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pathologising normality? BBC radio prog on new DSM

MeSci

MeSci

ME/CFS since 1995; activity level 6?
Messages
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Location
Cornwall, UK
Being Normal
Jon Ronson On, Series 7 Episode 3 of 5

As a new edition of the American Diagnostic and Statistical Manual of Mental Disorders (DSM) is published this year, writer and documentary maker Jon Ronson travels around the UK meeting people whose behaviour might be considered normal, but may soon fall under the criteria of some brand new disorders.

He goes to a competitive eating competition in Bristol to speak to a man who has been obsessed with his weight. And he visits Adam Buxton, who may be a candidate for "intermittent explosive disorder" as he is prone to losing his temper in an explosive way.

Psychiatrist Dr Joanna Moncrieff says she believes the DSM is amplifying a tendency to label more and more people as having health problems. While Dr Jeffrey Lieberman, president elect of the American Psychiatric Association, which publishes the DSM, defends the manual saying it does not attempt to pathologise normal behaviour such as anger but look at repeated behaviour.

Jon also hears from David Aaronovitch who was sent to a psychiatrist by his parents for being a shouty teenager and he wonders if, these days, he would be misdiagnosed? Finally Jon speaks to Alex Trenchard who tells his story for the first time of how his obsession with his music festival resulted in a prison sentence.
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W

worldbackwards

Senior Member
Messages
2,051
I heard this when it was first on and really enjoyed it.
Jon also hears from David Aaronovitch who was sent to a psychiatrist by his parents for being a shouty teenager and he wonders if, these days, he would be misdiagnosed?
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Irony dying there, ladies and gentlemen.

Also very good on this, for anyone who hasn't read it:
This mad project is clearly something that its authors are fixated on to a somewhat unreasonable extent. In a retrospectively predictable ironic twist, this precise tendency is outlined in the book itself. The entry for obsessive-compulsive disorder with poor insight describes this taxonomical obsession in deadpan tones: “repetitive behavior, the goal of which is […] to prevent some dreaded event or situation.” Our narrator seems to believe that by compiling an exhaustive list of everything that might go askew in the human mind, this wrong state might somehow be overcome or averted.
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http://thenewinquiry.com/essays/book-of-lamentations/
 
Jeckylberry

Jeckylberry

Senior Member
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127
Location
Queensland, Australia
I'm interested if there are any like 'over-compliance towards medical professionals' where the patient fails to question or to research their own illness to verify the appropriateness of the diagnosis. That's probably seen as perfect in their eyes!
 
Hip

Hip

Senior Member
Messages
17,858
I know people who argue that the ADHD / ADD diagnosis is just a lot of nonsense, that that children with ADHD / ADD are just dreamy types, not inclined to pay attention. They say that ADHD / ADD is just creating an artificial diagnosis, and medicalizing a normal condition.


Well, I can tell you, I struggled miserably throughout my years in higher education and universities in the 1980s, as a result of having an undiagnosed ADHD / ADD condition. In that era in the UK, few had heard of ADHD / ADD, and I don't think kids at school were routinely screened for such disorders. As a consequence, my ADHD / ADD went entirely untreated throughout my years in education, which left me at a significant disadvantage.


When considering new psychological labels or conditions, the thing to bear in mind is whether the diagnosis and then treatment the condition can lead to improvements or benefits in the life of individuals who have it. If it can lead to improvements or benefits, then it is probably a good label.
 
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MeSci

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
Hip said:
When considering new psychological labels or conditions, the thing to bear in mind is whether the diagnosis and then treatment that condition can lead to improvements or benefits in the life of the individual with that condition. If it can lead to improvements or benefits, then it is probably a good label.
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I think that it is crucial to ask two particular questions:

Is the behaviour causing problems?
What might be the cause(s) of the behaviour?

and in the case of a child:

Is the child likely to grow out of the behaviour without intervention?

I was sent to a child psychiatrist - can't remember exactly what for - but I have a vague memory of being asked what appeared to be some very stupid questions, such as possibly whether I was upset when my mother died.

