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pspa123
672 Posts |
 Posted - 06/11/2013 : 16:19:10
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| Part of what bothers me, I guess, is that with DSM an astonishingly large portion of the population gets a psychiatric diagnosis. And "disorder" is not a neutral descriptive term. Didn't we do just fine before psychiatry and friends invented things like executive function disorder? |
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Peregrinus
250 Posts |
Posted - 06/11/2013 : 16:43:05
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PSPS123:
Thank you for your knowledge, insights and wisdom. Don't be bothered by those who love to hear their own voice but have nothing to say. Claiming an age of 0 years is a tipoff.
Thanks again for all I've learned from you. |
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bryan3000
USA
513 Posts |
Posted - 06/11/2013 : 16:48:22
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quote:
Originally posted by pspa123
Part of what bothers me, I guess, is that with DSM an astonishingly large portion of the population gets a psychiatric diagnosis. And "disorder" is not a neutral descriptive term. Didn't we do just fine before psychiatry and friends invented things like executive function disorder?
Exactly.
Yeah, people always function better when they have a clear "disorder" label to place upon themselves. lol!
What a joke. |
Edited by - bryan3000 on 06/11/2013 16:49:15 |
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alexis
USA
596 Posts |
Posted - 06/11/2013 : 17:03:43
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quote:
Originally posted by pspa123
Part of what bothers me, I guess, is that with DSM an astonishingly large portion of the population gets a psychiatric diagnosis. And "disorder" is not a neutral descriptive term. Didn't we do just fine before psychiatry and friends invented things like executive function disorder?
Unfortunately insurance companies won't pay enrich your life but only too fix something that's broken. Research, too, needs things to be classified as "in" or "out" where reality is a spectrum. The DSM, though, does have a recognition of Other Issues that May Be a Focus of Clinical Attention where you might get some of these things relocated...bereavement, for instance, is there.
But we're really talking a naming issue at this point. And if we're to analyze labeling for political or practical reasons I'd also question why Sarno, for instance, doesn't come out and admit he's talking about conversion disorder, aka, hysteria. I'd argue it's most likely that his approach is much more appealing to men that don't want a diagnosis documented as more common in women and associated with historically negative connotations. Everyone is playing politics. |
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pspa123
672 Posts |
Posted - 06/11/2013 : 18:22:03
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| In The Divided Mind Sarno talks extensively about hysteria. |
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alexis
USA
596 Posts |
Posted - 06/11/2013 : 19:31:41
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Hysterical symptoms, illogical and bizarre, TMS symptoms, logical. A little to simple and convenient a distinction I'd say, but for those who this makes feel better I won't try to take it from them. The point is just that everyone is playing the same word games.
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pspa123
672 Posts |
Posted - 06/11/2013 : 20:13:11
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quote:
Originally posted by alexis
Hysterical symptoms, illogical and bizarre, TMS symptoms, logical. A little to simple and convenient a distinction I'd say, but for those who this makes feel better I won't try to take it from them. The point is just that everyone is playing the same word games.
Are you saying this is Dr. Sarno's distinction in The Divided Mind, that certainly isn't what I recall. I understood him to be differentiating between behavioral and physical symptoms but acknowledging that the underlying process was the same. |
Edited by - pspa123 on 06/11/2013 20:14:32 |
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alexis
USA
596 Posts |
Posted - 06/11/2013 : 20:43:21
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| Yes, that and a claim that the symptoms of hysteria (many of which are physical and identical to those listed for conversion disorder) are not "real" in the same way he wants to claim TMS symptoms are...another feel good claim that is unproven. He goes on to say the symptoms are just an issue of what's in fashion, but that's no different than saying hysteria and other somatic symptom disorders change depending on the times. The distinction is trivial at best, and nonexistent on my belief. Yet telling people their symptoms are less bizarre (yes, his word) and more real than hysteria certainly won over a lot of followers. |
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pspa123
672 Posts |
Posted - 06/11/2013 : 20:57:21
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| OK, I see what you are saying. I confess that I was more persuaded by the general theme of the book than the specifics of his theories and how they fit/did not fit with Breuer, Freud et al. |
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alexis
USA
596 Posts |
Posted - 06/11/2013 : 21:21:17
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I don't think it's very important in benefitting from reading Sarno and I pretty much ignored it in my orginal readings too. But when people start talking about the integrity of Sarno vs. the politicized psychological establishment I think we have to recognize that there's BS everywhere, and Sarno's particular weakness in that area is pandering, perhaps rightly, to the egos of his readers. In the same light, picking certain terminology to ensure people get insurance benefits isn't the worst thing ever. None of this stuff is pure science, and it's not just here - the ICD has the same issue as I'm sure does the Chinese version (CCMD).
