Friday, October 29, 2010

Medicalization = Stigma

The Treatment Advocacy Center recently called for, "Universal recognition that severe mental illness is medical, NOT behavioral". They say this would be a "breakthrough", but in fact it would be meaningless or delusory.

To begin with, how can "medical" and "behavioral" be mutually exclusive categories of illness? This would necessarily imply either that behavior is not affected by anything which medicine can remedy, or that we just never use medicine to change behavior even when it's possible to do so. Obviously, the widespread existence and practice of psychiatry itself contradicts this.

T.A.C. pretends to advocate only in regards to severe mental illness. So perhaps they mean that millions of people taking Prozac who were never actually psychotic or completely disabled by their blue moods have behavioral problems, not any medical illness. The same would probably go for the millions who take Ritalin to stay sharper in school or more focused on the job.

Yet all of these guys, I'm quite sure, would argue long & hard that their condition is medical, too. If not, then why should their insurance pay for their drugs? Seems to me a condition is medical exactly according to whether or not somebody takes medicine for it, simple as that.

I might add, whether people take "medicine" for a condition doesn't have much bearing on whether they are helped or cured, in any objective sense. Last time I checked, good Scotch whiskey was a great "cure" for just about anything according to somebody, somewhere. And those who find that long-honored cure to be more of a nuisance than whatever the disease was which needed "treatment" can then choose to solve their addiction with LSD. This is all perfectly medical, of course. But I think most of us would see some behavioral aspect....

The T.A.C. guys would have us believe that they, or some expert somewhere, can draw a sharp line between "medical" and "behavioral" - that this is a matter of Science after all, or Special Knowledge.

No. Even schizophrenia and bipolar remain putative diseases, with no proven biological basis or etiology. Actually whether anything called mental "illness" is medical or behavioral can only be a matter of viewpoint in social policy, economics, philosophy, prejudice, and/or various other fuzzy and subjective things.

As the National Institute of Mental Health recently put it, "... curremt diagnostic categories likely do not distinguish among causal factors or provide homogenous endophenotypes." (Translation: nobody knows what any of these so-called mental illnesses actually are!)

So why, exactly, do these oh-so-smart guys at T.A.C. think a meaningless and delusory "universal recognition" would be such a breakthrough?

Because they think it would justify forced psychiatry, that's why. That's the only reason.

Tom Szasz has said, "The subject matter of psychiatry is human conflict. However, perhaps because men are men and not animals, they cannot simply coerce, oppress or exterminate their fellows; they must also explain and justify it."

As far as T.A.C. goes, fraud is still fraud, and what goes around comes around.

Friday, October 8, 2010

DSM5 proposal

Diagnostic criteria for 295.001 Prodromal Anosognosia

A. Excessive avoidance for a period lasting longer than a few weeks, for reasons not related to economic austerity, of normally effective medications or over-the-counter remedies for common discomforts such as cold symptoms, allergies, headaches, muscle soreness, hangover, or difficulty falling asleep.

B. Failure to visit a medical doctor for routine checkups for a period lasting longer than two years.

C. Failure to obtain health insurance; or consistent failure, neglect or refusal to answer official communications from insurance authorities, complete necessary forms and questionaires, or otherwise responsibly attend to administrative details which are recognized as necessary for fair and effective medical insurance coverage.

D. Habitual or repeated patronage of internet websites which puport to "expose psychiatric violations of human rights" or "advocate prosecution of psychiatric crimes".

E. A confirmed record of any four or more of the following statements of effective opinion, not subsequently disavowed:

  1. Mental illnesses are not real brain diseases.
  2. Mental illnesses can be controlled by individual will.
  3. There is no objective medical test to diagnose or rule out any DSM disorder.
  4. Psychotropic medications have dangerous side effects.
  5. Children can become addicted to Schedule II stimulants.
  6. Psychiatrists perpetrate fraud and abrogate the right to informed consent.
  7. Psychiatry kills.
  8. The insanity defense should be abolished.
  9. Involuntary commitment should be abolished.
  10. Psychiatry is pseudo-science.