Re: psychological impact of capitalism

[Brian McKenna <MCKENNA193@xxxxxxx>]

From the Nineveh list. . .just in (below). . .saw a link to your issues. . .

Brian

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http://www.cchr.org/doctors/eng/page10.htm

PSYCHIATRIC DIAGNOSIS
A PARODY OF MEDICINE AND SCIENCE


"There are indeed many illusions about DSM and very strong needs among
its developers to believe that their dreams of scientific excellence
and utility have come true, that is, that its diagnostic criteria have
bolstered the validity, reliability, and accuracy of diagnoses used by
mental health clinicians." The "bitter medicine" is that DSM has
"unsuccessfully attempted to medicalize too many human troubles."57

â Professors Herb Kutchins & Stuart A. Kirk
Making Us Crazy, 1997


While the appearance of Virchow's Cellular Pathology as Based upon
Physiological and Pathological Histology in 1858 firmly established
medicine's scientific credentials, psychiatry was still fumbling
around with brutal treatments and the lack of any systematic approach
to mental health until the 1950s. The absence of an equivalent system
of diagnosis for mental problems contributed greatly to psychiatry's
poor reputation, both among professions and the population as a whole.

  
Psychiatrists Emil Kraepelin (above) and William Menninger are
credited as the pioneers of mental disorder classification and
diagnosis. However, there is no test to validate any psychiatric
disease or disorder. Many are literally voted into existence without
scientific proof.

  
The development of the sixth edition of WHO's International
Classification of Diseases (ICD) in 1948, which incorporated
psychiatric disorders (as diseases) for the first time, and the
publication of Diagnostic and Statistical Manual of Mental Disorders
(DSM) in the United States in 1952, were the first steps toward
systematic diagnosis.

Later, with criticism of the day running high due to inherent
ambiguities and inaccuracies in DSM-II, psychiatry sought to create an
improved diagnostic system, one that would provide an international
foundation of agreement for the entire profession.

David Healy, psychiatrist, director of the North Wales Department of
Psychological Medicine and author of The Anti-Depressant Era, says
that psychiatrists sought more alignment with medicine, believing that
"discrete and identifiable mental illnesses" existed and that
"psychiatry should treat these and not problems of living and
unhappiness."58 Following the introduction of neuroleptic drugs in the
1950s, the number of mental disorders exploded from 163 in DSM-II
(1968), to 224 in DSM-III (1980), and 374 in DSM-IV (1994).

Science by Skirmish

According to Healy, "There must inevitably be a struggle, or a
dialectical process, to determine the meaning of physical symptoms and
where the boundaries of health and disease lie."59 In psychiatry's
diagnostic battle, the line was drawn between psychopharmacology and
psychotherapy.

"There followed a set of political skirmishes. These were political in
that the pitches made by both sides were based on what would secure
votes rather than by appeals to the evidence..."60 Healy writes. The
final result, DSM-III, was what he calls a "revolution by committee."61

What was politically voted in was a system of classification that was
drastically different from, and foreign to, anything medicine had seen
before. Among numerous other distinctions, the most notable was that
the new DSM was devoted to the diagnosis or categorization of symptoms
only, not disease. Another was that none of the diagnoses were
supported by objective evidence of physical disease or mental illness.

Psychiatrist David Kaiser states, "Symptoms by definition are the
surface presentation of a deeper process. This is self-evident.
However, there has been a vast and largely unacknowledged effort on
the part of modern (i.e., biologic) psychiatry to equate symptoms with
mental illness." He says he would be a "poor psychiatrist" if the only
tool he had for treatment was a prescription pad for medications which
may "lessen symptoms", but which "do not treat mental illness per se."
He is left, he said, "still sitting across from a suffering patient
who wants to talk about his unhappiness."62

