could see through the frosted window on the door into the lighted hallway that it was a dame. And boy, what a dame! The outline of her body looked like an hourglass with a head on it.

“Come in,” I said. As she started into the room I reached for the desk lamp.

“No,” she drawls in a Mae West voice, “I prefer the dark side.”

As she walked closer to me I could see her face, lit by the flashing neon light shining through the window. She had long brown hair that hung to her shoulders. Her green eyes sparkled from the flashing light. Her full lips were covered with ruby red lipstick, smiling a smile that hit me smack in the libido. She must have greased up real good to fit into that dress.

“Are you the one they call, ‘the Doc’?” she purred, interrupting my inventory of her.

“Yeah,” I replied. I felt like that wolf in those Tex Avery cartoons, with my tongue hanging to the floor and my eyes popped out of my head a foot. “Have a seat,” I managed to say.

“No thank you, I prefer to stand. My name is Linda. But you can call me Mrs. Robinson. Tell me Doc, just what do you want most out of life?” she asked.

I was in luck. Philosophy was my long suite. “A thousand a day, plus expenses,” I told her.

Without batting an eye, she reached into her big black purse and pulled out a big wedge of smackers. She then threw it on the desk in front of me. “Ten days, in advance,” she said.

Well, here’s to you, Mrs. Robinson. I just love it when women talk dirty. And this broad spoke my language.

“So, what’s the case?” I asked.

“You are,” she said.

“Case solved,” I replied. “That’ll only cost you five thousand bucks.”

“No,” she said, “you don’t understand. My clients are a little concerned about your Chinese friend. They want you to call her off.”

I only had one Chinese-sounding friend. A little lady called Qui Tam. And I wasn’t about to sell her down the Suwannee, even for the Abe Lincoln picture collection that was lying on my desk right now.

“So just who are your clients?” I asked. I was getting wary of this dame. She was the kind who lied just to keep in practice.

“Is that any of your business?” she replied sweetly, her smile playing a rumba on my nether regions.

”I could make it my business,” I replied.

”I could make your business mine” she countered.

”Oh, you wouldn’t like it,” I told her. “The pay’s too small.”

Sure, the dame was sharp, but not sharp enough to cut the baloney. I knew I could end up making small talk all evening if I wasn’t careful. Talking to her was like trying to open a sardine can after you’d broke off the metal lip.

“So what’s a smart dame like you doing working for a bunch of crooks like the Big P?” I asked, hoping to make some headway.

She smiled. It hit me in the hip pocket. “It’s a long story and it’s not pretty,” she replied.

”I got lots of time and I’m not squeamish,” I shrugged.

Mrs Robinson sighed. My heart played hoopla in my chest. “Why do you bother with Qui Tam?” she pleaded. You know she’s no good for you.” She gestured to the greenbacks on my desk. “Why not take the money and give up on her? Why do you have to go on?”

It was a good question, and one that I’d often asked on those long lonely nights when sleep itself seems like a dream too good to be true.

“Because too many people have told me to stop,” I replied. “Trouble is, I’m a romantic at heart, see? I hear voices crying in the night and I go to see what’s the matter. I know I don’t make a dime that way. There’s no percentage in it at all. But it’s just something I do.”

It was all beginning to make sense, in a screwy sort of a way. I get dragged in and get money shoved at me. I get pushed out and get money shoved at me. Everybody pushes me in, everybody pushes me out. Nobody wants me to DO anything. Okay, put a check in the mail. I cost a lot not to do anything. I get restless. Throw in a trip to Mexico.

“I hadn’t supposed there were enough whistleblowers these days to make litigation consultancy very attractive to a man like you.” she sneered.

”I stir up trouble on the side.”

“You know, I think you’re nuts. You go barging around without a very clear idea of what you’re doing. Everybody bats you down, smacks you over the head, fills you full of stuff and you keep right on hitting between tackle and end. I don’t think you even know which SIDE you’re on.”

”I don’t know which side anybody’s on. I don’t even know who’s playing today. I had more careers than you’ve had lovers, sweetheart, and they’ve gone just the same way. Don’t try and ask me why.”

“I’m afraid I don’t like your manners.”

“Yeah, I’ve had complaints about them, but they keep getting worse. I grieve over them on long winter evenings.”

Mrs. Robinson finally turned off the megawatt smile. My libido breathed easy.

“I think we’re done talking, Doc,” she said. “I’m at the Courtyard Marriot, Basking Ridge, New Jersey, room 108. Let me know if you change your mind.”

She turned and walked out of the office. “I’ll be waiting,” she purred.

