Who is the Real Dr. Peter Breggin, "The Conscience of Psychiatry"?

how mental health conspiracy theories cozy up to the mainstream

Dr. Breggin testifies in court, Getty Images, 2017

Dr. Peter Breggin is one of most prominent and influential voices in the modern anti-psychiatry movement, and indeed in American understanding of psychology writ large. More than any other figure, he’s been the ideas man for anti-psychiatry in the 21st-century, following the retirement and 2012 death of Thomas Szasz. Szasz, the libertarian extremist philosopher and author of The Myth of Mental Illness (which functions as something like the bible of the movement), dealt with mental illness as an abstraction, but Breggin’s role as a practicing psychiatrist has lent his opinions considerable heft in the relevant communities. When researching anti-psychiatric ideas and looking for evidence for its many extravagant claims, your trail will lead you to Breggin again and again. I cannot tell you how many times people have sent me his articles or videos, advising me to stop taking my medication, since my mental illness became public. For many, he appears to add the intellectual backing for what are often inchoate and scattered feelings of anger and resentment towards the medical establishment. As far back as 2000, Frontline stated that Breggin’s work “reaches the households of millions of people.”

The anti-psychiatry world is large and amorphous, but its vague boundaries have actually strengthened it. As much as any political tendency I can recall, the anti-psychiatry movement has avoided easy categorization into left or right, drawing adherents from all across the political spectrum, particularly the crunchy environmentalist left and the anti-establishment paranoid right. This kind of cross-ideological potential is rare in a country gripped by culture war. In official medical circles, anti-psychiatry ideas remain fringe, and yet those ideas have had remarkable penetration into popular consciousness. Decades of hippie movement-inflected anti-psychiatric messaging, such as in Ken Kesey’s book One Flew Over the Cuckoo’s Nest and its film adaptation, have created a reflexive skepticism about psychiatry in American culture, which draws strength from the fact that psychiatric medicine remains deeply imperfect thanks to our continuing ignorance about how the brain functions. Perfectly mainstream publications like The New York Times Magazine run pieces that are quite radical in their rejection of modern psychiatry, and there are large online communities that cater to this impulse, like the fringe website Mad in America. Anti-psychiatry writ large is an influential space that intersects with all manner of “holistic” approaches to medicine and alternative viewpoints on public health, such as the anti-fluoride and anti-GMO worlds.

Breggin is a major celebrity to many people in those spaces. He has impressive conventional medical credentials, having been trained in medicine at Case Western Reserve medical school, served as a teaching fellow at Harvard, and held a prestigious appointment at the National Institutes of Mental Health. He has enjoyed an unusual degree of crossover appeal in both academic and popular circles. He’s published dozens of academic articles, including in prestigious venues like The Archives of General Psychiatry (the precursor to JAMA Psychiatry) as well as JAMA itself and Science. To this he’s added voluminous output in mainstream publications like The Huffington Post, and he’s the author of more than twenty books. He’s been quoted in prominent newspapers and magazines many times. He has provided expert testimony for the Food & Drug Administration and for other federal agencies. He’s presented for the likes of the US House of Representatives Veterans Affairs Committee and Committee on Education, the American Psychiatric Association, the Harvard University School of Education, the Georgetown University School of Medicine, the Walter Reed Army Hospital Psychiatric Residency Program, the National Naval Medical Center, the Florida Public Defenders Association, and many others, including multiple presentations for the National Institutes of Health and the National Institutes of Mental Health. Dr. Breggin has appeared on 60 Minutes, The Oprah Winfrey Show, Good Morning America, Larry King Live, and 20/20. He was the subject of a soft-focus biography called The Conscience of Psychiatry, featuring supportive contributions from science writer John Horgan and media bigwig Ariana Huffington, as well as a documentary by the same name.