Science Fiction

In their 1997 book Making Us Crazy, Professors Herb Kutchins and
Stuart A. Kirk say that the transformation of psychiatry's diagnostic
manual is a "story of the struggles of the American Psychiatric
Association to gain respectability within medicine and maintain
dominance among the many mental health professionals."63

As Dr. Thomas Dorman, an internist and member of the Royal College of
Physicians of the United Kingdom and Fellow of the Royal College of
Physicians of Canada, wrote, "In short, the whole business of creating
psychiatric categories of `disease,' formalizing them with consensus,
and subsequently ascribing diagnostic codes to them, which in turn
leads to their use for insurance billing, is nothing but an extended
racket furnishing psychiatry a pseudo-scientific aura. The
perpetrators are, of course, feeding at the public trough."64

Dr. Thomas Szasz writes, "Psychiatrists spend many years learning
their specialized language whose authoritative use distinguishes them
from other physicians and lay persons. Under the heavy weight of habit
and self-interest, they are likely to be taken in by their own jargon
and believe that persons called `mental patients' have brain diseases,
that cause them to have mental diseases. The possibility that mental
diseases are merely names no longer occurs to them...."65

Shorter puts it this way: "...in psychiatry, where genetics apart, the
causes of few conditions are known. What is the cause of something
like erotomania, the delusional belief that someone else is in love
with you? Nobody knows.... These considerations suggest that in
classification it is very easy for psychiatry to lose its way."66

The Myths of Biopsychiatry

Seeking to attract government research funds in testimony before a
United States House of Representatives Committee in 2000, Steven
Miran, Medical Director of the APA, stated that "scientific research
over the last two decades has shown that severe mental illness and
addictive disorders are... diseases of the brain with a strong genetic
and biological basis."67

In contrast, Healy reports, "There are increasing concerns among the
clinical community that not only do neuroscientific developments not
reveal anything about the nature of psychiatric disorders but in fact
they distract from clinical research.... There has been astonishing
progress in the neurosciences but little or no progress in
understanding depression."68

Glenmullen reports that with the "absence of any verifiable diseases",
psychopharmacology "has not hesitated to construct `disease models'
for psychiatric diagnoses. These models are hypothetical suggestions
of what might be the underlying physiologyâfor example, a serotonin
imbalance."69

Pushing the Psychiatric Envelope

A June 2000 article in Toronto, Canada's Globe and Mail headlined,
"The Gap Is Closing Between Psychiatry And Family Medicine", reported
that "Psychiatrists are wary of the unfamiliarity family doctors often
show with mental health problems." The article quoted Glenn Thompson,
the executive director of the Ontario division of the Canadian Mental
Health Association, saying that there's nothing wrong with the primary
care physician being "the likely first port of call", provided the
physician is connected, above all, to a psychiatrist.

      
  
"There is no test for depression. Our understanding of the brain is
simply not sophisticated enough. You diagnose from behavior... We are
more likely to treat depression because there are drugs available to
treat it."

â Dr. Jim Bolton Lecturer in Psychiatry St. George's Hospital, London,
2001
  
    

The "mental health problems" to which the article refers are, of
course, those outlined in the DSM. The reliability of that contrived
system of diagnosis and the inevitable assignment of a psychoactive
drug prescription is the singular "expertise" that psychiatry has to
offer.

Non-psychiatric medical acceptance of psychiatric thinking and
practice may come at a steep price. Says J. Allan Hobson and Jonathan
A. Leonard, authors of Out of Its Mind, Psychiatry in Crisis, A Call
For Reform, "...DSM-IV's authoritative status and detailed nature
tends to promote the idea that rote diagnosis and pill-pushing are
acceptable."70

"In scientific terms, there are underlying serious issues of
reliability and validity. You cough. Does that mean you are suffering
from `Cough Disorder'? That is the nature of psychiatric diagnoses,"
says Kutchins.

If psychiatrists are indeed mental physicians, let them restrict
themselves to mental doctoring and leave physical doctoring to
non-psychiatric physicians. That is the gap that should not be bridged.



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