Perhaps It’s Time to Change Models

The DSM, through DSM-V revisions, is being restructured according to the latest reports. This restructuring is based on the latest scientific discoveries.

You can believe that if you’re naïve perhaps, or if you’re a convert to the “mental illness” religion, but it doesn’t really hold water. The most apt analogy for this revision process that I can think of is with a woman going to her beautician for her scheduled ‘make over’.

This is an instance of bad science approving itself.

Why bad science? Well, essentially because the science of specifically medical model psychiatry, the very psychiatry behind the manual, is based primarily upon premise. Good science isn’t based upon such premises. Good science is based upon evidense.

What premise do I mean? I mean the premise that “serious mental illness” is biologically determined. Theory has it that “serious mental illness” is 70 % or so determined by hereditary, and that the other 30 % is determined by environmental and social factors.

Biological determination of this sort allows our psychiatrists to see “chronicity”, “incurability”, or “non-recovery” as a matter of biology rather than as a matter of professional and systemic failure. Were the case the way they’d have it, then the situation becomes less rather than more mutable.

Whether what is conventionally thought of as “serious mental illness” is determined by this, that, or the other hasn’t really been clearly established. The scientific method is not truth; the scientific method is merely a method for arriving at the truth.

The reason that “serious mental illness” is seen as 70 % determined by genes is because the people doing the seeing are biological medical model psychiatrists. Were another premise used, by another school of treatment, you’d get a different estimation.

In the case of an estimate like this you have to have well over 50 % of the determination to ground your theory. Biological medical model psychiatry wouldn’t be viable if its theory attributed more than 50 % of the basis for “serious mental illness” to the environment or society.

The key word here, folks, is theory.

This is an instance of theory guiding science rather than science guiding theory. Given another theory these estimates would reverse themselves with “serious mental illness” being 70 % determined by environment or society, and only 30 % or so determined by heredity.

The numbers 70 and 30 are, of course, purely arbitrary. It could be 80 and 20. It could be 60 and 40. The idea is that your estimate must support your theory.

The statistics you are not getting here are those dealing with the growing numbers of people labeled by doctors using the DSM. The number of those who become casualties of this labeling process, and the prescription drugging that goes along with it. These numbers are growing, and the revisions put in the upcoming version of the manual are not likely to reduce this incline one iota. In fact, if anything, the revision is likely to increase the numbers of people psychiatrically labeled and harmed.

Someday biological medical model psychiatry is going to have to look in the mirror, and the truth will be out. No amount of cosmetic effort is going to make this school of practice desirable.

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13 Responses

  1. I agree.

    Psychiatry is not based upon science. Period.

    Or, in the words of Leonard Roy Frank –

    “Psychiatry is to medicine what astrology is to astronomy.”

    http://www.endofshock.com/about%20Leonard.pdf

    You’re right…
    History will get the last word.
    And history will not be kind to the “profession” of psychiatry!

    Duane Sherry, M.S.
    discoverandrecover.wordpress.com

    • I just did a search for the origin of the saying: “History is written by the winners.”
      It is often attributed to Alex Haley, but he certainly couldn’t be the origin of the expression. George Orwell said it before him. Napolean Bonaparte said it before him. Although someone wrote something about Pliny the Elder and perhaps some other ancient statesman saying something of the sort, I haven’t gotten any further on it than Napoleon.

      Hopefully we will win that one, and the worst of psychiatric mistreatment can be tossed onto the rubbish heap of history, and left behind us.

      The best that can be said of it is that it is idiomatic or axiomatic, that is, it has been accepted in the popular consciousness as a “truism.” Contemporary U.S. historian Howard Zinn acknowledges this fact and uses the idea to write the history of the U.S. from the standpoint of those who were oppressed by and/or the victims of the exploits of the “victors.”

      ~Yahoo! Answers

      The very act of writing a history of the oppressed, for the oppressed, then can be a way of triumphing over oppression.

      I envision a time when things will be very different, and when a disused and abandoned lunatic asylum can serve as a museum of archaic mental health practices. Right now, they’re doing things like making Halloween amusement parks out of closed hospitals, and that’s just a little too unreal. Given the eugenics policies and practises of the first half of the twentieth century, a holocaust has taken place in this country that is yet to be fully acknowledged.

      In my opinion asylum cemeteries are representative of this mistreatment. Patient number 4469 had a name and a life. All we’ve got now is a number on a slab of concrete, if that. When this is done, you’re sweeping someone under the rug, rather than commemorating the life of one departed. It defeats the idea of having markers, but, at least, we’ve got those.

      As an aside.

      “Everyone says history is written by the victors, but it’s actually written by the historiographers.”

      ~anonymous

      Unfortunately, the DSM is authored, edited, and revised mostly by biological minded psychiatrists. I think from the above discussion we can discern that some kind of oppressive power disparity is at work in this process of deriving this psychiatric gospel from those “dead sea scrolls” previous editions represent.

    • I disagree about the “psychiatry is to medicine”
      When a psychiatrist medicates-drugs their patient, they can create the future. There is no brain chemical imbalance until the psychiatrist applies the drugs, and the ” patients” response to the drugs or E.C.T. and imprisonment is “mental illness” .
      Everyone must obey a-their psychiatrist.
      This is vastly different than the voluntary entertainment of astrology.

