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Medicalization 101

Were Franz Kafka alive today I could very easily imagine him writing a novel entitled The Hospital. Bureaucracy seems to be as much alive in this institution as it ever was in the banking industry. Just go to the emergency room or a regularly scheduled appointment even, at some hospitals, and see how long you are forced to wait. The paper work, the wrong turns, the complications, and the red tape seem endless. The faceless bureaucrat is certainly not dead in this industry, and here, ironically, that faceless bureaucrat has pretensions of appearing to be a care provider.

This revelation leads naturally to a consideration of my future shock word of the day: medicalization. Like Franz Kafka, if a George Orwell or an Aldous Huxley were writing now, I feel certain that aspects of this phenomenon would take center stage in whatever futuristic satiristic projection such an author might be envisioning.

Let’s look at what the dictionary has to say about this word.

Here’s what THE FREE DICTIONARY has to tell us.

med•i•ca•lize
tr.v. med•i•ca•lized, med•i•ca•liz•ing, med•i•ca•liz•es
To identify or categorize (a condition or behavior) as being a disorder requiring medical treatment or intervention: “Increasingly, [attention deficit disorder] has become a catch-all diagnosis that medicalizes troublesome behavior in kids” (Judy Foreman).

Merriam-Webster’s definition is even more disturbing as it is more direct.

Main Entry: med•i•cal•ize
Pronunciation: \ˈme-di-kə-ˌlīz\
Function: transitive verb
Inflected Form(s): med•i•cal•ized; med•i•cal•izing
Date: 1970
: to view or treat as a medical concern, problem, or disorder <those who seek to dispose of social problems by medicalizing them–Liam Hudson>
med•i•cal•i•za•tion \ˌme-di-kə-lə-ˈzā-shən\ noun

Your Dictionary.com gives us this definition.

medi•cal•ize (med′i kəl īz′)
transitive verb medicalized -•ized′, medicalizing -•iz′•ing
to use medical methods or concepts in dealing with (nonmedical problems, conditions, etc.)
Related Forms:
• medicalization med′i•cali•za′•tion noun

Wikipedia further elaborates on the development of the expression.

The term medicalization entered academic and medical publications in the 1970s in the work of Thomas Szaz, Emile Zola, and Peter Conrad. The expansion of medical authority into the domains of everyday existence was promoted by doctors and was therefore a force to be rejected in the name of specific kinds of liberation. Medicalization in this sense was characterized as “social control.” This critique was embodied in now-classic works such as Conrad’s “The discovery of hyperkinesis: notes on medicalization of deviance,” published in 1973 (hyperkinesis was the term then used to describe what we would now call ADHD) and immediately illiciting a round of commentary.

About 30 years on, the definition of medicalization is more complicated, if for no other reason than because the term is so widely used. Many contemporary critics position pharmaceutical companies in the space once held by doctors as the supposed catalysts of social transformation. Titles such as the The making of a disease or Sex, drugs, and marketing critique the pharmaceutical industry for shunting everyday problems into the domain of professional biomedicine. At the same time, to suggest that society simply reject drugs or drug companies in much the same ways some have suggested it “liberate” itself from the medical system is implausible. The same drugs that treat deviances from societal norms also help many people live their lives. Even scholars who critique the societal implications of brand-name drugs generally remain open to these drugs’ curative effects — a far cry from earlier calls for a revolution against the biomedical establishment. The emphasis has come to be on “overmedicalization” rather than “medicalization” per se.

More there than here I should add. Referring to ‘medicalization’ as ‘overmedicalization’ is kind of like directing your conservation efforts towards extinct species. What we find in this Wikipedia piece is a growing acceptance of the concept of medicalization, even as it is being critiqued.

On a more positive note, Wikipedia goes on to add:

The antithesis of medicalization is the process of paramedicalization, where alternative therapies and theories of health, wellness and disease are adopted. Even if medicalization and paramedicalization are contradictory, they also feed each other: they both ensure that the questions of health and illness stay in sharp focus.

When we speak of medicalization then we are talking about social control attained through the expansion of the medical authority into the domains of everyday life, and the use of medical concepts and methods on problems that are not, strictly speaking, medical.

