I've mentioned here several times that the DSM is no "bible" for me or for most of my colleagues. We rarely find our patients in there, or human beings, for that matter. When the premise is wrong (that surface symptoms and complaints lead directly back to a neuro-chemical abnormality), then the entire endeavor is only useful for completing insurance forms (with a handful of partial exceptions).
A few relevant and interesting links:
- The Real Problems With Psychiatry - A psychotherapist contends that the DSM, psychiatry's "bible" that defines all mental illness, is not scientific but a product of unscrupulous politics and bureaucracy.
Not to mention the pharmaceutical industry. Always question Authority!
- Psychiatry’s Guide Is Out of Touch With Science, Experts Say in the NYT via 1 Boring Old Man's Groundhog Day
- How Scientific Is Psychiatry?
Like many fields of endeavor, good Psychiatry is part art, part science, but mixed with much life experience, much interpersonal experience, and as much painful self-knowledge as the doc him- or herself can handle to "sharpen the scalpel" as it were. We are called upon to be experts in real life, relationships, religion, the brain, the mind, the body, and the soul. It's a tall order which is why it is often termed "the impossible profession."
Readers know that I have trademarked the term "psycho-utopianism" to refer to the naive and reductionistic notion that, if all our our chemicals and all of our neurons were straightened out, and if we docs could fix it all by a cookbook, we'd all be some kind of "normal" and some kind of moral and some kind of "happy" of a serene, bourgeois sort. It ain't never gonna happen, and it's for the best that it cannot.
It would not be human, and it would not be real life. I recently was referred an evaluation for depression. Patient fit the DSM perfectly, but it didn't "smell right" to me so I took a chance and ordered her a total body MRI. She had an undiagnosed gastric cancer.
Tracked: May 09, 02:41