{"id":23563,"date":"2012-05-26T09:00:40","date_gmt":"2012-05-26T13:00:40","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=23563"},"modified":"2012-05-26T04:42:01","modified_gmt":"2012-05-26T08:42:01","slug":"hypothesizing","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2012\/05\/26\/hypothesizing\/","title":{"rendered":"hypothesizing…"},"content":{"rendered":"
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inertia    [\u00c9\u00aan\u00cb\u02c6\u00c9\u0153\u00cb\u0090\u00ca\u0192\u00c9\u2122,-\u00ca\u0192\u00c9\u00aa\u00c9\u2122]<\/strong><\/div>\n<\/td>\n<\/tr>\n
— noun<\/sup><\/td>\n<\/tr>\n
 <\/sup><\/td>\n1.<\/sup><\/td>\nthe state of being inert; disinclination to move or act<\/sup><\/td>\n<\/tr>\n
 <\/sup><\/td>\n2.<\/sup><\/td>\n\n
the tendency of a body to preserve its state of rest or uniform motion unless acted upon by an external force<\/sup><\/div>\n<\/td>\n<\/tr>\n<\/table>\n

Inertia isn’t just a property of physical bodies. It’s applicable as a concept in a wide range of circumstances. Things in place tend to stay as they are. There are plenty of psychological examples: a substance use that self perpetuates as an addiction; a character trait that endures no matter how maladaptive; a child who ‘takes things’ who grows up to be a thief. Things that repeat or endure are the bedrock of our personae – sometimes the essential structures that support our growth, but at other times, the mechanism of our downfall. In a psychotherapy, it’s not terribly hard to identify what repetitive pattern of living is causing the patient’s discordant life. The hard part is figuring out how to change the pattern – to interrupt the inertia. And when I look back over the medical errors I’ve seen, mine and others, they’re almost always the same – categorical errors. They’re situations where the initial diagnostic category was wrongly chosen and by the time that became clear, it was too late. An anxiety attack that turned out to be a pulmonary embolus; a ruptured retroflexed appendix that eroded through the diaphragm or a ruptured esophagus both presenting as pneumonia; a hysteria that was, in fact, a brain tumor; an alcoholic whose D.T.s were really a symptom of fungal meningitis. Once the wrong categorical diagnosis is made, that initial mistake has an an inertia as strong as that of a resting boulder or an avalanche – a powerful resistance to change.<\/p>\n

Looking back over the history of how the Major Depressive Disorder came to be a unitary diagnosis, I’ve been trying to locate some motivated force that was opposed to the fractionation of the depressive syndromes that we used in the past –  some reason for the "lumping," but I haven’t succeeded so far in finding anything that makes any sense. The only clear thing I know is that they didn’t want to have anything that smacked of this DSM-II category:<\/div>\n