He’s also a conspiracy theorist loon and highly-influential anti-vaxxer, a man who has spoken darkly about CIA-developed brain control microchips and sees the hand of pharma companies and DARPA in all human affairs. He has claimed that the drive for mass Covid-19 vaccination was the product of a conspiracy that involved, somehow, both Bill Gates and the Chinese communist party, among others. He and his wife’s 2021 book COVID-19 and the Global Predators: We Are the Prey has quietly become one of the more commonly-cited texts by the international anti-vaccine movement, despite being published when the vaccine rollout was less than a year old. He argues that vaccines are an “insidious gateway to transhumanism and human control,” as well as a Trojan horse for using nanotechnology to enforce government domination. He has been an outspoken critic of the so-called climate change agenda, claiming that “global warming alarmists are liars and cheats.” He strongly suggested that the horrific Maui fires of last year were planned by some sinister entity, and speculated that “directed energy weapons” may have been to blame. His work is full of vague, paranoiac references to “globalists” and dark muttering about how the United Nations seeks to dominate us all. He has argued that Nidal Malik Hasan, the Fort Hood mass shooter, could have been stopped but was not because the military was afraid to run afoul of political correctness. Breggin is an opponent of universal health coverage, as such - not just a particular expression of such coverage, like Medicare for All, but for the concept of universal health care writ large. He believes that universal access to medical care will necessarily lead to coerced abortions and widespread euthanasia and that the push for universal health coverage is a front for global domination and one-world government.

Here’s a good encapsulation of Breggin’s philosophy, an essay that posits that the American and Chinese governments are working “to utterly crush individualism and personal freedom, and… seek to replace Western civilization and its freedoms with a totalitarian Global Empire.” The various claims he makes amount to a laundry list of contemporary American conspiracy theories.

These fringe views are made more disturbing by how much Breggin’s thinking has penetrated into mainstream spaces, including spaces that matter. It’s in the courtroom that Breggin has perhaps been most influential. He has served as an expert witness many, many times, and frequently brags as such. Usually he testifies in cases against pharmaceutical companies or medical providers, but he has also participated in legal proceedings where mental illness might be an exculpatory factor, such as when he testified in the notorious case of Michelle Carter, who was charged with manslaughter for encouraging a friend to commit suicide. There’s no way to know how much exactly Breggin might have been paid for these services over the years, but expert witnesses typically charge four-or-five figure retainers in addition to extravagant hourly fees, and they can make even more than the usual when a defendant is a deep-pocketed entity like a pharma company. Though other experts have long complained that Breggin is unqualified and misrepresents the available evidence, he expresses himself with total confidence and has a religious zeal when it comes to his pet topics, which are likely very compelling attributes in a courtroom. Because of the sheer volume of his work as an expert witness - his website suggests that he has testified in more than a hundred cases and also cautions that many are not listed due to being settled on condition of secrecy - he is likely one of the most influential psychiatrists in the United States, despite not working for any hospital or holding any governmental or academic professional appointments.

The heart of Breggin’s position is simple: all psychiatric drugs are necessarily damaging and do nothing to address underlying psychological issues. He is very close to opposed to the use of such drugs in literally all cases; though he occasionally makes rhetorical points that suggest that there could be some potential scenario in which he would support the limited and brief use of a psychiatric drug, I cannot recall him ever advocating for such use in any actual or hypothetical scenario, and I have watched dozens of hours of his talks and interviews. Breggin believes that all psychiatric medications are neurotoxic, and further disputes that they can effectively treat any medical condition. These claims are certainly tendentious - though the efficacy of SSRIs has been controversial for decades, they likely provide some relief, and the efficacy of stimulants for providing focus or neuroleptics for reducing psychosis has been established for decades. Breggin engages in a lot of mystification of the question of drug effectiveness. For example, he constantly claims that any seeming therapeutic benefits of antipsychotics really only amount to sedation. Subjectively I can tell you that this simply isn’t true; I’ve been both sedated while psychotic and treated with injectable antipsychotics like Haldol and Geodon while psychotic, and the latter absolutely reduced my paranoia and delusions in a way that simple sedation did not. More importantly, the scientific evidence agrees. I also think this demonstrates the fundamental extremity of the anti-psychiatry tendency - there is no space for “these drugs are, on balance, not worth the side effects,” only the denial of any positive benefit whatsoever. I can promise you, after a decade of fighting with these people, that there is no moderate wing of the movement. There can be calls for reform from outside of it, and reform is often necessary in any medical field. But anti-psychiatry types want not reform but revolution, and Breggin is a perfect avatar of its extremism and lack of caution.

