Wednesday, March 09, 2011
Deviation from the mean
Reprinted, originally published, February 2010
As long time readers of the Clarion Content know we are not believers in a bright line standard that delineates crazy from sane. Life is cast hues. It was then we read with great interest, and a tremble that fluttered between nervous laughter and real trepidation, an article in the New York Times about The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
This book, last revised sixteen years ago, is what its title purports, the handbook of what the profession of psychiatry considers crazy. The New York Times quotes Dr. Michael First, a professor of psychiatry at Columbia University who edited the fourth edition of the manual, "Anything you put in that book, any little change you make, has huge implications not only for psychiatry but for pharmaceutical marketing, research, for the legal system, for who’s considered to be normal or not, for who’s considered disabled."
One book to rule them all, One book to define them,
One book to cast them all and in the darkness bind them.
Not surprisingly when this is the scenario, the manual and its contents have been the subject of intense lobbying efforts. One significant change being recommended according to the Times is adding a childhood disorder called temper dysregulation disorder with dysphoria, a move that grew out of recent findings that many wildly aggressive, irritable children who have been given a diagnosis of bipolar disorder do not have it. Sounds to the Clarion Content like trying to take two wrongs and produce a right; bad idea. The Times reports, "The misdiagnosis led many children to be given powerful antipsychotic drugs, which have serious side effects, including metabolic changes...there have been widespread reports that doctors promoting the diagnosis received consulting and speaking fees from the makers of the drugs."
The urge to label and stereotype is a powerful human desire. The unknown is fearful and threatening, people who do not behave as expected even more so. In an existence limited and capped by looming mortality, uncertainty produces angst. Pigeonholing and defining the "other" give a sense of security. What is known is in the realm of what has been conquered. Humanity has explored the planet to near its ends, gaining great comfort in knowing more about what exists. With the exploration of terra firma nearly complete, societally we have turned the lens inward.
The Clarion Content cannot hold with the kind of labeling that this manual of psychiatry implies. Our understanding of the metaverse believes that this sort categorizing falls somewhere between repugnant and unhelpful. While not entirely false, stereotypes contain tropes that repeatedly misdefine and misunderstand individuals. The shrinks try to account for this type of critique by using scales of severity, from mild to severe, and rating symptoms. This attempt seems paradoxical to the Clarion Content. When labeling fails to address the specificity and uniqueness of the underlying individual cases, how does more labeling appear to be the answer? At what point do the categories lose meaning? Could we not rate every human being to be their own unique combination of characteristics? The fallacy of treating the mind like other physical ailments of the body becomes more ludicrous with every passing year. In our view the direction we should be proceeding is to examine the physical ailments of the body as things that can be treated and ameliorated by processes within our own minds.
The best treatments, mental and physical, imply an acceptance of our individuality and uniqueness however threatening it might be.
As long time readers of the Clarion Content know we are not believers in a bright line standard that delineates crazy from sane. Life is cast hues. It was then we read with great interest, and a tremble that fluttered between nervous laughter and real trepidation, an article in the New York Times about The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
This book, last revised sixteen years ago, is what its title purports, the handbook of what the profession of psychiatry considers crazy. The New York Times quotes Dr. Michael First, a professor of psychiatry at Columbia University who edited the fourth edition of the manual, "Anything you put in that book, any little change you make, has huge implications not only for psychiatry but for pharmaceutical marketing, research, for the legal system, for who’s considered to be normal or not, for who’s considered disabled."
One book to rule them all, One book to define them,
One book to cast them all and in the darkness bind them.
Not surprisingly when this is the scenario, the manual and its contents have been the subject of intense lobbying efforts. One significant change being recommended according to the Times is adding a childhood disorder called temper dysregulation disorder with dysphoria, a move that grew out of recent findings that many wildly aggressive, irritable children who have been given a diagnosis of bipolar disorder do not have it. Sounds to the Clarion Content like trying to take two wrongs and produce a right; bad idea. The Times reports, "The misdiagnosis led many children to be given powerful antipsychotic drugs, which have serious side effects, including metabolic changes...there have been widespread reports that doctors promoting the diagnosis received consulting and speaking fees from the makers of the drugs."
