Psychology Today has a post titled “60 Million People in the U.S. Negatively Affected By Someone Else’s Pathology.” Here is an excerpt:
A psychiatrist once remarked, “I consider pathology to be the country’s number one public health issue.” And with good reason–these 60 million people are negatively (and sometimes criminally) impacted by someone else’s extreme pathology (Otto Kernberg called this pathology ‘Severe Personality Disorder’).
Exposure to a pathological causes emotional aftermath (sometimes with or without PTSD). This aftermath causes treatable mental health symptoms like cognitive dissonance, intrusive thoughts, sleep disruptions, increase use of alcohol, concentration problems, flashbacks, depression, anxiety and paranoia. The emotional impact–referred to as ‘the aftermath symptoms’–leaves 50% of the affected people with PTSD. That’s almost equal to the percentage of war vets who return home with PTSD.
The emotional aftermath affects the work environment. Almost 50% of the people negatively affected by the pathological find their work performance negatively affected. As they struggle to manage the aftermath symptoms, some drop from full time to part time, demote and make less money, or go on short term disability. This results in MILLIONS of dollars in lost wages. I have seen doctors move to ‘impaired practitioner’ status, attorneys step down to paralegals, social workers become mental health techs. Others take paid time off, use their vacation time, or go on disability and begin using state services such as food stamps and subsidized housing.
(Find the image above here.)
The Economist has an article titled “That way, madness lies: A new manual for diagnosing diseases of the psyche is about to be unveiled,” about the 2013 release of the American Psychiatric Association (APA) next revision of its Diagnostic and Statistical Manual of Mental Disorders (DSM-V). On Feb. 10 the APA plans to release a draft of the DSM-V. According to many critics, this process of revising the manual has been cloaked in secrecy and surrounded by uncertainty regarding the direction this manual and the diagnostic process will take. It doesn’t help that the effort to revise the manual has taken over ten years now, with three years to go before its intended publication. We have commented on the DSM and its hold on our culture in previous posts. Read more…
With a background in organizational systems and management, focusing on mental heath systems in particular and how they affect our understanding of ourselves (identity), others, and the world around us, I track the progress and complications associated with the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is thought of as the Bible of the mental health industry. It is interesting, however, that when I have talked to a significant number of licensed mental health professionals throughout the years they tell me they don’t really adhere to much of the DSM when treating their patients other then for the purpose of providing a diagnosis for insurance providers. The DSM is tied intimately to how clinicians get paid, which I have always found problematic because it can lead to fitting clients into categories that are not necessarily where they belong. Funding (money) is the great driver of any industry and the mental health field is no exception.
I have tried to walk a fine line of not negating much of the good work that is going on in the mental health field and diagnostic psychiatry/psychology, but also assessing where this field is not working as well. Part of this focus, as frequently noted, has been on the broad net being cast across our culture to diagnose so many of us with mental health disorders. This process of diagnosing and then medicating categories/tribes of people is not only an effective marketing/business model it also has an enabling affect, making us think, perceive, and feel that we are sicker then we in fact are. We are all given a diagnostic reason and label for why we can’t cope rather then distinguishing who in reality has a true psychiatric disorder. Treating less of us is not as lucrative. Read more…
To follow-up on the previous posts “Diagnostic Voices of Community: Global Mental Health” and “Diagnostic Voices of Community: Global Schizophrenia” Scientific American Mind has an article titled “Foreign Afflictions: Mental Disorders across Country Borders.” Here is an excerpt:
The evidence to date strongly suggests that culture can influence the expression of mental illnesses. Whether radically different cultures can give rise to entirely new psychiatric disorders, however, is a matter of fierce debate.
This issue is of more than academic importance. Psychotherapists often consider cultural differences in their treatment, to be sure, but they typically assume that depression, for example, looks pretty much the same everywhere with minor exceptions. If so-called culture-bound syndromes—mental illnesses that are specific to a particular society—are merely variations of Western disorders, then mental health professionals in Western countries can safely continue to draw on existing knowledge about familiar disorders to treat them. In contrast, if some psychiatric ailments are entirely distinct from those in Western countries, psychologists and psychiatrists may need to start from scratch in figuring out how best to treat them.
(Read about the image above here.)
One of the central themes of this site, my research, and our work as an agency is identifying the ways in which psychiatric diagnoses are named and how they are treated by all of us, professionals and laypersons alike. This quest for insight and answers is why you see the naming and treating logo in childrens’ blocks in the banner above. Throughout these many posts we survey the progress being made on behalf of people who are truly suffering from mental disorders and where the harm is being done when too broad a net is being cast over our population in terms of who in fact has a mental illness and who does not. Why is this particular focus so important to us? The answer is that we have seen so much damage being done in the ways we name and treat each other and nowhere is this more apparent then in the rising tide of diagnosing mental disorders since the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) came into power, leading to the dramatic rise in psychiatric diagnoses and use of psychiatric medications. Read more…
We are very fortunate to have found the work of Barbara Steffens PhD LPCC and the book she has co-authored Your Sexually Addicted Spouse: How Partners Can Cope and Heal. In an e-mail exchange with Dr. Steffens she shared the following with us:
I specialize in working with partners of sex addicts…I use that term loosely as there is no agreed upon definition of that disorder as of yet. I use it more as a short-hand description of compulsive, repetitive sexual behavior. In my work, I see partners who have experienced the shock of finding out about/discovering their loved one’s secret life of out of control sex. In my research, I found that close to 70% of my sample met the symptomatic criteria for post traumatic stress disorder! Sex addiction professionals have long held that these partners are “co-dependent” or “co-addicted” due to their own “crazy” behaviors after they learn of the sexual betrayal. My clients and I know that their behaviors are attempts to adapt to feeling violated and very unsafe, both emotionally and physically. In response to the needs of these partners and to help validate their experiences, my co-author and I wrote and published Your Sexually Addicted Spouse: How Partners Can Cope and Heal. To date, I have received many comments from partners who feel finally validated. Calling what they experience as traumatic also underscores the reality and damage associated with out of control sexual behavior or addiction.
Read more…
Mind Hacks has another great post titled “The insanity epidemic, 1907:” Here is the post:
I’ve happened upon an interesting snippet from the regular Nature “100 years ago” feature concerning a 1907 debate on whether insanity was really increasing or whether it just seemed that way due to changes in diagnosis and treatment methods.
It made me smile because it is almost exactly the same argument that is being had now about whether cases of autism are genuinely increasing or whether this just reflects changes in diagnosis and treatment methods:
Notwithstanding the much improved statistics recently issued by the Lunacy Commissioners, thoroughly satisfactory materials are still wanting for solving the question whether the prevalence of insanity is or is not increasing. The importance of the problem… imparts special interest to a paper by Mr. Noel A. Humphreys on the alleged increase of insanity… This paper shows in a striking manner the value of scientific statistics in checking crude figures.
The author expresses a decided opinion that there is no absolute proof of actual increase of occurring insanity in England and Wales, and that the continued increase in the number and proportion of the registered and certified insane is due to changes in the degree and nature of mental unsoundness for which asylum treatment is considered necessary, and to the marked decline in the rate of discharge (including deaths) from asylums.
From Nature 18 July 1907.
Link to Nature “100 years ago” snippet.
Link to Wikipedia page on epidemiology of autism.
—Vaughan.
Read more…
