Map of life expectancy at birth from Global Education Project.

Tuesday, January 31, 2012

Yep, you're probably nuts

My friend Gary G. discusses the upcoming, brand new, shiny DSM-V in the NYT. I believe I may have noted here once or twice that the psychiatric diagnoses aren't real entities. If a diagnostician makes the judgment that you have two from column A and three from column B of whatever subjectively rated symptoms are on the list, you get a disease label. But whether any two people with that label have the same disease, or any disease at all, is completely unknowable.

If Gary had more space, I expect he also would also have mentioned that applying disease labels to psychological traits or states is necessary in order to get insurance companies to pay for drugs, prescribers' time, and counselors. I will also extend his remarks (I'm sure he won't mind) to say that applying a disease framework has other important consequences.

Despite the complete lack of evidence (in fact plenty of evidence to the contrary) that psychiatric diseases are caused by "chemical imbalances" that are "corrected" by psychiatric medications, many people, including the psychiatrists who prescribe them, continue to believe that they are. And the disease framework is essential scaffolding to the deep cultural proclivity to respond to distress by finding a defect in the sufferer and trying to fix it by pumping in a chemical or some similar technical intervention. Perhaps we could look for the cause of suffering outside of the sufferer, and try to fix that; or decide that sometimes, it makes sense to suffer and that some good can come from it.

But no, all problems are medical.

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