I couldn’t keep my eyes off her swaying hips as she walked towards the stairway and disappeared down the steps. The smell of her perfume lingered on after she left. I could hear the radio again now that she was gone, although it was playing the whole time she was here, Eddie Fisher was singing “I’m Walking Behind You,” and in my mind I was walking behind Mrs. Robinson.

I got up and looked out the window just in time to see her getting into a big red Caddy. Holding the door for her was the biggest guy in the world, at least 6′6″ and 400 pounds. As she was getting into the car, she glanced up at me with a look that could melt your heart.

“Tiny” also looked up at me. His stare could have melted iron. As they drove away, I couldn’t get her out of my head.

But I couldn’t give up on Qui Tam. She was all I had lived for these past two years. I had put in too much to get out. It was a matter of pride. But pride doesn’t pay the rent. I walked over to the coach and laid down. I tried to get some shut-eye but all I could do was think of Mrs. Robinson. And her client’s money.

[via Peter Rost MD blog]

Read more Pharma Giles here.

This week President Barack Obama named Thomas Frieden MD as Director of the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, and Dr. Margaret Hamburg as Director of the Food and Drug Administration (FDA) with Joshua Sharfstein MD as Deputy Director.  

NYC Mayor Michael Bloomberg and Thomas Frieden MD

Frieden is the former Public Health Commissioner for New York City, where he became famous for banning trans fat and smoking from restaurants and bars, and pushed aggressive screening for HIV. NYC has been described as a city state and likened to Florence in the Middle Ages, where you would have much more power than at the head of a federal agency like CDC. Well, anything would be better than Julie Gerberding, whose main goal in life seemed to be pleasing the father figures that were above her in the federal bureacracy.

Julie rides off into the sunset. Bye the bye, Julie...

Hamburg is a bioterrorism expert who also used to run public health in NYC. Sharfstein was director of public health in Baltimore an developed a reputation for an aggressive approach to public health.

All have a reputation for idealism and taking an active role toward public health, which will be a welcome improvement over the lame pandering to anti-science creationists and corporate interests which characterized the last eight years of the CDC , and the lack oversight and whining deference to drug companies at the FDA, all of which led to the total collapse of public trust in these agencies.

CDC SAYS DON'T DO THIS!!!

Mrs. Bremner and mine (and Mary Kelley) editorial on the famous JUPITER study (in which statin medications were used to prevent heart disease in healthy people who had an elevation of the marker of inflammation C Reactive Protein (CRP) which has been linked to heart disease risk) just came out here in the journal Circulation, in which we argue that the results of the study do not dictate that such large numbers of people should start taking statin drugs for the prevention of heart disease based on the marker of inflammation C-Reactive Protein (CRP). I mean CRP can go up with a number of things, like not exercising, or being overweight, etc. There was a response written by the lead author of JUPITER, Paul M. Ridker MD MPH which I read but cannot put online yet, which basically states that it was justified to stop the study early (which incidentally was used to hype the results of the trial) and that the apparent increase in markers of diabetes with statin treatment was not a big deal. I reprint the conclusion of our editorial here:

We believe that the treatment benefits achieved in the JUPITER trial are not large enough to advocate an expansion in the clinical indications for statins. The potential implications of this trial for a change in clinical practice are further limited by a lack of information on the long-term risks and benefits of statin therapy in predominantly healthy individuals. Unfortunately, it is unlikely that we will be able to gather these data in the future. Because sponsorship of major treatment trials is almost exclusively left to the pharmaceutical industry, it is doubtful that another trial will be carried out, with sufficient sample size and proper follow-up, to study the effects of statin treatment in such healthy individuals.

And we go on:

Perhaps the most important lesson to be learned from this trial is that extreme caution should be placed in deciding to terminate early an industry-sponsored trial, such as JUPITER. At the current status of knowledge, behavioral prevention strategies remain the best investment for the prevention of cardiovascular disease and its risk factors in predominantly healthy individuals.

In the news this week is this story about a company called qforma that creates lists of influential doctors that they of course sell to people who want to use the information for, well, whatever. In the online comments response to the story a lot of doctors flipped out and started making comments about how those weren’t the docs that they would recommend, etc. etc. Those docs totally miss the point that drug companies don’t care who the *actual* best docs are, they just want to know who are the docs are that will help them sell their drugs the most. And those are a mixture of researchers, schmoozers, and a combination thereof.

As I have written about before, sociologists know that there is a group of innovators, early adaptors, and then the “herd” that follows along (see “Diffusion of Innovations in Service Organizations” or “Disseminating Innovations in Healthcare“). It is true for farmers in Costa Rica adopting a new type of grain seed, or for psychiatrists prescribing a new brand of antipsychotic.

