The anti-DSM movement finds its poet. This guy can really write.
Psychiatrists get paid for treating mental illness. There is a strong motivation for them to look at things they used to attribute to chronic personality, or just life, and see them as psychiatric illness. If you have an unstable personality disorder I am afraid psychiatry has little to offer, but if we call you bipolar or cyclothymic we treat you with antidepressants and mood stabilizers, and get paid to do so.
… An apparently scientific argument is said to be “not even wrong” if it is based on assumptions that cannot possibly be falsified or used to predict anything. I am afraid after nearly 20 years in the belly of the beast of psychiatry I come to no other logical conclusion than that for the most part the DSM and the psychiatry behind it are “not even wrong.” … Because of this purely descriptive, medicalized approach untied to verifiable pathology, if I as a doctor want to see bipolar disorder as irritability and daily mood swings (as many do), than that to me is being “bipolar.” I can also look at it as a byproduct of a very challenging environment superimposed on temperament, but I cannot prove that it is or is not “bipolar disorder.” I can only prove that I choose to interpret some symptoms as diagnostic of that particular label. When the definition of the construct cannot escape subjective description or self report we cannot escape the arguments by certain groups with competing interests that we are either “under” or “over” diagnosing disorders. Whether we are or are not depends on what kind of world you want to live in and how you want to conceptualize what people tell you.
University psychiatrists who unwarily hand out diagnoses and pills to students, or who, as researchers sometimes compromised by industry affiliations, lend academic legitimacy to pseudo-science, have much to answer for.
December 14th, 2011 at 3:20PM
I saw a recipe for steelmaking, dated sometime in the late medieval or early Renaissance era, which said that you would get better results if instead of using water for the quenching you use “the urine of a small red-haired boy.” It’s tempting to believe that much psychiatry is on the same level.
(Although in fairness to some forgotten metalsmith I must not that the steel recipe was at least empirically testable, regardless of whether he actually did such testing or not)