Although I am all for universal health care, the idea of mandatory health insurance payments I find particularly distasteful and offensive for a country that prides itself on the amount of personal freedom it allows. I think everybody should be entitled to health care, yes, but I don’t think the way to achieve this universal care is by forcing people to buy insurance. This is 1. not going to decrease the amount of bureaucracy you get in the public hospital, and 2. going to entangle everybody in the bureaucracy of the insurance business, government run or otherwise.

Certainly, if universal health care of one kind or another is achieved, given the direction medicine is going in these days, it is likely to mean more rather than less medicalization as well.

Psychiatric Prisoner Escapes

I’m rooting for a fugitive today.

This man beat up some staff member you say, well, bully for him! He was locked up under Britain’s criminal Mental Health Act, and therefore this ‘assault’ would best be characterized as self defense.

I hope this man is able to elude the British law in the future, and I hope he finds a safe refuge somewhere. If the British authorities catch him, they are unlikely to see this act of self defense for what it was, and that’s the truly sad part of it.

He was being held against his will.

A couple of bruisers at the facility where he was being held could have held him down, and they could have stuck a needle in his posterior, and nobody would have raised an eyebrow, but that’s assault!

Keep running, Kristos! Keep running until you reach the more perfect place you are looking for.

Search For Mental Health Patient

Kristos Sofrianou, 25, a resident at Clare House, North Benfleet, near Basildon, was last seen there on Saturday night.

He is wanted in connection with an allegation of assault on a member of staff and should not be approached, Essex Police said.

It is believed he has links to London and the West Country.

Supt Steve Worron, of Essex Police, said: “Our primary concern is for public safety as well as Mr Sofrianou’s own welfare.

“We are hoping someone can help us return him to hospital where he can receive the treatment that he requires.”

Mr Sofrianou had been detained under the Mental Health Act, police added.

He is of mixed race, about 5ft 8in (1.72m), of slim build and has brown eyes and a shaved head.

He is described as having a mixed London and West Country accent and has a 4in (10.1cm) burn mark on the right side of his neck and a 4in (10.1cm) scar from a cut on his right leg.

He was wearing blue jeans, a black T-shirt with red and white lettering on it and black and green trainers.

He is not thought to have any family connections in Essex.

If you see this man, Kristos Sofrianou, be brave and befriend him if you can, even if that means breaking the law of your country to do so. Whatever you do, don’t turn him in. The law, in this instance, is very wrong.

Wellness Is The New Sickness

Oh, no. Here we go again. Mental illness more common than thought claims this United Press International article out of North Carolina. I guess it pays not to think.

The prevalence of anxiety, depression and substance dependency may be about twice as high as the mental health community has thought, U.S. researchers say.

Anxiety, depression and substance dependency…Okay. What mental illnesses were you referring to?

Duke University psychologists Terrie Moffitt and Avshalom Caspi and colleagues from the United Kingdom and New Zealand used data from a long-term study of more than 1,000 New Zealanders from birth to age 32.

The researchers say people vastly underreport the amount of mental illness they’ve suffered when asked to recall their history years after the fact, but self-reporting from memory is the basis of much of what is known about the prevalence of anxiety, depression, alchohol dependence and marijuana dependence.

There’s more mental illness out there than we’d previously thought. What we need is more men in white suits traveling in vans and ambulances. Alright, boys, go round up nervous people, bums, bluesaholics, beeraholics, recreational drug users and other annoying folk.

Should you be snagged. Don’t worry, man, woman. You have to put a positive slant on this development, and ‘recover’ as they put it. Education is key. Like, hey! Now that you’ve been found out the skies the limit! You might be washed up in your old line of work, but you can consider pursuing a career as a psychologist, a sociologist, a social worker, a human services worker, a life coach, or a peer support specialist no sweat. Haven’t you heard? This is the chance of a lifetime. Sickness is the new boom industry.

You Must Earn Your Fork And Horns

The school of good intentions is annoying me as usual. You can make a matter worse by magnifying it any day of the week, and you will find this happens every day of the week. Take the typical 1 in 4 people suffer from some form of mental illness or another statistic dished out by NAMI, the MHA, and other confused and confusing organizations. Wrong. 1 in 4 people may have seen a mental health professional at some time in their lives, but when I say so, I am implying something far different. I am not saying they were doing so because they were ‘sick’.