You can see this disdain for being careful in Breggin’s relentless, speculative assertions that famous crimes are really the fault of psychiatric treatment. As is also common practice in vaccine debates, there is a constant assumption of “post hoc, ergo propter hoc.” Because someone took the vaccine before they died, they must have died because of the vaccine; because a given crime or tragedy may have followed the use of psychiatric medicine, it must have happened because of psychiatric medicine. In 2002, Breggin testified that antidepressants most likely caused Eric Harris to commit the Columbine massacre, a truly inflammatory bit of speculation, especially given that Harris had shown psychopathic tendencies long before he was ever prescribed any psychiatric medication. Breggin says that the 2000s anthrax mailings were due to antidepressants, as was the 2008 murder of the chairman of the Arkansas Democratic Party. The late 2000s surge in military suicides? Antidepressants. Pilots crashing passenger airliners? Antidepressants. Breggin’s speculation that psychiatric medication caused the horrific Sandy Hook elementary school shooting amounts to a textbook case of assuming that correlation suggests causation: “It is worth noting that as we have an increase in the use of psychiatric medication in the general population, we simultaneously see an increase in suicides and mass shooting. As Breggin notes, both have been going on, with a corresponding ascent, for years.”

In an inspired bit of kabuki, he also argued that the Virginia Tech shooter Seung Hui Cho (who was not medicated) was permitted to kill not because of too little psychiatric intervention but in a sense because of too much. Authority figures were afraid to confront Cho, Breggin suggests, out of fear of running afoul of protections for the mentally ill. Had they not been put off the scent by the influence of early psychological investigations, the police would have simply thrown him in jail where he belonged. People like me have been saying for a long time that many lives could have been saved had psychiatric evaluation resulted in confining Cho to involuntary treatment, but Breggin here argues that without any investigation, Cho would have been more likely to have been locked away. That lives could have more likely been saved with involuntary treatment of an obviously, deeply-disturbed young man is ignored.

Breggin, unsurprisingly, has an evidence problem. He has claimed repeatedly that ADHD actually stems from insufficiently strict parenting and a lack of involvement by fathers specifically, despite never remotely establishing a causal relationship between fatherlessness and ADHD. This is typical of Breggin’s approach, which is to state with total confidence that for which he has precious little but speculation. He believes for example that stimulant medications used to treat ADHD work by damaging the brain rather than by healing it, but has never convincingly articulated a specific physiological or chemical process through which this process happens or what the actual damage entails, nor presented documentary evidence to justify this claim. I turned to his ADHD book The Ritalin Fact Book: What Your Doctor Won’t Tell You, but even there he fails to prove or even define his claims with anything like adequate scientific rigor. Part of what makes Breggin so frustrating is this tendency to refer to all psychotropic medications as inherently damaging, and in fact neurotoxic, while remaining consistently vague in the specific mechanism or etiology of this harm. Stimulants are neurotoxic, antidepressants are neurotoxic, antipsychotics are neurotoxic, anxiolytics are neurotoxic, mood stabilizers are neurotoxic…. But how, specifically? In most of Breggin’s work, there’s no technical explanation. Yet he describes drug neurotoxicity as a condition that afflicts anyone who uses these medications, despite the fact that an antipsychotic and an anxiolytic and an anticonvulsant, etc, all function differently in their basic pharmacology. How could they all harm the brain in the same way?

