Monday, March 1, 2010

Non-existant diseases, ineffective drugs

Edward Shorter's Wall Street Journal article is getting some quick reactions. One I found interesting is from Phylameana lila Desy, who describes herself as an energy medicine practitioner, clairvoyant, intuitive counselor, and (of course) flower essence consultant:

"I don't know about you, but I generally feel better having been given a diagnosis. In my world, once an imbalance has been given a name, I'm one step closer to finding balance because at least I know who my enemy is. Easier to go into battle with something tangible, right? But, what if the diagnosis is merely a label, and not a true ailment? What are we supposed to do with that?"

Seems to me this just about says it all. A diagnosis gives people a tangible enemy because they figure it means there's a disease, and a disease is some kind of an evil microscopic creature, and it's so devious that you can't even see it.

But unfortunately for many of us, mental illnesses are not diseases like that, whatever psychiatrists and pharmaceutical companies might want the drug-buying public to believe. Nothing in the DSM is, or ever has been, any more legitimate as a disease than spring fever. That's why you don't find chapters in pathology textbooks discussing schizophrenia or depression. There's just no pathology to discuss. Edward Shorter is technically correct, psychiatry treats non-existent diseases.

Of course the fact deprives some people of a preferred enemy. There's no adventure or heroism in battling mere labels. That may be why NAMI's war on stigma never catches on. They're not creative enough to convince people stigma is a real bacterium or an invisible little alien organism of some sort. Why brain imaging can't show stigma just as easily as ADHD, I have no idea. Apparently NAMI's just damn poor at selling.

We all like a good fight. Personally, I'd rather fight people than bugs too small to see, or labels, or imbalances. To each his own.

I can understand, however, why your average energy medicine practitioner, clairvoyant, intuitive counselor, and flower essence consultant might feel cheated and betrayed when a perfectly good enemy suddenly disappears.

And without mental illness, we confront each other.


  1. On the other hand, our human limitations sometimes require that we are able to "name" something. Many patients in my practice cope much better with their lives when they realize they "have" ADD. We laugh at the "disorder" part of the label together, but we do not laugh at the consequences and challenges of being wired differently. When we get clear in the therapy room, we can work to build the skills, self-insights etc. that (I agree) leave meds in the dust. Love your advocacy! -dr di

  2. Yes, absolutely, to each his own, and I have no obvious right to demand justifications ("our human limitations sometimes require...").

    But what consequences and challenges might result from forgetting that a metaphor ("wired differently" - quotation marks not yours) is in fact a metaphor?

    Thanks for your comment and clear, honest thinking, Di.