I think that they also interviewed me in the presence of my stepmother and/or father. If so, I would not have been able to tell them what the problems were, as they emanated largely from those very people, and those very people would mock and/or dismiss my honest answers.
 
TiredSam

TiredSam

The wise nematode hibernates
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Germany
S

shahida

Senior Member
Messages
120
I heard that progrmme too - it strikes at the heart of the issue of what is meant by a 'mental disorder' and what is normal dysfunctional human behaviour? I agree with the title of this thread, it does seen to be ever increasingly pathologising human behavioiur. you Just have to listen to the news at all the mad crazy things going on in the world- peolle killing others in the most awful way- cruelty, bad and dysfunctional behaviour seems to part of the human ocndition.
 
I

Invisible Woman

Senior Member
Messages
1,267
Progress ......

It used to be mainly women who wouldn't behave i.e. wouldn't marry someone they didn't want to, had an interest in someone they shouldn't, wouldn't follow the path dictated by their families, were at risk of causing a scandal or who were simply in the way who were locked up.

At least they're not sexist anymore. Now everyone is fair game!
 
MeSci

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
chipmunk1 said:
We already have "treatment non-compliance disorder"

http://www.icd9data.com/2012/Volume1/V01-V91/V10-V19/V15/V15.81.htm
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Good grief.

The list includes:
  • Noncompliance with dietary regimen
  • Noncompliance with fluid volume management
  • Patient declines colonoscopy
My comments:
  • Dietary advice from doctors tends to be very poor, at least in the UK.
  • Fluid volume management - I was put on fluid restriction last time I was in hospital, despite already being dehydrated. Result - severe constipation, which I had to treat myself with herbs from the garden as I was refused laxatives on being discharged from hospital.
  • Are colonoscopies not voluntary?!
As for non-compliance with medication supposedly being hazardous - taking medication can be extremely hazardous, indeed lethal. It was a prescribed drug - taken as prescribed - that had put me in hospital.
 
chipmunk1

chipmunk1

Senior Member
Messages
765
Invisible Woman said:
Progress ......

It used to be mainly women who wouldn't behave i.e. wouldn't marry someone they didn't want to, had an interest in someone they shouldn't, wouldn't follow the path dictated by their families, were at risk of causing a scandal or who were simply in the way who were locked up.

At least they're not sexist anymore.
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Note so sure :)

http://www.ncbi.nlm.nih.gov/pubmed/12901244

Patterns of misdiagnosis of multiple sclerosis.

RESULTS:
The patients had been referred to 2.2 +/- 1.3 specialists before seeing a neurologist, and learned about their disease 3.5 years after the onset of symptoms. Twenty-nine patients (58%) were initially given 41 wrong diagnoses. While the majority of women were misdiagnosed mentally, orthopedic work-up was offered to the men
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SOC

SOC

Senior Member
Messages
7,849
MeSci said:
Good grief.

The list includes:
  • Noncompliance with dietary regimen
  • Noncompliance with fluid volume management
  • Patient declines colonoscopy
My comments:
  • Dietary advice from doctors tends to be very poor, at least in the UK.
  • Fluid volume management - I was put on fluid restriction last time I was in hospital, despite already being dehydrated. Result - severe constipation, which I had to treat myself with herbs from the garden as I was refused laxatives on being discharged from hospital.
  • Are colonoscopies not voluntary?!
As for non-compliance with medication supposedly being hazardous - taking medication can be extremely hazardous, indeed lethal. It was a prescribed drug - taken as prescribed - that had put me in hospital.
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Big Brother is looming larger every minute.

I wonder how many of the people who make up and use these diagnoses ever consider themselves to have these kinds of disorders? Or are they all perfectly mentally healthy because, well, they're them and that's the definition of mentally healthy, right? It's probably only the rest of us who don't do what they want (eat in a certain way, drink in a certain way, have a colonoscopy) who are disordered. :rolleyes:
 
chipmunk1

chipmunk1

Senior Member
Messages
765
Surfing the Internet according to psychiatry:

When the psychiatrist is using the Internet it is called: Research.
When the average person is using the Internet it is called: Using the Internet.
When someone with medically unexplained illness is using the Internet it is called: Reinforcement of false illness beliefs.
 
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