The Real Problems With Psychiatry

[Anatta]

Kia Ora,

A psychotherapist contends that the DSM, psychiatry's "bible" that defines all mental illness, is not scientific but a product of unscrupulous politics and bureaucracy.

Interesting.....

http://www.theatlantic.com/health/archive/2013/05/the-real-problems-with-psychiatry/275371/

In 1850, doctor Samuel Cartwright invented "drapetomania" -- a disease causing slaves to run away. How do social and historical context affect our understanding of mental illness?

Cartwright was a slaveholder's doctor from New Orleans -- he believed in the inferiority of what he called the "African races." He believed that abolitionism was based on a misguided notion that black people and white people were essentially equal. He thought that the desire for freedom in a black person was pathological because black people were born to be enslaved. To aspire to freedom was a betrayal of their nature, a disease. He invented "drapetomania," the impulse to run away from slavery. Assuming there wasn't horrible cruelty being inflicted on the slaves, they were "sick." He came up with a few diagnostic criteria and presented it to his colleagues.

So we corrected our notion of what counts as a "disease." Is there a modern equivalent?

Homosexuality is the most obvious example. Until 1973, it was listed as a disease. It's very easy to see what's wrong with "drapetomania," but it's easier to see the balancing act involved in saying homosexuality is or isn't a disease -- how something has to shift in society. The people who called homosexuality a disease weren't necessarily bigots or homophobes -- they were just trying to understand people who wanted to love people of their own sex. Disease is a way to understand difference that includes compassion. What has to shift is the idea that same-sex love is acceptable. Once that idea is there, it doesn't make sense to call homosexuality a disease.

Metta Zenda

[brainiac]

Awesome article! I don't agree with everything he says, but he brings up a ton of valid criticisms of diagnosis in psychiatry. I really like this quote: "the DSM does not capture real illnesses, [...] it's a set of constructs".

Mental illness is so much more varied than the DSM would have people believe. Depression isn't a simple "chemical imbalance", otherwise SSRIs would be much more effective at treating it than they are. You can also have two people with the same diagnosis and literally zero overlapping symptoms (which is especially problematic with the DSM-IV).

That said, because of the way health insurance works in the US, I think it's ultimately necessary in order to get people access to the care they need.

[Anatta]

Awesome article! I don't agree with everything he says, but he brings up a ton of valid criticisms of diagnosis in psychiatry. I really like this quote: "the DSM does not capture real illnesses, [...] it's a set of constructs".

Mental illness is so much more varied than the DSM would have people believe. Depression isn't a simple "chemical imbalance", otherwise SSRIs would be much more effective at treating it than they are. You can also have two people with the same diagnosis and literally zero overlapping symptoms (which is especially problematic with the DSM-IV).

That said, because of the way health insurance works in the US, I think it's ultimately necessary in order to get people access to the care they need.

Kia Ora Brainiac,

Yes it is quite interesting, I just scanned through it this morning, and thought "this looks interesting"  I'll read it again later...

Metta Zenda

[BlonT]

Yes the asume and looking at there word choice .The are only great to lure you into buying bad stuff !Races ? There is only ONE human race,with local diverances.But i am crazy
Other hand mmm  whe believe what politicians say so maybe 

[Eveline]

Here's a supporting opinion from another psychiatrist:

One manual shouldn't dictate US mental health research

The new edition of the DSM "bible" is so flawed that the US National Institute of Mental Health is right to abandon it, says eminent psychiatrist Allen Frances

The controversies swirling around the imminent update of the Diagnostic and Statistical Manual of Mental Disorders, produced by the American Psychiatric Association, have badly hurt confidence in psychiatric diagnosis. The problem arises from the fact that the update, called DSM-5, includes new diagnoses and reductions in thresholds for old ones, that expand the already stretched boundaries of psychiatry and threaten to turn diagnostic inflation into hyperinflation.

In my opinion, the DSM-5 process has been secretive, closed and sloppy – with confidentiality restraints, constantly missed deadlines, botched field testing, the cancellation of an important quality control step, and a rush to publication. A petition for independent scientific review endorsed by 56 mental health organisations was ignored. There is no reason to believe that DSM-5 is safe or scientifically sound.

(more)
http://www.newscientist.com/article/dn23490-one-manual-shouldnt-dictate-us-mental-health-research.html?cmpid=RSS|NSNS|2012-GLOBAL|online-news

[Eveline]

http://www.newscientist.com/article/dn23487-psychiatry-divided-as-mental-health-bible-denounced.html

The world's biggest mental health research institute is abandoning the new version of psychiatry's "bible" – the Diagnostic and Statistical Manual of Mental Disorders, questioning its validity and stating that "patients with mental disorders deserve better". This bombshell comes just weeks before the publication of the fifth revision of the manual, called DSM-5.

On 29 April, Thomas Insel, director of the US National Institute of Mental Health (NIMH), advocated a major shift away from categorising diseases such as bipolar disorder and schizophrenia according to a person's symptoms. Instead, Insel wants mental disorders to be diagnosed more objectively using genetics, brain scans that show abnormal patterns of activity and cognitive testing.

