Saturday, July 9, 2011

DSM-5...postoned..and may lead to more talk and less precision in human condition

Ian Brown's feature story in the Globe and Mail, Saturday, July 9, tells a tale about the conflict around the generation of the new DSM-5.
And while there are stories of pharmaceutically-financed research in prestigious universities like Harvard, the real issue seems to be a dance around the long-standing "black hole" known as the unconscious in psychiatric thinking and diagnosis.
Because of the "science" of psychiatry, there are more and more people with mental "conditions" who need medications for their ailments. Of course, both the profession (psychiatry) and the pharmaceutical industry are incestuously mating, with many of the doctors who generated DSM-IV as investors in those very companies, and these relationships sponsor a mind-set that keeps the profession feeding and feeding off the drug industry.
Now that the publication of DSM-5 has been delayed by a couple of years, there is some hope that both "talk therapy" and an open admission of the lack of specificity in their diagnoses, and in the overlap of multiple symptoms for a variety of illnesses, will generate a most ambiguous, more creative and a more humble document when DSM-5 actually appears.
We need to have the best brains doing their best work in this important field, without falling prey to the dollars that produce a drug-dependent, yet still not healed cadre of patients, who, if they were to find a second opinion, would find in at least 80% of the cases, a completely different diagnosis of the same symptoms.
As potential patients of psychiatry, and certainly a majority of people in North America are or will become patients, we need to be exceptionally sceptical of both a diagnosis and a drug treatment, many of those side effects are far more serious than the illness they are trying to ameliorate. And we need to be very careful that we do not fall into the trap that enmeshes the drug companies, the psychiatric profession and the insurance companies who will pay only for prescriptions for illnesses in the DSM regardless of the number.
This is a trap to be avoided, with all the imagination, courage and self-reliance available to each of us, including the kind of friendships that permit, encourage and foster real dialogue, and authentic empathy with another, partner, spouse, friend...who can and will be permitted to talk straight, about what they see, and what they feel when they are around us.
Maybe, just maybe, our working together, in a non-professional setting, facing the whole truths honestly and compassionately, we can see the needed shrivelling of this monster that threatens to engulf a whole continent in its self-feeding narcissistic grasp.

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