Is it iatrogenic, or is it the result of trauma?

Here’s a weird one. This doctor responds to the question, Is dissociative identity disorder real? He claims that other doctors have suggested that “dissociate identity disorder”, or what used to be referred to as “multiple personality disorder”, is often an iatrogenic condition.

Many biological psychiatrists who base their practices around medication management will tell you the condition doesn’t exist, or that if it exists it is “iatrogenic,” meaning it is caused by therapists training their patients to interpret their symptoms as if they have a whole set of distinct personalities. On the other hand, there are clinicians who specialize in the condition and they take the presence of multiple personalities so seriously that they will separate therapeutic meetings with each of a patient’s “alters” (i.e. individual personalities). True believers will point to data that different personalities have different electroencephalogram tracings. Cynics will point out that actors can generate different EEG tracings when they switch characters.

Iatrogenic is not so much a matter of interpretation, iatrogenic means physician caused, and thus an iatrogenic disease is a disease caused by the treating physician. We seldom refer to “schizophrenia” or “bipolar disorder” as iatrogenic conditions, but when you make the claim that “dissociate identity disorder” may be such a disorder you are opening up the flood gates for doing so. The implication being made is that this “mental disorder” development is based upon the power of suggestion, but the problem here is that there are real and physical iatrogenic diseases that exist beyond the confines of any individual’s head.

By biological psychiatrists Dr. Charles Raison means psychiatrists who subscribe to the biological medical theory of psychiatry. Non-biomedical minded psychiatrists like to point out that there are iatrogenic diseases that are not psychiatric in the slightest that can be laid at the feet of these biological medical minded psychiatrists. There is no doubt involved that these conditions are real, unlike in the case of DID, and there is no doubt as to the doctors culpability. These are the neurological conditions and the metabolic changes that develop due to the cumulative effect of neuroleptic drug use.

Neuroleptic drugs, the drugs most often used to treat schizophrenia and sometimes bipolar disorder, have long been known to cause movement disorders indicative of brain disease. These brain diseases, progressive and often irreversible, are the tardive, which in latin means ‘late forming’, syndrome of diseases. The most notorious manifestation of this brain disease is known as tardive dyskinesia, but there is also a tardive dystonia, and a tardive akathesia, and other related illnesses that may develop as a consequence of the taking of these drugs. Tardive dyskinesia is a crippling condition that manifests itself in involuntary facial twitches, torso twistings, and tongue curlings.

The atypical neuroleptic drugs, developed in the 90s in an effort to lessen some of the more pernicious effects of the original neuroleptic drugs, have been found to cause excessive weight gain and a slew of associated health problems, such as heart disease and diabetes, any one of which has the potential of cutting short a life. The metabolic changes associated with these drugs are the primary reason why the average age at death for people in psychiatric treatment has been shown by some recents studies to be 25 years younger than that of the general population.

This doctor is not very optimistic about the prospects for treating patients labeled with dissociate identity disorder. He sees the source of the dissociation phenomenon as origining in traumas experienced early in life.

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3 Responses

  1. Iatrogenics in psychiatry is a real mind bender isn’t it? It’s not always easy to define or recognize when it occurs in real medicine. It’s a multidimensional continuum with axes labelled “foreseeability”, “severity”, “culpability”, “reasonable expectation” etc.

    I think of DID or schizophrenia etc as being “a state of affairs” in the world. But when it happens it’s a “state of affairs” that appears to be owned by a particular person and able to be described by speaking about and pointing to that particular person.

    I also think of “mental illness” as being a plot device or a theatrical effect. And I don’t mean from the point of view of the “patient”. I mean just like it is in the Greek or Shakespearean plays. It’s used as a cheesey plot device for the benefit of the audience. DID probably got it’s start in a Greek play. The audience liked it so we’ve kept it. Psychiatrists act as custodians of DID. They nearly lost it a couple of times but managed to keep it safe through the ages so we still have it today.

    Mental illness is like George Costanza. There are fat people, short people, bald people and people who wear glasses. And there are even people who are all four. But mental illness, like George Costanza, doesn’t really ever exist. It’s never quite what the shrinks say it is.