Here is story from a TV news desk in the state of Maine,Reducing the Stigma of Mental Illness , containing a similar statistic, by one Dr. David Prescott.

Why Is Reducing the Stigma of Mental Illness Important? There are probably dozens of reasons that challenging the stigma of mental illness and addiction is important. But none seem more compelling than the fact that nearly two-thirds of people who experience a mental illness never receive any type of professional help for their problems. The negative attitudes, fears, and stereotypes that surround mental illness are one of the largest barriers to people receiving professional help.

If 2/3 of the people who experience a mental illness never receive any professional help for it, why rock the boat! What I am hearing here is an argument for tripling the number of mental patients in this country, and I wouldn’t go in that direction myself. Once you have tripled the number of the mentally ill, then you can turn around, and say what you were saying to begin with. 2/3 of the people who experience a mental illness never receive any professional help for their problems. Hey, everybody! Let’s triple the mental illness rate again.

The Bias Of The MadSci Network

I’m upset. The MadSci Network website will have a pseudo-scientist, a psychiatrist, answering questions concerning “mental disorders” if you should ask one. How mad is that!? I do a search on psychiatry, and what comes out on top?

John Doe of West Virginia asked

Since schizophrenia is a life long illness and schizophreniform is a short-term one time episode, are they caused by the same things. Is a person with schizophreniform simply a lucky schizophrenic in permanent remission?

To which the answer, from one Dr. Gabriel Vargas, came.

Schizophrenia is a devastating mental illness with no known cause. It has a genetic component but likely involves many genes. Schizophreniform disorder is the name given to a cluster of symptoms which are very similar to those seen in Schizophrenia but occurring within a time frame of more than one month and less than six months. If those symptoms (which include hallucinations, delusions, disorganized speech and behavior, affective blunting) last for less than a month the disorder is labelled brief psychotic disorder; if it lasts more than six months it is called schizophrenia. It is thought that 60-80% of those diagnosed with schizophreniform disorder will eventually meet criteria for schizophrenia. As in the case of schizophrenia there is no known etiology. Furthermore, in revising the Diagnostic and statistic manual of mental disorders (DSM), the criteria for schizophreniform disorder was changed from symptoms lasting at least one week to symptoms lasting at least one month. Therefore some of the research that was done using the old definition will not apply. In short, it seems most people with schizophreniform disorder will develop frank schizophrenia though it is clear that a small minority do not and the reasons for this are poorly understood.

References
Kaplan & Sadock’s Comprehensive Textbook of Psychiatry/VII
by Benjamin J. Sadock (Editor), Virginia A. Sadock (Editor).

If schizophrenia has ‘no known cause’, how can you go onto say that it has a genetic component? Good try, doctor. Additionally, regarding the small minority of those deemed schizophreniform that do not develop into schizophrenia. 20% may indeed be a small minority, but is 40%? Most psychiatrists I have encountered repeatedly make the same mistake of emphasizing the negative at the expense of the positive. Results may differ from place to place. World Health Organization studies have shown that in developing countries that rely less on psychiatric drugs than in the developed countries, recovery rates from schizophrenia have been found to be much better than 50%, and these rates are nearly twice as high as they are in the more industrialized world.

Search for madness or mad pride on the MadSci Network site, and you get results dealing with mad cow disease. Ask about antipsychiatry, and the site draws a complete blank.

I thought I would ask a question of my own. I don’t expect an answer really, but we will see what happens in this case.

Question: Is psychiatry hard science or is it psuedo-science, junk science?

Comments: In Russia disagreeing with the government is characterized as a mental disorder. In America a polygamist Mormon, a possessive parent, an unfaithful spouse, or a stingy heir can get rid of an associated threat by having him or her admitted into a state mental hospital. Most diseases can be placed on a microscope slide, this is not true of so called mental illnesses. Don’t these factors ask some serious questions about the validity of psychiatry as a science?

I would expect better of any science website making a claim to madness. I get the idea these guys and gals don’t have a clue as to what psychiatric torture is really all about. I’m not optimistic about my prospects of getting a satisfactory answer to my question. Until such time as I do get an acceptable answer, I can only say, “ Shame on you, MadSci Network!”