Breggin once argued that Xanax was ultimately to blame for killing Whitney Houston (whom he calls “our Whitney”) even though he more or less concedes that, as the conventional wisdom states, benzodiazepines almost never cause death on their own. How then was Xanax to blame? Because of “medication spellbinding,” Breggin’s most cherished notion. Breggin claims that psychiatric medications “spellbind” the people who use them into believing that their effects are positive, even though (he claims) they invariably ruin the lives of those patients. This, I take it, left Houston unable to understand the danger she was under. Like essentially everything Breggin argues, there is no clear definition of medication spellbinding that has reference to any specific evidentiary basis or psychopharmacological mechanism; again, given that these medications all function in markedly different ways, it’s hard to imagine how this effect could be found so broadly in such varied medications. It’s also the case that it’s notoriously hard to keep psychiatric patients on their medications, which would seem to give lie to the whole idea. But it’s a particularly cute little rhetorical move by Breggin: whenever a patient claims that medications have helped them and that they’re content with taking them, he simply asserts that those patients have been misled by the effects of medication spellbinding. Meds-positive patient testimonials are therefore dismissed out of hand or even used as proof that medication spellbinding is real, leaving Breggin securely in an impregnable bubble. It’s a non-falsifiable disagreement-killer.

I thought a good encapsulation of Breggin’s approach to medical conspiracies could be found in the title of this video interview with “the Quantum Nurse,” a classic bullshit holistic healer whose website advertises “Bioenergy Resonance Assessment.” That title: “Connecting the Dots to Save Your Lives: WHO, Big Pharma, DARPA, Oligarchy, Technocracy and more.” I like it because it demonstrates so clearly the kitchen-sink philosophy Breggin has developed when it comes to conspiracies, throwing more and more outlandish “anti-establishment” beliefs into the pot as he goes along. My research on him, conducted over the course of years, suggests that he has always harbored outlandish beliefs, as well as conventional conservative ones. Before widespread internet accessibility, I suspect, he simply had less ability to make those theories known. His personal website is… really something.

It frustrates me no end that I still regularly encounter mainstream amplification of his perspectives with no mention of his many disqualifying conspiracy beliefs. Wikipedia’s editors are perfectly willing to apply the pseudoscience tag (sometimes too willing), but Breggin’s entry is overwhelmingly positive and does not make clear how tendentious and controversial many of his claims are. (The “Criticism” section refers to a single incident, a dispute between Breggin and the National Alliance for Mental Illness, and describes that incident and its resolution in a way that’s comically sympathetic to Breggin.) This article suggests that said Wikipedia article was much more negative in the past. Breggin also has been accused of engaging in deceptive practices regarding his research record, such as referring to publications in certain journals without distinguishing letters to the editor or other non-peer reviewed work from actual empirical research, which is what most people think of as bestowing credibility. But certainly I can understand how you might scrape together the impression that Breggin is simply a responsible dissident doctor; a lot of people in positions of authority seem eager to help him maintain that reputation.

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I am, in fact, someone who has a good deal of patience for unsanctioned narratives and fringe ideas; they just have to be correct ones. I think the liberal war on “misinformation” has generally been misguided, and it’s certainly the case that some ideas regarded as conspiracy theories turn out to be true. (Stories of American foreign policy crimes spring immediately to mind.) Narratives like the lab leak hypothesis, while unproven, are certainly plausible enough that they should not have been suppressed, and you can make a strong case that young and healthy people should not have been pressured to get Covid vaccines, given how incredibly low the chance of serious illness was for them. But, also, there is absolutely no evidence of widespread deaths from the vaccines, and that which is offered up by anti-vaxxers is comically unreliable. The anti-vaxx world in general is full of dangerous cranks. We all have to navigate these distinctions for ourselves. And with psychiatry, especially, that can be difficult; as I suggested above, our continued ignorance about human brain function makes the field an inexact science, modern healthcare is filled with problems, and I myself have articulated profound disagreements with some common psychiatric practices. (The psychiatric emergency room experience is an abomination.) I remain open to radical critiques of contemporary psychiatry - but they have to be the right critiques. And anti-psychiatry is wrong about almost everything.