Although a new and superior kind of seed was introduced in 1925 it took another 10 years for all farmers to adopt it.

Doctors don’t “read” the literature and then go out there and make a decision about what they should do. They look to their “mentors” or the early innovators, in this case their professors from medical school, or their surrogates.

Human behavior dictates that a few early adopters are looked to for guidance by most

Most look to the early adopters defined as ”experts” in the medical field, who are often branded as such at national professional meetings with the support of the pharmaceutical industry, who have coined the term “key opinion leader” or KOL. They, unfortunately, are often heavily subsidized by the pharmaceutical industry.

Qform is a business, and they are not developing a list of KOLs in every city and speciality for their own amusement, or to help people find doctors. They are doing it because they can make money by selling the lists to others who can make money by identifying the KOLs. They are selling influence. To see another particularly egregious example, take a look at the company called kolonline, where they openly boast on the internet about their ability to “manage” your kol for you (their words, not mine). I couldn’t believe it either when I first saw this.

So I guess that would make kolonline... what?

From their website:

As our name implies, we are a company devoted to providing Key Opinion Leader software and Key Opinion Leader Management services for pharmaceutical, biotechnology and device companies. We have invented two (2) world-class proprietary web-based applications for managing and developing relationships with KOLs (some have described them as ‘knowledge management systems’). More importantly, because we have actual real-world experience from working in the Pharma industry we provide unparalleled service and consulting. We have held positions in medical/scientific affairs, medical science liaisons, medical education, drug information, sales training, strategic marketing, product management and field sales.

The principals in KOL, L.L.C. have deep experience in cardiology, anti-infective, pain management, diabetes, gastroenterology, urology, women’s health and central nervous system products. As such, we have developed personal relationships with many KOLs.

We are “The Key to Opinion Leader Development™”.

Sidebar reads:

We have developed a “validation tool” which provides a systematic, unbiased ranking of all the KOLs in OLms or ISCP.

We can manage your key opinion leaders (KOLs) for you

And let’s not forget their handy software, the Opinion Leader Management Service (OLms), a “web-based application with accompanying on-going services designed to help pharmaceutical and biotechnology companies:”

• Manage and develop KOLs
• Demonstrate value to their organization (ROI)
• Showcase MSL activities
• Build and Monitor KOL Development Plans, Goals and Activities

OLms provides:

• Convenient, secure, confidential, web-based access (24/7/365) to information about your KOLs, including their contact information, publications, presentations, trials, society memberships, etc (the KOL ‘Knowledge Capital’) and links their activities to your core scientific concepts
• KOL identification
• KOL validation – provides an unbiased ranking of KOLs based on predetermined criteria to ensure consistency and avoid favoritism
• Effective communication system – users can enter notes and insights
• Thousands of reports – KOL contact info, KOL Development Plan goals and activities, compliance (consulting/confidentiality agreements), MSL monthly reports, etc
• Service – we build the records of each KOL and continually update them
• Cost-effective KOL management – our pricing is reasonable and OLms is designed to demonstrate a return on your investment (ROI)

How about their demo?

As you can appreciate, for confidentiality reasons, we can not take you to any of our client sites; however we do have two (2) demonstration sites with generic, non-confidential information which will provide you an overview of the kind of information and service we provide. Because these demo sites are web-based, you and your colleagues can view from your office while we are in ours. Then, if we appear to be the “right wrench for the job”, we are happy to come to your office for a formal presentation. A demo normally takes about 30 minutes on line.

Do you think this wrench will work?

In research news this week there is a study on how vitamins decrease the benefits of exercise. Sorry about that health wise exercisers.

During exercise there is metabolism of glucose, with release of reactive oxygen molecules that cause oxidative stress, which in turn can cause tissue damage. It is this oxidative stress which is felt to contribute to aging. Since vitamins have anti-oxidant properties, you would think that taking vitamins with exercise would be a good thing. So far, so good.

In the study (see the paper here) 20 physically trained normal young men were compared to 19 untrained normal young men. Before and after a 4 week intervention of physical exercise training the men underwent measurement of insulin sensitivity (a marker of risk for diabetes and poor health) using glucose infusion rate (GIR) measurement while a hyperinsulinemic euglycemic (normal blood sugar) clamp was in place. Subjects were treated with 1000 mg/day of vitamin C and 400 IU/day of vitamin E or with no vitamins. In both trained and untrained men, in untreated (but not treated) men there was increased insulin sensitivity as measured with GIR, increased mediators of defense against reactive oxidant species (superoxide dismutases 1 and 2 and glutathione peroxidase, and other mediators of response to reactive oxygen species. The authors posited that vitamins, by destroying reactive oxygen species, interfere with the body’s natural response to the increase in reactive oxygen species seen after exercise.

