hi all,
look, it is true that the way psychiatry has evolved contains many many problematic issues..
but there is no question that it has evolved- at least in part- due to the very serious dilemas and discomfort that arise in human life. we are creatures of cognition and emotion. and sometimes these elements are related to suffering and/or to difficulty living fully and taking on the tasks of life..
so there is real suffering and disability involved.
when we do a psychiatric interview, we are doing a physical exam but its an exam of the mind/brain- we are talking with people to understand how they are experiencing their emotions and how they are experiencing their thoughts. it is as subjective and materialisitic as listening for a heart murmur. do our diagnositic categories come close to being able to shorthand how a persons brain/mind is working? absolutely not! is the perception of the psychiatrist subjective- of course. (so is the perception of the heart murmur. dont go to a deaf cardiologist and dont go to an insensitive psychiatrist...
ultimately, i think the issue before us is how do we construct a profession of people who attend to the issues of suffering and disability of the brain/mind without creating a hierarchy of oppression. for me, i am working to do this, along with others, to build the recovery movement, to understate the overclaims of science, but most of all, to engage as authentically and as wisely as possible- having the courage to change the things that i can, the capacity to accept those i cant, and the wisdom to know the difference.
of course, in this context, i can only quote robert burns
would some gift the giftie gie us, to see ourselves as others see us..
ken
-----Original Message-----
From: Social Determinants of Health on behalf of Graeme Bacque
Sent: Sat 6/11/2005 1:23 PM
To: [log in to unmask]
Subject: Re: [SDOH] primary health care models
Anneliese Poetz wrote:
> True, there are stigma issues but that is more a societal issue, not
> just confined to healthcare workers. These are also not easily overcome.
Healthcare workers frequently aggravate this situation in collusion with
the media.
And let's ditch this word 'stigma', OK? What we are talking about here
is bigotry, pure and simple. There is a pervasive social prejudice at
work here that is every bit as malignant as racism, misogyny, or
homophobia - and which is just as unacceptable.
>
> However, your claim that "*/there is no physiological basis that has
> been identified for any psychiatric diagnosis"/* is based on what? I
> know of a few psychiatric diagnoses that have physiologic bases: 1)
> ADHD patients have a noticably smaller brain on MRI scans
Blame that one on Ritalin. The manufacturers of this drug are facing
lawsuits in the United States over just this type of thing.
> 2) depression can occur from a number of measurable things such as low
> iron, not just chemical imbalance or social/personal issues.
I was referring to /*psychiatric*/ diagnoses, not iron deficiencies or
other clearly physical issues that generally fall under the domain of
other medical professionals. You can detect iron deficiency through a
simple blood test. /*There is no equivalent clinical diagnostic
procedure for any so-called 'mental illness'. */Every day, people are
losing their rights and having their lives ruined on the basis of these
diagnoses - only this is the result of the labels themselves rather
than any underlying 'disease'.
Psychiatrists base their labels entirely on their observations of
someone's behaviour and a subjective evaluation of their 'patient's'
answers to a set of (trick) questions rather than any kind of
physiological examination. Frankly, I have yet to hear of anyone
actually being given any kind of physical exam by a psychiatrist prior
to being diagnosed. (I certainly never experienced one). Do you know of
any other physicians who make their diagnoses or prescribe treatment on
the basis of a verbal interview alone?
>
> Further, the field of medicine is not just science and things you can
> /quantify and measure/ it is also an art. So, many diagnoses involve
> guesswork, not just mental disorders.
Psychiatrists are almost entirely guessing when they make 'diagnoses',
(much more so than other fields of medical practice) and as well, they
represent the only branch of medicine with the legal power to routinely
impose its decisions on unwilling individuals based on this brand of
guesswork.
Graeme
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