The urge to label and stereotype is a powerful human desire. The unknown is fearful and threatening, people who do not behave as expected even more so. In an existence limited and capped by looming mortality, uncertainty produces angst. Pigeonholing and defining the "other" give a sense of security. What is known is in the realm of what has been conquered. Humanity has explored the planet to near its ends, gaining great comfort in knowing more about what exists. With the exploration of terra firma nearly complete, societally we have turned the lens inward.
The Clarion Content cannot hold with the kind of labeling that this manual of psychiatry implies. Our understanding of the metaverse believes that this sort categorizing falls somewhere between repugnant and unhelpful. While not entirely false, stereotypes contain tropes that repeatedly misdefine and misunderstand individuals. The shrinks try to account for this type of critique by using scales of severity, from mild to severe, and rating symptoms. This attempt seems paradoxical to the Clarion Content. When labeling fails to address the specificity and uniqueness of the underlying individual cases, how does more labeling appear to be the answer? At what point do the categories lose meaning? Could we not rate every human being to be their own unique combination of characteristics? The fallacy of treating the mind like other physical ailments of the body becomes more ludicrous with every passing year. In our view the direction we should be proceeding is to examine the physical ailments of the body as things that can be treated and ameliorated by processes within our own minds.
The best treatments, mental and physical, imply an acceptance of our individuality and uniqueness however threatening it might be.
Labels: Language, science, thought
Comments:
This is a great article. It makes me wonder about the placebo effect. Of course we can cure someone of an ailment that does not exist but can we ever cure a business practice that relies on the weak consumer? Is there a placebo that we the people can give to the pharmaceudical companies?
Varying A-
A terrific question, can we (people) cure ourselves of our consumer addiction? It is very tough because our human nature means we will have external needs. We cannot supply all the sustenance we need for life without interaction with the world around us. Can we interact and not be duped?
At minimum, I guess I would say that the paradigm has to shift. We have to want to get better without assuming our better has to come at the expense of others. Stop playing a zero sum game and try to raise each other's games.
A terrific question, can we (people) cure ourselves of our consumer addiction? It is very tough because our human nature means we will have external needs. We cannot supply all the sustenance we need for life without interaction with the world around us. Can we interact and not be duped?
At minimum, I guess I would say that the paradigm has to shift. We have to want to get better without assuming our better has to come at the expense of others. Stop playing a zero sum game and try to raise each other's games.
CC,
Fascinating analysis. The idea that we are directing our questions and explorations "inward" is an exciting but scary prospect.
Our kids do not need to be further diagnosed, they need to be treated and cared for as individuals. Prescription drugs have enough behavioral and financial control over our society.
Perhaps this book of which you write, too, should be tossed into the fires of Mount Doom.
-CG
Fascinating analysis. The idea that we are directing our questions and explorations "inward" is an exciting but scary prospect.
Our kids do not need to be further diagnosed, they need to be treated and cared for as individuals. Prescription drugs have enough behavioral and financial control over our society.
Perhaps this book of which you write, too, should be tossed into the fires of Mount Doom.
-CG
C Gangsta-
The Fires of Mt. Doom, indeed, for those who would label and herd us to the halls of the pharmaceutical companies. Health and longevity is inevitably individual.
As for our inward explorations, I agree with you it is an intimidating prospect, daunting perhaps in its limitlessness.
The Fires of Mt. Doom, indeed, for those who would label and herd us to the halls of the pharmaceutical companies. Health and longevity is inevitably individual.
As for our inward explorations, I agree with you it is an intimidating prospect, daunting perhaps in its limitlessness.
I like that a lot of the thought in Social Work these days is anti-diagnosis, anti-DSM, anti-mental illness for the most part. I think that a lot of mental illness is diagnosed for the benefit of pharmaceutical companies. Despite the fact that some people clearly face considerable obstacles to thinking and acting in ways that allow them to function healthily in society, I think our conceptions of mental illness are totally messed up, as are our approaches to treatment. -AT
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# posted by 
: 3/23/2011 2:39 AM
: 3/23/2011 2:39 AM