Why do I care about Breggin specifically? Because he’s the most obvious symbol of the way that the anti-psychiatry movement constantly skates between utter quackery and mainstream acceptance. As noted, he has served as an advisor to all manner of important governmental, medical, and academic bodies. His expert testimony has been considered especially influential on the American legal system’s relationship to psychiatric medicine. He’s been published all over the place and it’s not uncommon to see him cited in perfectly mainstream news sources as an expert in psychiatry. What gets to me is the way that he can live with one foot in both worlds - Breggin has appeared multiple times on Infowars, Alex Jones’s font of conspiracy theory, but has also been featured approvingly on PBS and many other places. And my deep frustration stems from the fact that, while our efforts to police conspiracy theory and extremism are deeply imperfect, and while I never support censorship, broad public understanding that anti-psychiatry is of a piece with the world of outlandish conspiracy theories has never developed, and it should. People who would never dream of associating with an anti-vaxxer or climate change denialist are often remarkably credulous towards the appeals of the anti-psychiatry narrative. But you can’t throw a rock in that space without hitting bizarre claims about the Illuminati and mind control.

I’m used to being on an island with my political positions, and usually quite comfortable with that. But I frequently feel quite alone when it comes to debating the anti-psychiatric impulse. Consider the NYT magazine story I linked to above. Daniel Bergner’s essay frustrated me immensely, with its fanciful depiction of psychotic disorders as benign conditions that merely need to be accepted by a conformist society. The piece is frustrating not only because this simply is not the reality for most people with those disorders, but also because there’s no qualification in it, no alternative perspective. Bergner does not interview any psychiatrists who disagree with his conclusion or family members who are terrified of their loved one going off meds. And I would argue that this simply would not happen with a different part of the conspiracy-adjacent world; the Times would never give a similarly unchallenged hearing to, say, the anti-GMO crowd. If you check the comments to that piece and click Reader Picks, you’ll find dozens of critical comments from people whose personal experiences demonstrate the complexity and difficulty of managing psychotic disorders. This divide demonstrates a strange element of this conversation: with radical critiques of psychiatric medicine, it often feels like establishment forces are more sensitive to the extremists than to the moderates.

I would think the importance of all of this would be obvious, but for a broader “who cares?” perspective, simply consider both the needs of the chronically mentally ill and of public safety. The latter has been largely left out of recent liberal narratives on this topic, recently, but ultimately we can only secure the former if we ensure the latter. To create a humane and universal system of psychiatric medicine requires public buy-in and robust spending of tax dollars, and we can only get both if we convince the public that our systems are keeping them safe.

For a good example of the potential consequences we’re talking about here, look at the muscle that anti-psychiatry has been able to build in Canada. Various forms of conspiracy-adjacent dissident political movements have flourished in Canada for a long time, such as their particularly militant anti-GMO crowd. Anti-psychiatry is no exception; this is a country where, for example, the University of Toronto endows the the Bonnie Burstow Scholarship in Antipsychiatry, which memorializes one of the most virulently anti-psychiatry scholars to ever publish. In addition, Canada’s long march towards a particular progressive vision of personal licentiousness, exemplified in their notorious assisted suicide system, has frequently left the government ill-equipped to use involuntary psychiatric treatment when it is badly needed. And in 2017, the insufficiency of the Canadian government’s tools to deal with the violently mental ill was exposed.

In 2008, 22-year-old Tim McLean was unlucky enough to board the wrong Greyhound bus in Edmonton. A severely schizophrenic and itinerant man named Vince Li got on the bus as well. Soon after leaving the station McLean fell asleep, without ever interacting with Li. As he would later tell doctors, Li’s paranoid delusions caused him to believe that McLean was an alien. He pulled out a large combat knife and hacked at McLean’s neck until he had beheaded him. The passengers and bus driver fled from the bus; in response, Li held McLean’s head by the hair up to the window so that the other passengers could see it. Li then proceeded to cut pieces of McLean’s flesh off of his body and consumed them, which he continued to do for hours until help arrived.