This would mean abandoning the manual published by the American Psychiatric Association that has been the mainstay of psychiatric research for 60 years.

(more)

[Dawn Heart]

There are more problems with psychiatry than what has been listed so far. I have watched the slippery slope happen up - close. The REAL problems in regards to application and practice of psychiatric science happened in the late 1980s as psychiatry and psychology slowly became what we know today as "Behavioral Health". The clinical model went from being focused on the patient as a whole person, from being focused on emotions and processing of thoughts, and their associated behavioral reactions; to everything being either a "negative behavior" or a "positive and desired behavior".

None the less, there was nothing human about human individuals anymore, because everything was some sort of behavior and everything became a symptom of something. The symptoms of mental illness became even the everyday acts of living. If you slept - in after a long week, you were depressed. If you ate more during one week and less on another, you had a mental illness. If you disagreed with someone else, if you had personality conflicts that involved being bullied or not accepted by a core group of people...you had a mental illness. If you had a headache, had an asthma attack, or any other medical problem, displayed ANY sort of emotion, asked any sort of question, you had some sort of mental illness.

I really DO hope they get rid of the DSM, stop classifying and categorizing people, start focusing in more on clear symptoms and start trying to get answers for the more vague symptomolgy, revert back to processing of thoughts and emotions as part of a focus on the whole person, and then use these other scientific methods such as various types of testing.   

[gennee]

The psychiatry field on the whole is a total fraud. Normal behavior has been classified as a mental illness. Save for psychoanalysis and counseling, the psychiatric community is responsible for wrecking the lives of millions of people over the decades. Scientists knew that there were more gender identities, expressions, and sexualities than the two binary system currently in place but they put it under wraps.

Another point is big pharma is behind a lot of the policies.  The medical system's current paradigm is totally flawed.  Some day I will post some articles about this.

[Revenna]

I wouldn't say it's a total fraud... I would have killed myself long ago if it weren't for antidepressants and counseling. However I do not look forward to DSM-V. Although I've heard they're going to revise the section on sex/gender disorders that was based partly on the babblings of quack sexologist John Money, it looks like they'll be replacing it with the babbling of quack sexologist Ray Blanchard.

[Rebekka]

The psychiatry field on the whole is a total fraud. Normal behavior has been classified as a mental illness. Save for psychoanalysis and counseling, the psychiatric community is responsible for wrecking the lives of millions of people over the decades. Scientists knew that there were more gender identities, expressions, and sexualities than the two binary system currently in place but they put it under wraps.

Another point is big pharma is behind a lot of the policies.  The medical system's current paradigm is totally flawed.  Some day I will post some articles about this.

There are more problems with psychiatry than what has been listed so far. I have watched the slippery slope happen up - close. The REAL problems in regards to application and practice of psychiatric science happened in the late 1980s as psychiatry and psychology slowly became what we know today as "Behavioral Health". The clinical model went from being focused on the patient as a whole person, from being focused on emotions and processing of thoughts, and their associated behavioral reactions; to everything being either a "negative behavior" or a "positive and desired behavior".

None the less, there was nothing human about human individuals anymore, because everything was some sort of behavior and everything became a symptom of something. The symptoms of mental illness became even the everyday acts of living. If you slept - in after a long week, you were depressed. If you ate more during one week and less on another, you had a mental illness. If you disagreed with someone else, if you had personality conflicts that involved being bullied or not accepted by a core group of people...you had a mental illness. If you had a headache, had an asthma attack, or any other medical problem, displayed ANY sort of emotion, asked any sort of question, you had some sort of mental illness.

I really DO hope they get rid of the DSM, stop classifying and categorizing people, start focusing in more on clear symptoms and start trying to get answers for the more vague symptomatology, revert back to processing of thoughts and emotions as part of a focus on the whole person, and then use these other scientific methods such as various types of testing.   

^this and ^^this, along with having to have been a ritalin kid in the public fool system, is a really big part of why i cannot, nor ever will see any sort of psychologist, psychiatrist, counselor, or other 'thought police' diagnosticians, as anyone who should be trusted with any sort of useful information about my thought processes and inner feelings.

Now, i will admit that there are some seriously mentally sick people out there who desperately need help, but,

by the same turn of the hand, it is my at-hand understanding that ever since the idea of mental health was happened upon, mental medicine has mostly been used as a tool and a method to enforce socio-political conformity and to regulate the citizenry, and when that fails, mental health provides a suitable oubliette for more famous/infamous political dissidents, militia leaders, whistleblowers, and other categories of individuals who cannot or will not toe the party lines.

[kelly_aus]

Wow.. Have you had crappy psychiatrists.. I saw mine for 4 years and not once did he try enforce any ideas on me or try to convince me a prescription was going to solve my issues. All we did was talk..

[stephaniec]

Wow.. Have you had crappy psychiatrists.. I saw mine for 4 years and not once did he try enforce any ideas on me or try to convince me a prescription was going to solve my issues. All we did was talk..

I've been through a lot of therapy and quite a few psychologists and one psychiatrist and only had one idiot psychologist where for a couple of years I spent the session crying so much because I hurt so bad and all this idiot did was watch me cry , but all the others were great.