I must admit to a little bit of vitamin whistleblower fatigue, having written extensively in the past both in my book (see sidebar) and this blog about vitamins not only not being useful to prevent, but actually increasing the risk of cancer and heart disease. The supposed benefit of antioxidant capacities are a marketing scam to sell stuff that doesn’t help you. And no you do not need to take a multivitman a day, unless you are suicidal. And it doesn’t matter if you don’t eat enought fruits and vegetables. And yes I have heard the argument that manufactured vitamins, or the doses used in the studies, are not the real thing. So eat some vegetables.

Hat tip to CDC mole.

A story that has been coming out recently by dribs and drabs is the role that psychiatrists and psychologists have played a role in the development of torture techniques by the U.S. military. Now right away this raises a red flag as physicians are trained to help people and have taken the Hippocratic Oath to above all do now harm. Developing torture techniques is in no way consistent with the mission of the healing professions, which is why the American Medical Association and the American Psychiatric Association have come out against the involvement of professionals in the development of torture. The American Psychological Association (APA), however, has been more sanguine. In a May, 2007 statement, the APA said having psychologists consult with interrogation teams helps keep the interrogations “safe and ethical.”

It is consistent with the APA Code of Ethics for psychologists to serve in consultative roles to interrogation- or information-gathering processes for national security-related purposes. While engaging in such consultative and advisory roles entails a delicate balance of ethical considerations, doing so puts psychologists in a unique position to assist in ensuring that such processes are safe and ethical for all participants

Bolding is mine. “Safe and ethical”?? How can torture ever be ethical? Perhaps because the did not take the Hippocratic Oath, the military has found psychologists to be more malleable than psychiatrists. And the APA still has not come out in opposition to the involvement of psychologists in the development of torture.

Psychologists were involved in the development of Survival, Evasion, Resistance, and Escape (SERE) training at Fort Bragg Army Base in North Carolina and Fairchild Air Force Base Survival Training School in Spokane, WA. SERE training was developed as a way to train military personnel to resist capture or withstand interrogation if captured by foreign armies that did not follow Geneva Convention rules regarding torture. SERE training is hard enough to justify on its own, with no proven efficacy, it is a sadistic and humiliating practice that involves, waterboarding, prolonged isolation, psychological abuse, sexual humiliation, and exploitation of phobias.

Sound familiar?

If so that is probably because these techniques were “reverse engineered” to be used at Guantanamo Bay and later in Iraq.

In July 2005 an article in The New Yorker and more recently an article in the Washington Post described how the military used SERE psychiatrists and psychologists for advice on how to interrogate terrorists in the aftermath of 9/11. They were non-treating clinicians called Behavioral Science Consulting Teams, or BISCUITS. They were using their knowledge of psychology to not treat people with mental conditions, but to coerce prisoners. 

An article in the Spokane WA newspaper The Spokesman Review outlines how local Spokane area psychologists James E. Mitchell and John Bruce Jessen were key developers of the interrogation program used by the military. A local blog in the Spokane area describes in detail the history of how psychologists from the Behavioral Sciences Consulting Team (BSCT) of the military became involved in developing torture techniques like waterboarding (see a video of the technique here if you aren’t sure that is torture for use by the military. Later they trained military personnel in these techniques and even participated in interrogations in Iraq. Military psychologists also drafted memos stating that the SERE techniques which were being applied to prisoner interrogations did not cause physical or emotional harm, in spite of a well documented literature showing that SERE training is asssociated with extreme stress responses. This was while lawyers were drafting memos stating that it wasn’t illegal because, I guess, the prisoners weren’t human or something.

In case it isn’t clear, here is the United Nations Convention on Torture’s definition of torture:

torture means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind

The U.S. was a signatory on the UN Convention and the Geneva Accords. These state that individuals should be prosecuted in their countries for committing torture, even if their own country said that it was A-OK.

Another area I have been uncomfortable with is the use of psychological research to promote resilience. Some psychiatrists and psychologists (including a former spammer on my post “DSM Shadow Team Strikes Back in PTSD Wars“) have conducted research to measure biological correlates of what confers resilience to the abusive techniques at SERE, ostensibly with the goal of helping the military make their soldiers more resilient. The last time I saw that particular researcher, I… didn’t see him. He was supposed to be at a conference we both were speaking in and he never showed up, or called, or anything.