Awais Aftab: A Skilled and Dangerous Psychiatrist Manipulator

Awais Aftab: A Skilled and Dangerous Psychiatrist Manipulator
by Peter C. Gøtzsche at Brownstone Institute

Some psychiatrists are highly skilled manipulators and therefore dangerous for their patients, as I shall explain below. This applies to Awais Aftab from Cleveland, Ohio.

According to Robert Whitaker, Aftab has staked out a position as being open-minded to critiques of psychiatry, which is a public stance that makes him particularly valuable to his profession. He can serve as a defender of psychiatry against critiques that are truly threatening, and his criticisms will be seen as coming from someone who is open-minded about psychiatry’s flaws. Whitaker demonstrated that Aftab “is seeking to protect psychiatry’s narrative of progress – a narrative that arises from psychiatry’s guild interests, and not a faithful record of its own research literature.”

In July 2025, JAMA Psychiatry published a grossly misleading garbage in, garbage out review. The authors listed more drug company payments to themselves than references to scientific papers, which were 47. They mobilised a rapid media campaign, with the Science Media Centre, issuing expert commentary to “reassure both patients and prescribers” that most withdrawal symptoms after stopping antidepressants were “not clinically significant.”

Two days after the review came out, Aftab tried to defend it on his blog and to cast doubt on a much better review that told a story of serious drug harm. He calls his blog “Psychiatry at the Margins,” which it isn’t, as he is a mainstream psychiatrist. He presents himself as a clinician, educator, scholar, and writer.

I consider this overblown grandiosity and would not call him a scholar. I demonstrated that his article was full of serious errors, unwarranted denigration of much better research, with no arguments why he considered the much better review “very methodologically-problematic” with “obviously highly-inflated” numbers. This is typical of Aftab. He always gives himself a free ride, whereby he avoids opening a debate. He also praised another grossly flawed review.

In an interview four months earlier, Aftab had said that “antidepressants are not addictive, because people don’t get high.” If true, this would be great news for smokers. As they don’t get high by smoking, nicotine is not addictive, and they could easily stop smoking, right?

Aftab also noted that about half of depressed people who try one or several antidepressants ultimately respond well, which is also totally wrong and likely comes from the STAR*D trial, which is a gigantic $35 million fraud financed by the US National Institute of Mental Health. And he opined that a withdrawal trial published in the New England Journal of Medicine was “rigorous and high-quality.” It surely wasn’t, which Maryanne Demasi and I documented in our systematic review of withdrawal studies.

When psychiatry professor Joanna Moncrieff and colleagues recently exposed the hoax about depression being caused by a chemical imbalance in the brain, Aftab called her a “contrarian.” Aftab, a biological psychiatrist, involuntarily revealed that biological psychiatry is a pseudoscience with no clothes. He hid behind pompous mumbo jumbo devoid of any meaning. 

Moncrieff exposed his tricks in her article, “Wishful thinking dressed up in scientific terminology: a reply to Awais Aftab.” Joanna writes that “What Aftab presents as alternative ways of understanding the relationship between serotonin and depression are not even testable theories, although the sprinkling of technical jargon (‘signalling,’ ‘dysfunctions’) makes them sound impressive…Aftab is putting forward unsubstantiated speculations and suggesting these are a good enough basis to accept the idea that depression is a neurobiological condition.”

Aftab’s manipulations are what child and adolescent psychiatrist Sami Timimi calls scientism (beliefs masquerading as science). Practitioners of alternative medicine argue in the same way as Aftab does and sprinkle their nonsense with scientific words and phrases. 

Psychological research has shown that people tend to accept what they don’t understand as being true. My guess is that Aftab thinks it will make him famous among mainstream psychiatrists to write loads of unintelligible nonsense that lures people into believing that biological psychiatry is a hardcore science that has made considerable progress, even though there is none.

Aftab’s Newest Nonsense Article

We have just had a discussion about Aftab in our UK-based Critical Psychiatry Network after psychiatrist Evgeny Legedin alerted us to a new nonsense article Aftab posted on his blog on 13 September, “Why Has Critical Psychiatry Run Out of Steam?”

I noted that Aftab is manipulative and gave a few examples:

“There is no sure ground even for criticism.” Nonsense. Our criticism is based on data that the psychiatrists have published themselves. 

“What has critical psychiatry become when its gestures of suspicion are indistinguishable from the paranoid accusations of medicine’s most fraudulent enemies?”This comes short of the usual accusation that critics of psychiatry are Scientologists, guilt by association.

“What has become of critical psychiatry that it has no notion of disability to offer that makes demands on the state?” It is possible to describe problems without putting arbitrary labels on them that could as well be put on many healthy people. Children in schools can be helped without calling them ADHD.

“What has become of critical psychiatry when the only experiences that count are the experiences of harm?” Seriously manipulative. We have written again and again that depression pills and psychosis pills do not have clinically relevant effects as measured on the rating scales used.