The Mad Science Network Responds:

Stumping The Mad Science Network

Campaign Launched – STOP FORCE NOW!

stopforceddrugging

Calling All Individuals, Groups, & Organizations to Take the Pledge
Our Mission is to Stop Forced “Mental Health” Treatment

Our Principles:

1. People should not be forced to take psychiatric drugs or given electroshock against their will. Period.

2. People should not be subjected to forced psychiatric detention/confinement.

3 People should not be subject to restraint, seclusion, and aversive interventions.

4 People should not be subject to Involuntary Outpatient Commitment.

5 Choices to alternatives of the coercive medical model of the “mental health system”.

6. Children, youth, and young people should not be subject to inappropriate and harmful psychiatric interventions including:

Electroshock
Psychiatric Drugging
Restraint
Seclusion
Aversive Interventions
Psychiatric confinement/detention.

Take the Pledge. “I pledge to do my part . . .” Act Now.

Start a Crew. Build a Squad

For more information:

http://www.StopForceNow.org

Also – join our Facebook group:

http://www.facebook.com/group.php?gid=127912834046&ref=mf

Nationwide Organizing Call to Action
Campaign Headquarters

158 Jefferson Street
Albany, NY 12210
Daniel Hazen (202) 340-4372
& Lauren Tenney (516) 319-4295
Action@StopForceNow.org———

Callings Real And Hallucinated

I was once involved with a consumer advisory council associated with a community mental health agency that was resorting to what I think is another contemporary folly happening with more and more frequency these days. Members of this consumer advisory council had come up with a number of sound bites on ‘mental illness’ to be distributed and released over the radio. This effort was seen as some part of an overall campaign against stigma. Unfortunately for them, fortunately for the rest of us, the media didn’t take to the idea.

My view was that the community in this instance had less of a need for understanding ‘mental illness’ than these ‘consumers’ had a need for understanding ‘mental wellness’. You can spend your entire life in the system, talking about recovery, but that’s not recovering. Blaming community members is not the same as creating some kind of meaningful dialogue with actual members of the community. The only thing standing in between any of these council members and that kind of dialogue was an impediment in their way of thinking.

The mental illness rate has been climbing for years. It has been climbing because 1. the drugs used to treat the illness typically make folks sicker, and 2. mental health care is a business. Law enforcement officers and mental health professionals are now looking into the community imagining all these mentally ill people that are afraid to come forward and have some doctor slap a diagnosis on them. It is claimed that they are not stepping forward because of the stigma attached to ‘mental illness’. Yeah, right.

As I was saying, mental health care is a business. If that business declines, people are even less likely to spend money on it, and people in that business will lose their jobs. There is no danger of this business declining right now. Mental health care is booming actually, despite all reports to the contrary. Many more undiagnosed people have come forward to receive their diagnoses every year. A 40 fold rise in the number of bipolar cases reported certainly wouldn’t have occurred if the business hadn’t room to expand.

Throw into this mix advertisements for mental illness, and you have a concoction the doctor couldn’t have imagined if he had been dreaming. Are there enough masochists out there to fill the community mental health centers throughout this country? You betcha! This is America after all! Just go and take a peek inside your local mental health center sometime, and you can see them coalesing. Well, there comes a time for a hiatus from hiatus after awhile. Have you ever heard the expression, “I’d rather be surfing”? It sure beats therapy, doesn’t it? Hey, why don’t we hit the beaches, and catch a few waves? That would be fun I imagine, and we could even look into making a career of it.

Googling ‘Madness’

If you want to know a little bit about the reasoning behind the Mad Pride movement I think I can shed a little light on the matter. I just used the Google search engine to search for news articles on ‘madness’. Very few of the articles that this search turned up had anything whatsoever to do with ‘mental illness’. The situation would be very different had I searched for news articles on ‘mental illness’ or ‘mental health’.

Looking only at the first page, and I’m not, for obvious reasons, going beyond that page. We get only a couple of what could be considered exceptions to our rule, but only a couple, if that. People in the Mad Pride movement know the mainstream media has not covered our movement very well, and this search page is only another example of how very true that fact is.

10 links were turned up.

The 1st link happened ironically to be one of the two exceptions. It was to a review of an Australian production of the Tennessee Williams play A Street Car Named Desire. I’m calling it an exception because the play deals with the hospitalization of Blanch Dubois. Whether she is ‘mentally ill’, or just a rape victim, is not for me to say. Note: this is about a work of drama, and not about the real system per say.