Li was found not responsible for the killing due to his severe mental illness. By 2015, he had begun to receive unsupervised excursion privileges and was transitioned to a group home. In 2017, after less than a decade in a secure psychiatric facility, Li was granted what’s called an absolute discharge in Canada by the relevant review board. That meant that not only was he free to leave the hospital, he was under no special restrictions whatsoever - he was not required to continue to see doctors, to stay on medication, or even to be monitored in any official capacity. He was free to simply leave, and so he left, changing his name to make it easier to disappear from public scrutiny. McLean’s family was understandably outraged over the decision, but the review board legitimately had little choice; a 1999 Canadian court decision had ruled that those found not responsible by reason of mental illness could not be held if they no longer represented an imminent threat to those around them. This immediately calls to mind the American O’Connor v. Donaldson Supreme Court decision, which established a standard of involuntary care entirely concerned with threat and not at all with sickness and in so doing created all manner of perverse incentives.

I’m glad Li didn’t end up in a conventional prison, but I’m also perfectly happy to tell you that someone who beheads another man and then begins to eat him is someone who should never be allowed to leave a secure psychiatric facility after less than even ten years, shouldn’t be allowed unconditional release even after 20. I know that this sentiment has become unpopular with many people. But at some point, society must balance its necessary desire to protect the severely mentally ill with a recognition that mental illness renders some people unspeakably dangerous and government must build structures to force them into treatment for their own protection and the protection of the public. It’s not about moral judgment, which is another conversation. Safety is a practical matter. I understand that Vince Li is a particularly incendiary case. But I could just as easily talk about another example of Canada’s paltry ability to maintain basic public security after a crime committed by a mentally ill person. In 2015 Rohinie Bisesar stabbed 28-year-old Rosemarie Junor to death in Toronto, was found not responsible by reason on mental illness, was then allowed unsupervised excursions into the community by an Ontario review board within a few years, then released into unsupervised living in 2022.

And if you’d just like to talk about the absurdity of recent liberal norms suggesting that the mentally ill are never dangerous, there’s David Peterson, the lifelong schizophrenic who killed a defenseless nine-year-old in my hometown when I was a child, or Stephen Morgan, who also committed a horrible crime in my hometown when he executed a college student he had stalked. I could talk about Bailey Hamor of Indiana, whose parents begged local officials to commit their schizophrenic son right up until he plunged a knife into another man’s head. I could talk about Martial Simon, who was in and out of psychiatric facilities for years before he pushed Michelle Go in front of a subway train. Or Kevin Salazar, of Los Angeles, or Bradley Dimmick, of San Antonio, or William Warrington and Nicholas Aina, both of the UK, or Paul Leslie Quirk, of Singapore, or the unnamed Australian man who stabbed his son 76 times…. There are thousands of such examples. Yes, the large majority of people with mental illness never commit acts of criminal violence. But as the NIH tells us, people with severe mental illness are significantly more likely to commit violent crimes generally and murder especially. I don’t understand how this basic piece of public knowledge has become so contested. You’re not helping people with mental illness when you try to obscure this fact. But those who reject contemporary psychiatry, psychiatric medicine, and the concept of mental illness entirely have made great inroads in American understanding of these issues.

More than anything, I’m asking for people to understand: despite abundant fringe extremism, the anti-psychiatry movement has been remarkably successful in the past half-century, to the point where people like Dr. Breggin can occupy positions of influence and statute in mainstream settings even while staying firmly planted in pseudoscience and conspiracy. The usual checks and balances that expose fringe ideas to particular scrutiny have failed for this issue, thanks to the confluence of 1960s anti-establishment romanticism, well-meaning but badly misplaced sympathy for the afflicted, the influence of academic social justice politics, and a community of conspiracists who have been working busily for decades. And I’m asking that people who oppose so many other kinds of conspiracy theory take a hard look at this world and its conspiracy theories too.