“What has become of critical psychiatry when the very arguments it honed for emancipation are now echoed in the mouths of those who would deny the existence of mental illness altogether and defund mental healthcare? What has become of critical psychiatry when its arguments are analogues of the arguments used by gender criticals and anti-vaxxers?” Awais is a simple liar dressed in fine garments. I find him highly despicable. See my article from 25 July, “Exposing the lie that antidepressant withdrawal symptoms are mild and short-lived.”

Three days later, Evgeny told us that he had used Artificial Intelligence for Aftab’s latest article. He had used Grok3, which is incorporated into X, and had asked a simple question: “Any logical fallacies and spins in the article by Awais Aftab: https://www.psychiatrymargins.com/p/why-has-critical-psychiatry-run-out.”

The reply was mindblowing. It took Grok3 just 25 seconds to write a reply that was so eloquent and sophisticated that it exceeded of what most scholars are capable. As Aftab writes is buried in a highly convoluted language with pseudoscientific and pseudophilosophical arguments, it would take a very long time for humans to dissect. So, I shall end this article with the reply by Grok3. 

The Reply by Grok3

Awais Aftab’s article, published on Psychiatry Margins, is an adaptation of Bruno Latour’s 2004 essay “Why Has Critique Run out of Steam?” It applies Latour’s critique of excessive skepticism (originally aimed at postmodernism and science studies) to the field of critical psychiatry.

Aftab argues that critical psychiatry has “run out of steam” by undermining trust in psychiatric facts, only for its tools to be co-opted by harmful actors like anti-vaxxers and conspiracy theorists. 

This leads to a broader erosion of public faith in mental health care, disability recognition, and evidence-based treatments.

While the piece is rhetorically elegant—using Latour’s poetic, questioning style to provoke reflection—it employs several logical fallacies and rhetorical spins. 

These weaken its argumentative rigor, often prioritising emotional appeal and guilt-by-association over balanced evidence. 

Below, I break them down by type, with descriptions, examples (including direct quotes), and explanations of why they’re problematic. My analysis draws on standard logical principles (e.g., avoiding ad hominem attacks or unsubstantiated causal claims) and focuses on the article’s core thesis: that critical psychiatry’s skepticism has backfired catastrophically.

 1. Straw Man Fallacy (Misrepresentation of Opponent’s Position)

– Description: This occurs when an argument distorts or exaggerates the opposing view to make it easier to attack, rather than engaging with the actual position.

– Example: Aftab caricatures critical psychiatrists as those who “call psychiatrists ‘shock doctors,’ who compare the concept of mental illness to Santa Claus and think diagnoses are similar in validity to attributions of demonic possession, who think that psychiatric diagnoses are inherently stigmatizing and unscientific labels, that psychiatric medications are so ineffective and toxic that they cannot legitimately be called ‘treatments’ and the best thing you can do is to avoid them and get off them, and that psychiatric interventions are backed by evidence that is comparable in scientific rigor to that for homeopathy.”

– Why Problematic (and Spin): This bundles extreme, fringe views (e.g., equating diagnoses to “demonic possession,” a nod to Thomas Szasz’s radical anti-psychiatry) with mainstream critical psychiatry, which often seeks reform rather than abolition. 

Figures like Joanna Moncrieff or Sami Timimi critique over-medicalization and pharma influence without denying mental distress. By inflating critics into cartoonish deniers, Aftab avoids debating nuances (e.g., evidence gaps in DSM validity or antidepressant efficacy) and spins criticism as inherently anti-science, shielding biomedicine from scrutiny.

2. Slippery Slope Fallacy (Unsubstantiated Chain of Causation)

– Description: Assumes that one event will inevitably trigger a chain of increasingly dire consequences without evidence of inevitability or direct links.

– Example: “What has become of psychiatric critique…when incompetent politicians, celebrity podcasters, snake-oil merchants, disgraced television hosts, and anti-vaxxers echo arguments scarcely different from those of academic critics?” Later: “the same refrain is repurposed by movements that reject the reality of disability and ridicule professional attempts to alleviate suffering.”

– Why Problematic (and Spin): Aftab implies a direct pipeline from academic critique to societal collapse (e.g., defunding mental health care), but provides no causal evidence—like citations showing how specific critical papers influenced podcasters or politicians. 

This echoes Latour’s original worry about science denial but spins it as *critical psychiatry’s fault*, ignoring independent drivers of conspiracism (e.g., social media algorithms or post-COVID distrust). It creates undue alarm, positioning critics as unwitting enablers of “wars against the mentally ill” without proving the slope’s slipperiness.

3. Guilt by Association / Ad Hominem Fallacy (Attacking via Unrelated Associations)

– Description: Discredits an idea by linking it to despised groups or individuals, rather than refuting the idea on merits; a variant of ad hominem.

