Posted by laima on March 2, 2007, at 15:10:08
In reply to Re: Diagnoses, interesting and otherwise, posted by Declan on March 2, 2007, at 14:31:48
Hey thanks.
I do think that there are some good doctors out there who are excellent and critical thinkers, who could still put an accurate dsm to good use, a good starting point, as a reference to review. But I imagine that the brightest of them are quite aware of the dangers of categorizing people very rigidly, and would use it as a guide, not as doctrine, anyway. It's not like a typical patient would have one exact condition and no other issue... and then causes vary, etc.
But think- if it could finally become specific and accurate- that could be so helpful for zeroing in on direction for helpful treatment. Rather than simply- "neurosis?" Give a sedative. "Psychotic? Give a sedative. etc. Imagine: "Atypical depression with some situationally induced anxiety and a sleep disorder?" Sounds like we should start by trying an maoi with some (whatever). Hmm, let's think about that in conjunction with this patient's particular circumstances. What did I initially get with those conditions? Prozac. Which made me an even more "active" sleeper than before, ultimately making depression worse. For prozac was for "depression". Fine-tuning treatment strategies as a result of better dsm- that would be fantastic. So would be some cross-referencing feature for help in designing treatments for people with overlapping conditions.
I appreciate that having depression officially listed as a medical condition has helped many of the skeptics who felt it's nothing more than an "attitude problem" understand that it's actually kind of more than that. And can help someone who tries in vain to "adjust the attitide" give him or herself a break, and feel ok about taking medication which could actually bring relief.
I also appreciate the general trend of eliminating people deemed to be social undesirables by society from the category of "ill".
You have a good point, "no such thing as normal"- I have to agree. But yet surely some consensus could eventually be reached about what counts as eccentricity/quirky personality/choice/lifestyle/diversity versus what counts as pathological, and/or in need of repair?
But it's still definately a work in progress. My understanding is that when a new edition is due, there is a lot of group discussion, debate, and arguing between loads of them about what should or should not be included, and why.
Still a long way to go!
Some of the existing difficulties surely must be due to the politics of whatever organization is in control of the content.
Another area of difficulty is obviously that much, if not the entire territory, is very murky and debatable- even for those with the most knowledge.
And even doctors and scientists can't help but have some aspects of the values of their own culture seep deep into their psyches, affecting judgement and perception. I think good scientists must know this, though. Probably not all of them do though. It can be hard to detect, even in oneself.
> There's just 2 things for me.
> Firstly that there is no such thing as normal.
> Secondly, the process of classifying suffering is not without risks, for the recipient of the help.
>
> I like the word 'suffering', the balance between acceptance and pain that the word implies.
>
> And laima, you have a point....I can't easily imagine a (decent) shrink who would apply the DSM in a doctrinaire fashion.
poster:laima
thread:737261
URL: http://www.dr-bob.org/babble/20070302/msgs/737735.html