Friday, October 29, 2010

Medicalization = Stigma

The Treatment Advocacy Center recently called for, "Universal recognition that severe mental illness is medical, NOT behavioral". They say this would be a "breakthrough", but in fact it would be meaningless or delusory.

To begin with, how can "medical" and "behavioral" be mutually exclusive categories of illness? This would necessarily imply either that behavior is not affected by anything which medicine can remedy, or that we just never use medicine to change behavior even when it's possible to do so. Obviously, the widespread existence and practice of psychiatry itself contradicts this.

T.A.C. pretends to advocate only in regards to severe mental illness. So perhaps they mean that millions of people taking Prozac who were never actually psychotic or completely disabled by their blue moods have behavioral problems, not any medical illness. The same would probably go for the millions who take Ritalin to stay sharper in school or more focused on the job.

Yet all of these guys, I'm quite sure, would argue long & hard that their condition is medical, too. If not, then why should their insurance pay for their drugs? Seems to me a condition is medical exactly according to whether or not somebody takes medicine for it, simple as that.

I might add, whether people take "medicine" for a condition doesn't have much bearing on whether they are helped or cured, in any objective sense. Last time I checked, good Scotch whiskey was a great "cure" for just about anything according to somebody, somewhere. And those who find that long-honored cure to be more of a nuisance than whatever the disease was which needed "treatment" can then choose to solve their addiction with LSD. This is all perfectly medical, of course. But I think most of us would see some behavioral aspect....

The T.A.C. guys would have us believe that they, or some expert somewhere, can draw a sharp line between "medical" and "behavioral" - that this is a matter of Science after all, or Special Knowledge.

No. Even schizophrenia and bipolar remain putative diseases, with no proven biological basis or etiology. Actually whether anything called mental "illness" is medical or behavioral can only be a matter of viewpoint in social policy, economics, philosophy, prejudice, and/or various other fuzzy and subjective things.

As the National Institute of Mental Health recently put it, "... curremt diagnostic categories likely do not distinguish among causal factors or provide homogenous endophenotypes." (Translation: nobody knows what any of these so-called mental illnesses actually are!)

So why, exactly, do these oh-so-smart guys at T.A.C. think a meaningless and delusory "universal recognition" would be such a breakthrough?

Because they think it would justify forced psychiatry, that's why. That's the only reason.

Tom Szasz has said, "The subject matter of psychiatry is human conflict. However, perhaps because men are men and not animals, they cannot simply coerce, oppress or exterminate their fellows; they must also explain and justify it."

As far as T.A.C. goes, fraud is still fraud, and what goes around comes around.

1 comment:

  1. One of the saddest days of my life - so far, yet, anyway..../
    Was reading the Time magazine obituary for Dr. Thomas Szasz, who of course wrote the seminal "Myth of Mental illness" in the early 1960's.... Guess who Time got to quote about good old "Uncle Tom"? Yup, E. Fuller Torrey. That's like if Time got Hitler or Mengele to comment on the death of Dr. Albert Sweitzer, or Mother Theresa....
    Just sayin'....