The 2nd link, Shark Madness on Cape Cod, refers to an article and video about a first tagging of great white sharks in the Atlantic. The 3rd link leads to an article about the actor who played a Dukes of Hazard Sheriff showing up at a stockcar race in North Carolina. The 4th links goes tin foil monsters, perhaps containing eatables that have something to do with gaming. Don’t ask because I don’t know, and I’m not going to take the time to find out either. The 5th link, Full Moon Madness, attaches to an announcement, among other announcements, for a fund raising event for a Science Museum, or to be more precise, The future Earth, Sea & Space Center. The 6th link goes to an article about the ‘madness’ a rugby player displayed, I think. The 7th goes to an article about the ‘madness’ of a certain Chilean Soccer star. The 8th concerns one high school marching band hosting an event for high school marching bands.

The 9th link was the only other exception, and it’s the best of bunch as far as I’m concerned. In this piece poet and author John Burnside writes for Scotland’s Sunday Herald an essay In Praise of Madness. His contention is that a little bit of craziness is an essential ingredient to the creative process. His essay suggests we should get rid of some of the archaic ideas we have with regard to the treatment of mental illness.

TS Szasz expressed this idea best, years ago, in his 1958 essay Psychiatry, Ethics And Criminal Law: “The question may now be raised as to what are the differences, if any, between social nonconformity (or deviation) and mental illness. Leaving technical psychiatric considerations aside for the moment, I shall argue that the difference between these two notions – as expressed for example by the statements “he is wrong” and “he is mentally ill” – does not necessarily lie in any observable facts to which they point, but may consist only of a difference in our attitudes toward our subject. If we take him seriously, consider him to have human rights and dignities, and look upon him as more or less our equal – we then speak of disagreements, deviations, fights, crimes, perhaps even of treason. Should we feel, however, that we cannot communicate with him, that he is somehow “basically” different from us, we shall then be inclined to consider him no longer as an equal but rather as an inferior person; and then we speak of him as being crazy, mentally ill, insane, psychotic, immature, and so forth.”

This is still the case. Anyone who has ever been in a mental hospital knows that, to be considered well, he must construct a narrative that the outside world can take seriously – and to do so, he must discard his own dreams and visions, no matter how vivid, diagnostically accurate or even just plain beautiful they might be. Why? Because our idea of what constitutes madness, whether in the asylum, or buried deep within our own social personae, is symptomatic of a system built on a near-total rejection of the wild mind.

The 10th links leads to an article about the madness that attends the first week of college attendance.

Alright, let’s look at our tally. We’ve got dramatic personas, scientists tagging sharks, a television actor, gamers or something of the sort, philanthropists, a rugby player, a soccer player, marching band members, a poet, and college students. Only one of these people has confessed to being a former mental patient, and that’s John Burnside, the poet and author mentioned previously.

Hmm. Makes a body think, doesn’t it?

What Is Mad Pride?

image001

I’m looking for a working definition of Mad Pride, but I don’t think I will find one, and so I will probably be settling for whatever I can fish up.

Here’s what a television story, ‘Mad’ men and women embrace their mental health issues, from Portland, Oregon says on the subject.

More than eight million Americans with either bi-polar disorder or schizophrenia are fighting the stigma of mental illness by embracing their “madness”, not suppressing it.

Really? I’m not so sure about this one. I will have to inquire deeper.

If you were wondering, I consider myself a part of the Mad Pride movement. The world says you are ‘mentally ill’ though, these days, not mad. My ‘mental illness’ and I had a falling out, and we went our separate ways. You won’t find any ‘mental illness’ on me. Ever.

This idea came from the Mad Pride movement, a new and growing grassroots movement of people with serious mental disorders who are rejecting traditional psychiatric treatments and standing up against the shame associated with mental illness.

Alright. I’m beginning to feel a little nauseous. You have a ‘mental illness’ you say. Oh, you naughty, naughty boy or girl.

Wikipedia further elaborates…

Mad Pride activists seek to reclaim terms such as ‘mad’, ‘nutter’ and ‘psycho’ from misuse, such as in tabloid newspapers. Through a series of mass media campaigns, Mad Pride activists seek to re-educate the general public on such subjects as the causes of mental disorders, the experiences of those using the the mental health system, and the global suicide pandemic.