    • According to Your Medical Detectives:

      If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.

      Even at the lower estimate of 225,000 deaths per year, this constitutes the third leading cause of death in the U.S.

      This website calls iatrogenic disease the 3rd leading cause of death in the USA.

      I would suspect that these statistics don’t entirely cover the area of psychiatric practice as iatrogenic disease, given the wide spread use of brain altering and health destroying drugs, is epidemic in that field. This consideration might make even the higher end of the above estimation low.

      Calling something a medical mistake is one thing, not calling something a medical mistake is another.

      I don’t think “dissociative identity disorder” got it’s start in a Greek play though, some psychiatrist had a patient, and this psychiatrist had to make sense of that patient’s behavior. If it’s not A, it must be B, and if it’s not A or B, it must be C, and so on. Problem is, and what is often lost sight of, the category homo-sapiens includes the sets of behaviors A, B, C, etc.) You’re not dealing, in other words, with less evolved life forms.

      It’s okay for mental health professionals to bring their brain’s to work, they just shouldn’t leave the heart part at home (& vice versa).

      The fundamental problem with ‘mental illness’ is that it’s not physical. Say it’s like a physical illness until you’re blue in the face. I don’t see any likeness. Physical illnesses manifest themselves differently from emotional problems. Where is any ‘mental illness’ on a microscope slide? Until you can give me a ‘mental illness’ on a microscope slide, it’s just a figment of somebodies imagination as far as any disease is concerned. Call it what you will, it’s probably something else entirely.

      The sad part of the matter is that when “mental illness” is treated like a “medical” condition, people are less likely to recover. How, after all, can you treat a chimera?

      People have problems. Sure. People can be unhappy. Yes. Problems and unhappiness are not diseases. That said, don’t take your problems and unhappiness to a psychiatrist if you don’t want them “treated as diseases”.

      When we replace “problems and unhappiness” with “mental illnesses”, we are mystifying the matter. You have a person saying don’t call a spade a spade. When we call “mental illnesses” “problems and unhappiness”, they cease to be illnesses.

      “Mental illness is like George Costanza.” Exactly!

  2. I’ve been researching the psycho / pharmaceutical industries for eight years now. And I’m quite certain at this point, almost all those diagnosed as bipolar and schizophrenic today are dealing with completely iatrogenicly caused diseases. The ADHD drugs and antidepressants cause “mania, suicides, and violence,” according to the black box warnings. And, due to Dr. Joseph Biederman’s inappropriate expanding of the bipolar criteria in the mid 1990’s, over a million children (and no doubt millions of adults) in the US have had this type of drug induced mania misdiagnosed as bipolar. But the DSM clearly states that if mania is caused by a drug, then a bipolar diagnosis is improper. Here’s a link from a foreign psychiatric professional’s book explaining this reality (read all 7 or so pages).

    http://books.google.com/books?id=KMapbFl0ZZMC&pg=PA59&lpg=PA59&dq=iatrogenic+bipolar&source=bl&ots=wcP_ee7V-k&sig=t2xEHJHWHylwaa23kidO9DLOjgU&hl=en&sa=X&ei=pOi8UY6ZEoq89QSt84DYCQ&ved=0CCcQ6AEwADgU

    And the medical evidence is now in proving the bipolar meds, antipsychotics, cause atrophy of the brain, exactly as seen in long run medicated schizophrenia patients. The antipsychotics actually cause schizophrenic outcomes.

    http://m.psychologytoday.com/blog/mad-in-america/201102/andreasen-drops-bombshell-antipsychotics-shrink-the-brain

    But if you step back and look at the big historical picture, it makes total sence. Of course the sadistic lobotomists sat around writing their “bible,” describing the the mental illnesses that their drugs cause. The psychiatric industry is an industry built on “pillars of sand.” I would imagine, realization of this is part of why Dr. Thomas Insel, the head of NIMH, recently conceded all the DSM disorders were “lacking in validity.”

    And as one embarrassed psychiatrist confessed to me, “The jokes is on us.” Their new “wonder drugs” weren’t really a breakthrough. But the sheer number of these iatrogenic crimes against humanity are staggering.

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