Re: (article) Science Remains a Stranger to Psychiatry’s New Bible

[Guest guest]

Well said, CJ. The politics of this whole process are even more "obscene." Ever since the DSM was first proposed in the 1950's, the sheer number of "mental health disorders" has bloomed fat and dripping wet with each new revision. It took almost an act of Congress to have the APA drop its characterization of homosexuality as a mental health disorder, and we won't go into other skeletons in the APA's closet, which are legion. The real problem "or solution" is this. In the 1950's, MD's were Gods. They were deferred to, no matter how ludicrous their moralistic prattle was, because the profession still enjoyed an unquestioned degree of acceptance. But what happened starting with the early 60's was a wholesale disgust against medical doctors insisting that they had the right to declare an exclusive on "morality" even higher than the Catholid church and other such medieval institutions and anacronysms. The bastion of "academia" has been riddled with holes, scandals, and irrelevance as a medieval institution somehow gone very wrong in the 21st century, although, of course, academia has its pivotal, valued aspects.

This is not the case with the medical profession. First, its members have priced themselves out of ordinary common sense medicine as it was practiced in western society for about two millenia. It's denizens have become fascinated with toys, technology, and pharmaceutical robo fixes, with attendant investment in the same, and, of course, built-in undeclared conflicts of interest all over the place. We won't for the moment talk about the role of the pharma industry, but what HAS happened is a fascinating retreat by the medical profession when it's come to clinial mental health treatment. Diagnosis they insist on holding onto, but they've lost considerable ground to Ph.D.'s and Psy. D's, and a good number of the other less papered counseling professions. They gave up some of this ground gladly in exchange for the added wealth (and no work) in charging for diagnostic consultations and pushing pills.The real hard work, except for the Freudian neo-classicists -- a furry headed bunch indeed, and primarily isolated, thank God, to the East Coast in this country but not so corralled in places like France--the primary work is now with counselors having masters degrees, and clinical social workers, and licensed psychiatric mental health practitioners (nurses) who the profession has begrudgingly allowed to diagnose, even prescribe to (in some states only) but mainly do the heavy lifting of actual face-to-face on a regularly scheduled basis with their patients.

But...in having given up the actual day to day interface with those they diagnose, they've also lost credibility by not being aware or even caring much about what used to be called a bedside manner. Since house calls are things of the past (except in some rather interesting areas of the UK) psychiatrists have lost touch with the real world of real people experiencing real, episodic and chronic distress. No wonder they treat increasing social incredulity at their antics with yet another dose of created labels, names generated from whole cloth, and have such incestuous relationships with one another than each succeeding generation of DSM editorial committee writers and scribes has become distanced and aghast at the one that's come before and after it.

As for bed side manner. Better call it courtside (in the case of the forensic experts hired only by those with axes to grind, persons to lock up, or clients to defend). Things have gotten so bad in the medical profession that instead of honoring the shortfall of rural physicians or recognizing a need to provide affordable medical help more broadly, the psychiatric profession has holed up in major metropolitan areas, dominated the academic chairs in medical schools, and as a consequence, has lost touch with its patients altogether. Except, of course, when it comes time to make a little or lots of money for medication consults or diagnosis. The one thing that's obvious in virtually every medical school is the loss of social communication skills that were supposed to be the sine qua non of the good doc. In fact, you'd have to go back to American TV episodes featuring fictional family doctors in the sixties and seventies to even glimpse at what should be requisite social skills. Even our heroes in increasingly silly hour-long medical TV series are laughable. Much as I enjoy Hugh Laurie as House, the real question is how much unacceptable behavior does one want in order for a very limited set of points to be made? And where, after all, are any shows depicting medical professionals sympathetically and genuinely? Documentaries yes. TV drama for the masses, Nyet.

More importantly, you have a profession whose members insist on being recognized, without question, every time they issue their diktats ex cathedra.

Sorry. Their credibility as experts has been overshadowed by study after study by less conflict-ridden social science researches which show in carefully controlled, legitimate, study after study that lay "civilian" support group members and placebos do less harm and more actual good than the ministrations of those with medical degrees dripping from their surnames.

But don't get me wrong. Some folks do have their place in the firmament. The only problem with "this profession" is that very few of them look much different than Chicken Little. Maybe it's not the sky falling on their head. Raindrops might do as well.

<g>

N. Meyer

(article) Science Remains a Stranger to Psychiatry’s New Bible > > > >This just in from Scientific American.... > > >Science Remains a Stranger to Psychiatry’s New Bible > >"In other words, the APA intended to make the DSM-5 the most scientific >edition of its reference guide yet, which would be a real boon for a >book that has been routinely lambasted as fiction borne out of >convenience, rather than a solid clinical text grounded in research. >Now, only one year away from the planned publication of the DSM-5, most >psychiatrists have accepted that the APA’s initial optimism about >informing revisions with cutting edge science is well intentioned, but >premature. Most of the proposed revisions to current DSM criteria—many >of which are genuine improvements—are based not on insights from >genetics and neuroscience, but rather on clinical experience, prevalence >studies and plain old common sense. Indeed, many of these changes could >have been made years ago." > >more... > >http://blogs.scientificamerican.com/streams-of-consciousness/2012/05/08/science-remains-a-stranger-to-psychiatrys-new-bible/ > > >Enjoy (or not), >~CJ > > > > >------------------------------------ > > "We each have our own way of living in the world, together we are like a symphony. >Some are the melody, some are the rhythm, some are the harmony >It all blends together, we are like a symphony, and each part is crucial. >We all contribute to the song of life." > ...Sondra > > We might not always agree; but TOGETHER we will make a difference. > > ASPIRES is a closed, confidential, moderated list. >Responsibility for posts to ASPIRES lies entirely with the original author. > Do NOT post mail off-list without the author's permission. > When in doubt, please refer to our list rules at: > http://www.aspires-relationships.com/info_rules.htm > ASPIRES ~ Climbing the mountain TOGETHER > http://www.aspires-relationships.com >