Pareto optimality is a red herring. Who cares about that weak efficiency if it ignores the fact that plenty of folks deserve to be "harmed" in the sense of having their ill-gotten wealth redistributed? An economist who uses pareto efficiency as a concept diverts attention from the decisive issue of who deserves what, to a bogus issue of the most "efficient" distribution of resources. The conceit is that society is a machine and can be compared to an optimally running car engine.

Again, psychiatrists play the same trick. Mental health is supposedly just a kind of social functionality, with no inherent moral component. That relieves the psychiatrist of having to philosophize or to admit that the scientific status of her discipline is superficial.

This is apparent also from the split between Western and Eastern medicine. The former is more scientific, so Western psychiatrists focus on handing out drugs, deferring to the drug companies instead of questioning their role in fostering the collective mental illnesses (such as infantilization) required for consumerism. Eastern medicine is more holistic, which means it incorporates philosophy and religion.

If psychiatrists and economists joined forces with philosophers, they'd have the makings for a comprehensive critique of secular society. But the social "scientists" have to stop pretending they're doing physics, and start thinking deeply about mental and economic problems.