Holy Smoke! Here we go 2006!!

[Guest guest]

2006 starts off with a bang!

http://www.latimes.com/news/opinion/sunday/editorials/la-op-psych1jan01,0,186875\

3.story?coll=la-home-sunday-opinion

January 1, 2006

Los Angeles Times

Psychiatry's sick compulsion: turning weaknesses into diseases

By Irwin Savodnik, Irwin Savodnik is a psychiatrist and philosopher who teaches

at UCLA.

IT'S JAN. 1. Past time to get your inoculation against seasonal affective

disorder, or SAD - at least according to the American Psychiatric Assn. As

Americans rush to return Christmas junk, bumping into each other in Macy's and

Best Buy, the psychiatric association ponders its latest iteration of feeling

bad for the holidays. And what is the association selling? Mental illness. With

its panoply of major depression, dysthymic disorder, bipolar disorder and

generalized anxiety disorder, the association is waving its Calvinist flag to

remind everyone that amid all the celebration, all the festivities, all the

exuberance, many people will " come down with " or " contract " or " develop " some

variation of depressive illness.

The association specializes in turning ordinary human frailty into disease. In

the last year, ads have been appearing in psychiatric journals about possible

treatments for shyness, a " syndrome " not yet officially recognized as a disease.

You can bet it will be in the next edition of the Diagnostic and Statistical

Manual of Mental Disorders, or DSM-IV, published by the association. As it turns

out, the association has been inventing mental illnesses for the last 50 years

or so. The original diagnostic manual appeared in 1952 and contained 107

diagnoses and 132 pages, by my count. The second edition burst forth in 1968

with 180 diagnoses and 119 pages. In 1980, the association produced a 494-page

tome with 226 conditions. Then, in 1994, the manual exploded to 886 pages and

365 conditions, representing a 340% increase in the number of diseases over 42

years.

Nowhere in the rest of medicine has such a proliferation of categories occurred.

The reason for this difference between psychiatry and other medical specialties

has more to do with ideology than with science. A brief peek at both areas makes

this point clear. All medicine rests on the premise that disease is a

manifestation of diseased tissue. Hepatitis comes down to an inflamed liver,

while lung tissue infiltrated with pneumococcus causes pneumonia. Every medical

student learns this principle. Where, though, is the diseased tissue in

psychopathological conditions?

Unlike the rest of medicine, psychiatry diagnoses behavior that society doesn't

like. Yesterday it was homosexuality. Tomorrow it will be homophobia. Someone

who declares himself the messiah, who insists that fluorescent lights talk to

him or declares that she's the Virgin , is an example of such behavior. Such

people are deemed - labeled, really - sick by psychiatrists, and often they are

taken off to hospitals against their will. The " diagnosis " of such " pathological

behavior " is based on social, political or aesthetic values.

This is confusing. Behavior cannot be pathological (or healthy, for that

matter). It can simply comport with, or not comport with, our nonmedical

expectations of how people should behave. Analogously, brains that produce weird

or obnoxious behaviors are not diseased. They are brains that produce atypical

behaviors (which could include such eccentricities as dyed hair or multiple

piercings or tattoos that nobody in their right mind could find attractive).

Lest one think that such a view is the rant of a Scientologist, it is no such

thing. Scientology offers polemic to lull the faithful into belief. Doctors and

philosophers offer argument to provoke debate.

It's a natural step from using social and political standards to create a

psychiatric diagnosis to using them to influence public policy. Historically,

that influence has appeared most dramatically in the insanity defense. Remember

Dan White, the man who murdered San Francisco Mayor Moscone and

Supervisor Harvey Milk in 1978? Or Hinckley, who shot President Reagan in

1981? Or Mark Chapman, who killed Lennon? White, whose psychiatrist

came up with the " Twinkie defense " - the high sugar content of White's favorite

junk food may have fueled his murderous impulses - was convicted and paroled

after serving five years, only to commit suicide a year later.

The erosion of personal responsibility is, arguably, the most pernicious effect

of the expansive role psychiatry has come to play in American life. It has

successfully replaced huge chunks of individual accountability with diagnoses,

clinical histories and what turn out to be pseudoscientific explanations for

deviant behavior.

Pathology has replaced morality. Treatment has supplanted punishment.

Imprisonment is now hospitalization. From the moral self-castigation we find in

the writings of , we have been drawn to Woody -style neuroses.

Were the psychiatric association to scrutinize itself more deeply and reconsider

its expansionist diagnostic programs, it would, hopefully, make a positive

contribution to our culture by not turning the good and bad into the healthy and

the sick.

The last thing the United States needs is more self-indulgent,

pseudo-insightful, overly self-conscious babble about people who can't help

themselves. Better, as Voltaire would put it, to cultivate our gardens and be

accountable for who and what we are.

==

You can write a letter to the editor here: letters@...

==

If you would rather not receive the latest news via this e-mail line, please

send a message to

records@... with " UNSUBSCRIBE ME " in the subject line.