      • Astrology is not science, it’s superstition. Psychiatry is closer to superstition than it is to science. Would you not agree?

        The quote was not about the entertainment value of astrology, if there is any. It was about the scientific validity of psychiatry.

        Psychiatric drugs are not medicines, they are drugs. These drugs do what drugs do, and they effect the behaviors and perceptions of the people taking them.

        Everybody need not obey their psychiatrist. Oppositional Defiant Disorder is a label applied chiefly to juveniles. Adult ODD, on the other hand, created this country. If it weren’t for adult ODD, we’d still be a colony of Great Britain. Psychiatry hasn’t caught up with adult ODD yet.

        These psychiatrists, primarily, that are part of the task force revising the DSM vote mental disorders into existence. Given disorders like ODD, what could possibly be remotely scientific about such a process?

      • RE”Psychiatry is closer to superstition than it is to science. Would you not agree?”
        Psychiatry uses science to sell their astrology.
        My point is that psychiatrists can MAKE their (astrological) predictions come true when they lie about the need for medications, and force drugs on their “patients”. This is a purposeful FRAUD, not just a superstitious belief.

  2. “Freedom is never voluntarily given by the oppressor; it must be demanded by the oppressed.” – Martin Luther King, Jr.

    My best,

    Duane

    • “Everything that is really great and inspiring is created by the individual who can labor in freedom.” – Albert Einstein

    • Although I wholeheartedly agree with the words of Reverend King, I feel the statement by Professor Einstein is not always the case. I do feel that it is often the case, and that there is much truth to it. Working under oppression, for instance, is not the same as working in a liberated zone, but the ultimate goal of liberation, nonetheless, must loom large. I think that a lot of great things have been accomplished by people who labored under apalling conditions, and so, in some of these cases anyway, it must be a matter of getting around the unfreedom of the conditions an individual was forced to labor in.

      • You raise a good point.

        The human spirit is strong, and does amazing things in spite of (outside) oppression… It seems to find a level of freedom everywhere, in any condition, under any circumstance… I believe this to be our nature.

        My best,

        Duane

  3. If you want to see more science on mental health treatment look at the work done in Finland over the last twenty years on the Open Dialogue approach as treatment of chose for psychosis. 80% recovery rate after five year follow up with little medication use or hospitalization. How do they do it? Well in the 1980s they started the National Schizophrenia Project run by clinicians–therapists. In the USA for profit and nothing else medical system we cedec control of all mental health research to BIG PHARMA, big hospitals and big psychiatry. Not a therapist or healer in the bunch. Just goes to disprove the old adage that you get what you paid for–we paid more and got much less. It rates in my book as a crime against humanity.

    • I’m well aware of the Open Dialogue approach, and I agree. The success of Open Dialogue is all the buzz in some quarters. Author Robert Whitaker uses the approach in his book Anatomy of an Epidemic as an example of a treatment method that works, and that does not rely so heavily on pharmaceutical products as other approaches do. Open Dialogue seems to work better, in fact, than methods that do rely chiefly on pharmaceutical products. I understand that new cases of schizophrenia have practically been eliminated from those parts of Finland where Open Dialogue has been implemented. Film maker Daniel Mackler recently released a DVD on Open Dialogue that can be purchased on the internet. I would encourage anybody who is interested to investigate the matter, and to find out about this approach for themselves.

  4. Sickle-cell disease (SCD), or sickle-cell anaemia. 100% genetic testable.
    “The sickling occurs because of a mutation in the haemoglobin gene.”
    “After the mutation responsible for this disease was discovered in 1979, the U.S. Air Force required black applicants to test for the mutation. It dismissed 143 applicants because they were carriers, even though none of them had the condition. It eventually withdrew the requirement, but only after a trainee filed a lawsuit.”wrote wikipedia.

    What is mental illness?
    Syphilis used to be mental illness.
    Epilepsy used to be mental illness.
    Homosexuality used to be mental illness.

    “Someday biological medical model psychiatry is going to have to look in the mirror”
    No they wont , they are making money selling potions , like charlatans sold potions since the invention of money . They are untouchable because they are “doctors” treating peoples pain-illness. IMO Only if , and when real doctors divorce themselves from psychiatry can psychiatry fail.

    • I would like to think that most people, even psychiatrists, given a good argument, will listen to reason, but maybe you are right. I’m trying to be optimistic. There are many people out there who don’t want to think that all is lost no matter what they do.

      You were right on the mark with those former “mental illnesses” you mention. I think we’ve got a number of “mental illnesses” labels in the present DSM that won’t survive for very long, but as you indicate, given the number of forces at work here, the situation is not likely to get much better any time soon.

      That said, such developments as Open Dialogue, mentioned above, offer a cause for hope. How long can professional psychiatrists ignore the evidence? The approaches they’ve taken don’t work, and many of them only make the condition of their patients worse. You’d think, if they had any concern for the physical health of their clients, they might be able to make the connection, eventually.

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