12 January 2004
Issue 76
The Damage of Labels: DSM-IV
by Sam Turton
It is useful for everyone to know about the Diagnostic and
Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV).
This huge bible of a book is published by the American
Psychiatric Association. It was supposedly created to assist
psychiatrists, medical doctors, and psychologists in diagnosing
mental illness. Each diagnostic category (and there are hundreds)
has a code number and a list of possible symptoms. With the label
and a number, the specialist can easily keep records, fill in
medical insurance forms, and find indications for treatment.
A sample of the diagnoses can be found at http://www.behavenet.com
With the DSM-IV, a diagnosis begins by gathering verbal accounts
from the patient and/or family, and searching for a disorder that
seems to match the problem. In each section, there is a list of
possible symptoms - a "multiple choice" checklist that requires,
for instance, "five (or more) of the following symptoms. . . " to
achieve a positive diagnosis. If, in this case, five or more
items are checked off, the client is categorized with a
diagnostic label and a number. Here are some examples:
300.0 Anxiety Disorder
309.0 Adjustment Disorder With Depressed Mood
300.19 Factitious Disorder
300.21 Panic Disorder With Agoraphobia
301.6 Dependent Personality Disorder
311.0 Depressive Disorder
314.01 Attention-Deficit/Hyperactivity Disorder
315.1 Mathematics Disorder
780.9 Age-Related Cognitive Decline
Or, if the specialist isn't sure:
300.9 Unspecified Mental Disorder
Then, with that label and code, various publications, websites,
and pharmaceutical advertisements can be consulted that list the
recommended treatments for that code number. Most of the choices
are medications. In fact, thanks to the DSM-IV, the drug
companies actively get their chemists to design drugs to fit the
defined and coded disorders.
It's so fast and easy. In fact, to make it easier, there are
computer "patient interview" programs available that not only
make the diagnosis for the specialist, but also prescribe the
medication! And if the patient doesn't agree with the diagnosis
and treatment - that is also conveniently classified as a
disorder:
V15.81 Noncompliance With Treatment
All doctors, including psychiatrists, take the Hippocratic Oath,
which states "Do no harm." I believe that the DSM-IV diagnosis
protocol, itself, violates that oath. When people are labeled in
this way, it does them harm. It is a judgment on their person,
their character, and their value. It is a subjective opinion that
places them under the control of so-called experts and will haunt
their personal record for life.
In the wake of such a judgment, clients often conclude that there
is something fundamentally wrong with them. Such a message can
injure self-esteem, increase a sense of despair, depress the
immune system, and endanger physical health.
We are not numbers. We are not labels. Our problems cannot be
reduced to lists and multiple choice. To objectify people and
treat them with such a lack of feeling is, in my opinion, a
serious disorder of its own.
People already know they have problems - that's why they come for
help. They don't need labels, they need understanding. Since
emotional issues are a whole-person phenomenon, their causes and
healing cannot be reduced to single categories. In fact, labels,
by falsely simplifying, obstruct the healing process.
Professionals argue that they need the criteria and a common
diagnostic language in order to discuss and act on the many
"cases" they have to process. This is itself an indictment of the
assembly line mentality of modern health care. If specialists
took the time, and treated those in their care as people - not
just cases and numbers - greater healing would take place at a
lesser cost, without the need for numbers and labels.
Quotations:
"The low level of intellectual effort was shocking. Diagnoses
were developed by majority vote on the level we would use to
choose a restaurant. You feel like Italian, I feel like Chinese,
so let's go to the cafeteria. Then it's typed into the
computer."
Dr. Paula Caplan,
Psychologist
Author of They're Making Us Crazy, commenting on the American
Psychiatric Association's 1987 hearings into DSM.
* * * *
"Given their farcical empirical procedures for arriving at new
disorders with their associated symptoms lists, where does the
American Psychiatric Association get off claiming a scientific,
research-based foundation for its diagnostic manual? This is
nothing more than science by decree. They say it is science, so
it is."
Dr. Margaret Hagen, Ph.D.,
Professor of Psychology
Boston University
* * * *
'There are too many diagnoses without any objective basis or
biological support,' said Dr. Pearlman, a psychiatrist in
Houston."
