An article on a couple of behavioral health articles in the Baltimore Sun, Psychiatric diagnoses prone to abuse, poses the question: why are psychiatric diagnoses particularly prone to misdiagnosis and overdiagnosis? And then supplies the following answer:
The reason is that psychiatric diagnosis is not based on pathological criteria. The closest the article comes to addressing this problem is the statement that “Even in the best clinical scenario, a psychiatric diagnosis is tricky, experts say; doctors have no X-rays to help apply the criteria defining a mental illness.”
My point is that if these diagnoses are not based on pathological criteria they’re not “diseases” in the strict sense of the word.
In fact a diagnosis can never be indisputably ruled in or ruled out in psychiatry. All we have is testimony by differing psychiatrists, psychologists and social workers. In somatic medicine there is an array of pathological tests which often permit much greater diagnostic certainty. A biopsy of a lump in the breast will almost always tell you whether it’s benign or malignant.
Note the mention of somatic medicine above. Antonyms for somatic are mental and spiritual.
Excuse me if I contradict a lot of the more popular views and theories being bandied about currently, but the opposite of a physical malady is not a physical malady. I’m not at all surprised that psychiatrists have not had very much success at relieving psychological and spiritual crises by treating them as physiological “illnesses”.
If you look at the work being done on the genetics of this endeavor you can see how it gets even further afield. Take, for instance, a recent article on the subject in the New York Times, Genes as Mirrors of Life Experiences.
For decades, researchers have ransacked the genetic pedigrees of people with mental illness, looking for common variations that combine to cause devastating conditions like schizophrenia and bipolar disorder. The search has stalled badly; while these disorders may involve genetic disruptions, no underlying patterns have surfaced — no single gene or genes that account for more than a tiny fraction of cases.
Perhaps our understanding of what we refer to as “mental illness” is not on the verge of the major breakthroughs that some of us thought it was.
So scientists are turning their focus to an emerging field: epigenetics, the study of how people’s experience and environment affect the function of their genes.
Whoa! You can’t find the gene or genes, but you can’t dispense with your theory, voila, epigenetics. When it comes to admitting failure, these doctor researchers take the cake. They are just incapable of going there.
Now we’re talking about experience and environment affecting the genes. Right. Somehow its become much more complicated than a matter of this person with these genes bangs that person with those genes and, whoops, you’ve got your big fat boo boo. Try to ignore the fact that we’re also talking environmental and experiential factors here as well. Maybe there were a lot of social factors involved in the production of the odd ball despite our atomistic presumptions.
I feel that much of this research is a matter of looking at junk DNA, and this junk DNA is a by product of living the kind of a hard life most people bearing “mental illness” labels often find themselves enduring. How did this life get to be so hard? Why, of course, somebody detected the presence of a “serious mental illness” in this person or that, maybe when they were only a kid or a teenager, and the next thing you know the expectations for this or that person take a nose dive, career and success-wise. The opportunity market locks them out. That’s a lot of environmental and experiential impact on the their genetic material. Yeah, sure.
Then turn your angle of vision and look, for instance, at the labeled person and his or her relationships. Maybe it’s these relationships that need to be readjusted, transformed, or severed. I would say also look at the relationship of the researcher to the labeled person. Perhaps that relationship could bear some changing, too. Sometimes the researcher seems to forget that this relationship even exists. In such cases I would heartily recommend taking a few classes in the humanities.