Harry Stack Sullivan was an American Psychiatrist in the first half of the 20th Century. His Interpersonal Psychiatry wove in and out of the psychoanalytic movement of the time, but there were substantive differences now little discussed in this era of pharmacology. One of those differences had to do with Freud’s concept of the unconscious. Sullivan’s concept was selective inattention – closer to don’t look at than don’t know. In everyday usage, it’s a much more reasonable way of looking at how the mind works. When I first read it, I immediately thought of my own childhood growing up in the US South in the 1940s and 1950s. There was something terribly wrong. It’s not that the impossibility and impact of segregation wasn’t known or knowable, it just wasn’t looked at – decried when it came up, but mostly not looked at. And when it was finally impossible for me personally not to look at it, it was all I saw – defining the entire culture of my youth, my place. I recall to this day the cognitive dissonance of those moments as if it happened yesterday, knowing something you’ve always known in a different light. I tried to keep that discomfort in my mind later when I had a patient who couldn’t move forward without looking at something they’d spent a lifetime not looking at. Selective inattention is a powerful adversary.
I wrote my opinion at my site, and just curious if you agree or have a different take: why is it psychiatry lists Antisocial Personality Disorder in the DSM, when it has no real likelihood of treatment interventions. As far as I am concerned, it just drags us as providers into the slime the “disorder” creates in the conflict and mayhem such individuals create. Do you agree it is dangerous to work with people who just prey on others’ empathy and caring?
I share your thoughts about this, Joel and am practicing responses to my fellow liberals who mistakenly think that being labeled with a mental illness reduces the stigma of mental illness, and that whenever mass murder occurs it could have been prevented if only the “mental illness” had been treated beforehand (as if medications taken as prescribed by any doctor always works and the diagnoses are always correct). They are wrong to attribute these mass murders to mental illness writ large, and are dangerously near approving of increased suspicions of any one labeled as mentally ill and diminished protection under the law.
Seeing how the overlords are reacting to unfortunate tragedy; I’m reminded of these words.
“Of all tyrannies a tyranny sincerely exercised for the good
of its victim may be the most oppressive. It may be better to live
under robber barons than under omnipotent moral busybodies.
The robber baron’s cruelty may sometimes sleep, his cupidity may
at some point be satiated, but those who torment us for our own good
will torment us without end for they do so with the approval
of their own conscience.” – C. S. Lewis
As Thomas Szasz said, “Behavior is not a disease.”
Sorry, Becky… some behavior is not a disease and some behavior really is. Like when a patient in a manic episode prevents passengers from boarding a plane because he plans to fly his entire family to Europe, claiming he has precedence over everybody else. That is a real event from my past practice. Security was called and he was, rightly, hospitalized, which is when I met him.
Dear Bernard:
Mania is only a disease if you perceive “behavior” to be disease. To use your analogy; any behavior deemed to not fit into the context of the social norm could/would constitute a disease being present.
Yet, you know as well as anyone that there is no confirmed pathological, biological test, or verified genetic component that can be used to verify the very broad & subjective diagnosis of “bipolar”.
If we are to use/accept your definition of disease; then each of us are very much diseased to one extent or another. If that is the case, then what does being “diseased” really mean?
At best you can make a statement that a person is demonstrating a psychological affliction (“behavior”) that may impede normal functioning within the scope of expectations being presented in a particular society. It might be wise sticking to the terms like “psychiatric diagnosis”, and leave “disease” to doctors that actually practice medicine. 🙂
http://hcrenewal.blogspot.com/2009/04/in-defense-of-psychiatric-diagnoses-and.html
That was a nice deflection link Bernard; Of course it comes as no great surprise or awakening that medicine has followed psychiatry’s lead in creating NEW so called “diseases” to directly fit a profitable treatment. After all, Greed is the new Hippocratic oath of medicine & related practices/industries.
Quite obviously there are always some medical exceptions were a “disease” has physical effects (sometimes devastating/debilitating) where no direct causation/test has yet been determined.
Yet, that is really a straw-mans argument when your comparing the world of psychiatry, to the world of actual physical medicine; since psychiatry has a whole diagnostic manual full of subjectivity without a single proven direct biological/pathological cause or correlating test to verify anything more than mere theory and unsubstantiated hypothesis. As it’s been said: that’s a Grand Canyon sized chasm that has to be filled with mountains of bullshit…
Again, The psychiatry “disease” defense you are presenting would include everyone in some degree as suffering from a psychological “disease”. Since psychiatry’s criteria are based upon the always fluctuating social/societal norms of particular culture, environment, & time. This is why psychiatry is often referred to as the Pseudo-science, or the coined bastard step child of medicine. 🙂
Wikipedia offers a useful description of the concept of disease
http://en.wikipedia.org/wiki/Disease
Disease
From Wikipedia, the free encyclopedia
“Medical condition” redirects here. For medical condition terminology, see Medical state.
For other uses, see Disease (disambiguation).
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs.[1] It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune diseases. In humans, “disease” is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, or death to the person afflicted, or similar problems for those in contact with the person. In this broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories. Diseases usually affect people not only physically, but also emotionally, as contracting and living with many diseases can alter one’s perspective on life, and their personality.”