Wikipedia – Mad Pride

Hopefully we can manage to disown the term “stigma” as well. I don’t want any ‘stigma’ surrounding me. It just doesn’t suit me.

This is what I picked up from the Mindfreedom International website and, uh, maybe they should know.

What is Mad Pride? Mad Pride is a movement that celebrates the human rights and spectacular culture of people considered very different by our society.

MindFreedom International – Mad Pride

This leads, naturally enough, to my next question. How very is very?

The point here is that this description applies to eccentrics and nonconformists, too. That’s right. You can get locked up in a psych ward just for being different.

So what can be said about the Mad Pride movement with certainty? I guess you could say that one thing it is not about is that it is not about being boring. One thing you’re not going to get out of this movement is more of the same old thing. What’s different about that!?

Way to go, Mad Pride! Wake a few more of those people up out there, please.

At What Age Were You Diagnosed?

This Bipolar Blog entry, Age At Diagnosis of Bipolar Disorder, by Kimberly Read, should peak a little curiosity. How easy it is now to imagine people reacting to human folly with an exclamation like,“What? Are you Bipolar or something!” Pardon my stigmatizing skepticism, but I’ve never been a fervent believer in the religion of mental illness.

I’ve been doing some reading this evening regarding the age of onset for those diagnosed with bipolar disorder.

A team comprised of researchers from several different countries, reviewed the Onset-Age of Bipolar Disorders at Six International Sites. They found the median age of onset – the age found in the middle of the set of all ages – was 25.2 years old. Those with bipolar I disorder tended to be diagnosed earlier than those with bipolar II disorder and men were diagnosed younger than women. 25% of those in the study were diagnosed on or before age 20; only 2.81% were diagnosed at age 13 or younger. What I found particularly interesting was the incredible range for the age of diagnosis. There were children as young as 10, but also seniors in their 80’s.

How old were you when you were diagnosed with bipolar disorder?

Regarding this post, a few points are to be made:

1. Diagnosing an 80 year old gentleman or woman bipolar constitutes elder abuse.
2. Diagnosing a 10 year old girl or boy bipolar constitutes child abuse.
3. Adults can be gullible, can’t they? And doesn’t this gullibility explain the success of many other religions besides.

When a person has entered their twilight years a diagnosis of bipolar disorder doesn’t make any sense. Experience should tell you, and them, that much. Alright, you’ve gotten so far, and then…swoosh, sudden decline? No. Say an 80 year old is more likely to develop Alzheimer’s or senile dementia, and I don’t think we’d have any argument. Convince an elderly person that he or she has bipolar disorder, and you’ve just joined a whole slew of scam artists preying on the infirmities of the aged.

10 years old! Hey, why 10 years old? This lady apparently hasn’t been reading the news lately or she would know kids have been diagnosed bipolar as young as 3 years old. This Harvard doctor got the bright idea of labeling children diagnosed ADHD early onset Bipolar disorder, and voila! The rate of bipolar diagnosis has made a 40 fold increase. While this is great for doctors making their living off the disturbed, it is not so great for the kid who may end up spending a lifetime in the mental health illness system. Significantly, before this doctor made ‘his discovery’, childhood bipolar disorder was rare to non-existent.

ADHD, Bipolar disorder, and schizophrenia are the current excuses many parents give for their lack of parenting skills. Nobody said the job was an easy one, and it’s not. Some parents apparently have always thought otherwise. The terrible twosomes and beyond can be interpreted in many different ways. Assigning a pathological label to the natural impulses children have is not a good way to treat them. Children are not adults, and they should not be expected to perform at an adult level. Just because they aren’t adults, this doesn’t make them ‘sick’.

The theory of biological psychiatry plays up biological causes for mental illness over environmental and social factors despite a complete lack of evidence supporting this theory. The DSM is the bible of the psychiatrist used for distinguishing one psychiatric condition from another. Psychiatrists still don’t have a clue as to what mental illness actually is while their approach is all about managing the symptoms of any such disease. The seriousness with which the serious mental illness is taken is a big part of the problem. Dispense with this belief factor, and the seriousness of the mental illness itself is likely to diminish. Once Lulu has reached a certain age, the monster under the bed, and the one in the closet, just shouldn’t be as disturbing as they once were.