(posted as a requirement under legal and contractual requirements)

[Guest guest]

2006 starts off with a bang!

http://www.latimes.com/news/opinion/sunday/editorials/la-op-psych1jan01,0,186875\

3.story?coll=la-home-sunday-opinion

January 1, 2006

Los Angeles Times

Psychiatry's sick compulsion: turning weaknesses into diseases

By Irwin Savodnik, Irwin Savodnik is a psychiatrist and philosopher who teaches

at UCLA.

IT'S JAN. 1. Past time to get your inoculation against seasonal affective

disorder, or SAD - at least according to the American Psychiatric Assn. As

Americans rush to return Christmas junk, bumping into each other in Macy's and

Best Buy, the psychiatric association ponders its latest iteration of feeling

bad for the holidays. And what is the association selling? Mental illness. With

its panoply of major depression, dysthymic disorder, bipolar disorder and

generalized anxiety disorder, the association is waving its Calvinist flag to

remind everyone that amid all the celebration, all the festivities, all the

exuberance, many people will " come down with " or " contract " or " develop " some

variation of depressive illness.

The association specializes in turning ordinary human frailty into disease. In

the last year, ads have been appearing in psychiatric journals about possible

treatments for shyness, a " syndrome " not yet officially recognized as a disease.

You can bet it will be in the next edition of the Diagnostic and Statistical

Manual of Mental Disorders, or DSM-IV, published by the association. As it turns

out, the association has been inventing mental illnesses for the last 50 years

or so. The original diagnostic manual appeared in 1952 and contained 107

diagnoses and 132 pages, by my count. The second edition burst forth in 1968

with 180 diagnoses and 119 pages. In 1980, the association produced a 494-page

tome with 226 conditions. Then, in 1994, the manual exploded to 886 pages and

365 conditions, representing a 340% increase in the number of diseases over 42

years.

Nowhere in the rest of medicine has such a proliferation of categories occurred.

The reason for this difference between psychiatry and other medical specialties

has more to do with ideology than with science. A brief peek at both areas makes

this point clear. All medicine rests on the premise that disease is a

manifestation of diseased tissue. Hepatitis comes down to an inflamed liver,

while lung tissue infiltrated with pneumococcus causes pneumonia. Every medical

student learns this principle. Where, though, is the diseased tissue in

psychopathological conditions?

Unlike the rest of medicine, psychiatry diagnoses behavior that society doesn't

like. Yesterday it was homosexuality. Tomorrow it will be homophobia. Someone

who declares himself the messiah, who insists that fluorescent lights talk to

him or declares that she's the Virgin , is an example of such behavior. Such

people are deemed - labeled, really - sick by psychiatrists, and often they are

taken off to hospitals against their will. The " diagnosis " of such " pathological

behavior " is based on social, political or aesthetic values.

This is confusing. Behavior cannot be pathological (or healthy, for that

matter). It can simply comport with, or not comport with, our nonmedical

expectations of how people should behave. Analogously, brains that produce weird

or obnoxious behaviors are not diseased. They are brains that produce atypical

behaviors (which could include such eccentricities as dyed hair or multiple

piercings or tattoos that nobody in their right mind could find attractive).

Lest one think that such a view is the rant of a Scientologist, it is no such

thing. Scientology offers polemic to lull the faithful into belief. Doctors and

philosophers offer argument to provoke debate.

It's a natural step from using social and political standards to create a

psychiatric diagnosis to using them to influence public policy. Historically,

that influence has appeared most dramatically in the insanity defense. Remember

Dan White, the man who murdered San Francisco Mayor Moscone and

Supervisor Harvey Milk in 1978? Or Hinckley, who shot President Reagan in

1981? Or Mark Chapman, who killed Lennon? White, whose psychiatrist

came up with the " Twinkie defense " - the high sugar content of White's favorite

junk food may have fueled his murderous impulses - was convicted and paroled

after serving five years, only to commit suicide a year later.

The erosion of personal responsibility is, arguably, the most pernicious effect

of the expansive role psychiatry has come to play in American life. It has

successfully replaced huge chunks of individual accountability with diagnoses,

clinical histories and what turn out to be pseudoscientific explanations for

deviant behavior.

Pathology has replaced morality. Treatment has supplanted punishment.

Imprisonment is now hospitalization. From the moral self-castigation we find in

the writings of , we have been drawn to Woody -style neuroses.

Were the psychiatric association to scrutinize itself more deeply and reconsider

its expansionist diagnostic programs, it would, hopefully, make a positive

contribution to our culture by not turning the good and bad into the healthy and

the sick.

The last thing the United States needs is more self-indulgent,

pseudo-insightful, overly self-conscious babble about people who can't help

themselves. Better, as Voltaire would put it, to cultivate our gardens and be

accountable for who and what we are.

==

You can write a letter to the editor here: letters@...

==

If you would rather not receive the latest news via this e-mail line, please

send a message to

records@... with " UNSUBSCRIBE ME " in the subject line.

(posted as a requirement under legal and contractual requirements)