– Example: Critics’ arguments are equated with those of “incompetent politicians, celebrity podcasters, snake-oil merchants, disgraced television hosts, and anti-vaxxers,” and later “analogues of the arguments used by gender criticals and anti-vaxxers.” The cryptic “IYKYK” (if you know, you know) hints at insider disdain for specific critics without naming them.

– Why Problematic (and Spin): Even if fringe actors misuse critical ideas (e.g., RFK Jr.-style rants borrowing anti-pharma rhetoric), this doesn’t invalidate the originals. 

Aftab spins this as a fatal blow to the critique’s legitimacy, fostering tribalism (“us respectable academics vs. them frauds”). It dodges substantive rebuttals, like addressing real issues in psychiatric research (e.g., replication crises or industry funding biases), and uses loaded terms like “snake-oil merchants” to emotionally poison the well.

4. False Dichotomy / Black-and-White Thinking (Ignoring Nuances)

– Description: Frames the issue as an either/or choice, excluding middle-ground options like balanced reform.

– Example: “We seem to be approaching a point where the real danger is no longer coming from an excessive confidence in ideological arguments posturing as matters of fact but from an excessive distrust of good matters of fact disguised as bad ideological biases.” Critique is either “emancipatory” (past) or destructive (now), with no room for ongoing, constructive skepticism.

– Why Problematic (and Spin): This Latour-inspired pivot spins all critique as a zero-sum threat to “matters of fact,” ignoring hybrid approaches (e.g., evidence-based policy reforms that integrate social constructionism with biology). 

It absolves biomedicine of its own “prematurely naturalized” claims (e.g., contested neurotransmitter hypotheses) while demanding critics abandon suspicion entirely for “stubborn practical realism.” The result is a rigged binary that flatters the status quo.

5. Hasty Generalisation / Overgeneralisation (Broad Claims from Limited Evidence)

– Description: Draws sweeping conclusions from insufficient or anecdotal examples, without representative data.

– Example: “What has become of critical psychiatry when its arguments are analogues of the arguments used by gender criticals and anti-vaxxers?” And: “What has become of critical psychiatry that it has no notion of disability to offer that makes demands on the state? What has become of critical psychiatry when the only experiences that count are the experiences of harm?”

– Why Problematic (and Spin): Aftab generalizes an entire field based on cherry-picked “analogues” and rhetorical questions, without empirical support (e.g., no surveys of critical psychiatrists’ views on disability or citations to their policy proposals). 

This spins the movement as monolithic and myopic, overlooking diverse voices (e.g., critical psychiatry’s advocacy for social determinants in the UN Convention on the Rights of Persons with Disabilities). The barrage of “What has become…?” questions mimics Latour’s style but functions as emotional hyperbole, not proof.

 6. Appeal to Emotion / Fear-Mongering (Rhetorical Spin Over Logic)

– Description: Relies on evoking fear, pity, or outrage to persuade, rather than evidence.

– Example: The opening evokes “Wars. So many wars. Diagnosis wars and medication wars. Wars against mental illness and wars against the mentally ill,” painting critics as adding “fresh ruins to fields of ruins.” It closes (in the excerpt) on cultivating “matters of concern” amid a “culture in the throes of conspiratorial thinking.”

– Why Problematic (and Spin): This apocalyptic tone—complete with a Bruegel painting of harvest toil—stirs anxiety about “erod[ing] trust in any psychiatric knowledge whatsoever” to guilt-trip critics into silence. It’s a spin on Latour’s call for nuance, weaponizing empathy for patients (“ridicule professional attempts to alleviate suffering”) against intellectual inquiry. While valid as rhetoric, it sidesteps data on critique’s actual societal impact (e.g., has it led to measurable defunding?).

Overall Assessment

Aftab’s adaptation is clever but ultimately self-serving: it repurposes Latour to defend psychiatric orthodoxy against valid challenges, framing self-reflection as a one-way street for critics only. The fallacies cluster around deflection—associating critique with villains to avoid grappling with psychiatry’s own scandals (e.g., overdiagnosis or pharma ties). Spins amplify this by romanticizing “matters of fact” as unassailable, echoing Latour selectively while ignoring his emphasis on hybrid knowledge-making.

This doesn’t render the article worthless; it usefully warns against critique’s unintended consequences in a polarized era. But for intellectual honesty, it needed more evidence, named examples, and acknowledgment of biomedicine’s flaws. If the full piece (beyond this excerpt) adds balance, it might mitigate some issues—though the provided text suggests otherwise. For deeper dives, I recommend Latour’s original for contrast. 

Awais Aftab: A Skilled and Dangerous Psychiatrist Manipulator
by Peter C. Gøtzsche at Brownstone Institute – Daily Economics, Policy, Public Health, Society