Crazy people are considered mad by the rest of the society only because their intelligence isn’t understood
– Weihui Zhou
IV – Psychiatry and the DSM
For someone working to help people deal with these conditions, it is helpful to look at specific symptoms, to classify, and to find common causes, and hence common solutions for these symptoms, if they are problematic for the person.
Systematising in this way is what we do well, and gives us our understanding of the world we have, so I don’t have a problem with it. In fact I fully support it.
However, with the failed biological model, this means that symptoms are given arbitrary disorder names and drugs applied to ‘fix’ them. The mainstream approach is predicated on an often unproven assumption of biological cause which leads to harmful decisions.
It also often means people give up responsibility for their conditions, and even for their actions. While this avoids blame it unfortunately goes further and avoids responsibility, resulting in people giving up and just living with their ‘condition’.
Tom Stafford says “we know that self-efficacy is one of the best predictors of recovery, so denying people’s role in their own decisions just undermines one of their most important tools for recovery“.
The approach I’m advocating here is that you can take responsibility, and that you can change. It means empowering the individual to change for the better if they want to.
As you can see, “having some psychiatric symptoms is part of the human condition and does not by itself indicate the presence of mental disorder. The boundary between the worried well and the psychiatrically ill is fuzzy; arbitrary, and subjective—there is no biological test.”
Tom Stafford says “The fact that the most senior psychiatric researchers in the US are now openly and persistently highlighting that the DSM is not fit for the purpose of advancing science and psychiatric treatment is a damning condemnation of the manual.”
Neuroskeptic says that “many people are now being prescribed antidepressants for emotional and personal issues which wouldn’t have been considered medical illnesses until quite recently“. He adds that they don’t work very well either.
We really do have a lot to learn about the brain. It was only 60 years ago that Freeman and Watts went around sticking a rod up people’s eye sockets and wriggling it about to mess up their frontal cortex. The frontal lobotomy certainly made them tractable, but left them in a terrible state, usually mentally and physically retarded and sometimes dead. These guys had sod-all idea of what they were doing. Some may say, ‘ah but today we have such a clear understanding of these issues, science has come so far‘. But some of these drugs are like a blunderbuss to the brain. I think that in another 60 years time many of these drugs will be considered an abhorrent way of treating people.
It’s not a question of whether or not these behaviours exist. It a question of whether the psychiatric approach and classifications are helpful. The disease model is fundamentally flawed. And many psychiatrists recognise this.
Final part – What Does Work in the next post…
Part III – Stigma in the previous post.