"There has never been any criterion that psychiatric diagnoses
require a demonstrated biological etiology' [cause], said Dr.
Harold Pincus, vice chairperson to the DSM-IV task force. 'In
fact, virtually no mental disorder, except those that are
substance induced or due to a general medical condition, has
one."
"The manual is also taken too seriously by the rest of society -
including the government, the courts, the hospitals, and
insurance companies,' said Dr. Suriff, a clinical psychologist
at the Massachusetts Institute of Technology in Boston."
Excerpts from an article printed in Clinical Psychiatry News
* * * *
"Research has yet to identify specific biological causes for any
of these disorders. Mental disorders are classified on the basis
of symptoms because there are as yet no biological markers or
laboratory tests for them."
The U.S. Congress Office of Technology
* * * *
"Mental illness is a metaphor (metaphorical disease). The word
"disease" denotes a demonstrable biological process that affects
the bodies of living organisms (plants, animals, and humans). The
term "mental illness" refers to the undesirable thoughts,
feelings, and behaviors of persons. Classifying thoughts,
feelings, and behaviors as diseases is a logical and semantic
error, like classifying the whale as a fish. As the whale is not
a fish, mental illness is not a disease. Individuals with brain
diseases (bad brains) or kidney diseases (bad kidneys) are
literally sick. Individuals with mental diseases (bad behaviors)
like societies with economic diseases (bad fiscal policies) are
metaphorically sick. The classification of (mis)behavior as
illness provides an ideological justification for state-sponsored
social control as medical treatment."
Thomas S. Szasz, M.D.
Professor of Psychiatry Emeritus
State University of New York,
Author of 25 books
http://www.szasz.com
* * * *
". . . modern psychiatry has yet to convincingly prove the
genetic/biologic cause of any single mental illness. . . Patients
[have] been diagnosed with 'chemical imbalances' despite the fact
that no test exists to support such a claim, and. . . there is no
real conception of what a correct chemical balance would look
like. Yet conclusions such as 'depression is a chemical
imbalance' are created out of nothing more than semantics and the
wishful thinking of scientist/psychiatrists and a public who will
believe anything now that has the stamp of approval of medical
science."
David Kaisler
Psychiatrist
* * * *
"There's no biological imbalance. When people come to me and say,
'I have a biochemical imbalance,' I say, 'Show me your lab
tests.' There are no lab tests. So what's the biochemical
imbalance?"
Ron Leifer
New York Psychiatrist
* * * *
"Contrary to what is often claimed, no biochemical, anatomical or
functional signs have been found that reliably distinguish the
brains of mental patients."
"... many are not aware of the enormous influence that the
[pharmaceutical] industry has in shaping our views of mental
disorders and the effectiveness of psychotherapeutic drugs..."
"I am convinced that the pharmaceutical industry spends enormous
amounts of money to increase its sales and profits by influencing
physicians and the public in ways that sometimes bend the truth
and that are often not in the best interests of science or the
public."
Dr. Elliot Valenstein
University of Michigan Neuroscientist
Professor Emeritus of Psychology
Author of Blaming the Brain: The Truth about Drugs and Mental
Health
* * * *
Many of the above quotes courtesy of: http://www.ritalindeath.com
Copyright (c) Sam Turton
Sam Turton is a Primal Integration therapist/facilitator
practicing a unified approach to growth and healing that is an
expression of his extensive personal background in Zen, Taoism,
aboriginal awareness, natural living and primal. Sam is also an
accomplished artist, musician and writer. He is presently
finishing his first book, which presents his approach to Primal
Integration. A CD of his original music has just been released.
More information on this recording appears on the Sam Turton
website:
http://www.samturton.com
In addition to his private practice, Sam is on staff for
intensives at the Primal Integration Center of Michigan, and,
with director Barbara Bryan, is offering a series of residential
training intensives for facilitators. Sam is Vice President of
the International Primal Association, and also serves as
Newsletter Editor and Publications Committee Chair. He and his
partner Jane Lewis live in the vibrant community of Guelph,
Ontario, Canada.
Visit Sam Turton's Primalworks website at:
http://www.primalworks.com/
The Primalworks offers information on personal growth and
healing, primal theory and process, emotional expression and
release, healthy living, Zen meditation, Sam Turton's Primal
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