1 Boring Old Man has a good post (one of a series) about current trends in Psychiatric diagnostics. One quote:
To my mind, the resulting evidence-based psychiatry seems like a tautology from my college logic class. A tautology is neither a proof nor fallacy. It’s the situation where the premise and the conclusion are just different ways of saying the same thing. Instead of experience informing, refining, or changing our new classification, practice was being designed to reaffirm and solidify it, since the only admissable evidence is group validation by clinical trial. No matter the outcome of the study, the validity of the group is affirmed. It depersonifies our patients - their diagnoses becomes bigger than their lives or experiences, and it locates the seat of knowledge outside the clinician/patient dyad, putting it in the hands of key opinion leaders who look at the studies and create the algorithms. The resulting relationship moved from doctor/patient to expert/diagnostic_group. I wish I were overstating this, but I don’t think I am by much.
Because human nature is so variable and strange and complicated, and because my field is still in recovery from an overdose of "Biological Psychiatry" (in which the "mind" plays no role), many of our Experts have seen fit to categorize people according to their symptoms.
Pursue sex too avidly? You got a sex addiction. Work too hard? You got OCD. Nervous about something? You got an Anxiety Disorder. Put stuff into your underpants at WalMart? You got Kleptomania.
To my mind, these things are not diagnoses - they are what we term in Medicine "Chief Complaints" - we scribble "cc -".
To my mind, surface emotional symptoms frequently say little about what is ailing or bothering a person, just as saying that a patient has a fever tells you little about what is wrong. It just tells you that something is wrong. I find it to be challenging, helpful, and always interesting to probe into what is really the matter rather than slapping a label on somebody.
A label is not a diagnosis. I had my training from the best, and they certainly agree. (We need to re-post my series on diagnosis one of these days.) I'd like to go on at length about the topic of depth Psychology and Psychiatry vs. cheap and superficial Psychiatry, but I can't do that right now.