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pspa123
672 Posts |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 05:50:26
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quote:
Originally posted by pspa123
BTW I meant to post this before -- DSM 5 recognizes FIFTEEN new disorders.
http://www.marketwatch.com/story/15-new-mental-illnesses-in-the-dsm-5-2013-05-22
And this, suggesting up to HALF the population will have a DSM "mental illness" in their lifetime.
http://www.slate.com/articles/health_and_science/medical_examiner/2013/04/diagnostic_and_statistical_manual_fifth_edition_why_will_half_the_u_s_population.html
I agree that for a lot of these "mental illness" might be an overkill term...but does the DSM actually use that term? They do use "disorder", which is also a bit overkill, on some of the developmental ones, but seems appropriate for something hoarding (one of the new additions) Would it be for restless leg syndrome? That's pretty disruptive, but alone counts for 10% or so of the population which is how these numbers add up. Alzheimer's, of course, is a disorder, and will arguably get a lot more of us in the end than that.
I guess the questions are 1) do we need to use the word disorder, and 2) is it really that bad. If the issue warrants attention, from the perspective of an insurance company, it better be a disorder or something similarly named. Most people into middle age already have physical disorders, be they high blood pressure or simply a bad knee (yeah...the hard core/in denial here will disagree...call it all TMS... heck, I've seen Alzheimer's called TMS). So if we accept that we have these physical disorders why would we not have mental/nervous system disorders? What is so bad about that (assuming you aren't a TMSer obsessing over it)?
Of course we don't call those "disorders" on a daily basis, because the physical issues are obvious enough to be accepted by the insurance companies without pointing out that they are disorders, but perhaps that unwillingness on our part is just more denial about the fact that most of us over 40 have notable physical degenrations. We're dying from about age 25, and as Sarno rightly points out a lot of people can't handle that. My argument has long been that until you *can* handle that fact, you aren't mentally healthy.
Back to restless leg. Are people really calling this mental illness? I kind of doubt it, but I haven't surveyed the population. Is it really so bad to have it in the DSM? Which of the 15 things listed there would you remove? Maybe caffeine withdrawal? I think that was included more for completeness and consistency, but I did read the description when the DSM-5 came out and learned it can cause nausea and vomiting when severe and may be confused with the flu. It seems it would be a good thing for physicians to know this when someone comes in with those symptoms. If it's not a "disorder", what is it?
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 06:10:19
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| The DSM actually puts restless leg at just 2-7% based on "more refined" criteria, which is lower than many estimates. |
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pspa123
672 Posts |
Posted - 06/12/2013 : 06:17:53
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http://www.motherjones.com/politics/2013/05/psychiatry-allen-frances-saving-normal-dsm-5-controversy
Interview with the chair of the DSM IV task force.
"There's been a rapid diagnostic inflation over the course of the last 35 years, turning problems of everyday life into mental disorders resulting in excessive treatment with medication. Pretty soon everyone's going to have a mental disorder or two or three, and it's time we reconsider how we want to define this and whether the definitions should be in the hands of the drug companies, which is very much what's happened in recent years." |
Edited by - pspa123 on 06/12/2013 06:19:38 |
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tennis tom
USA
4749 Posts |
Posted - 06/12/2013 : 06:25:59
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Almost all TMS, a whole new batch of disorders to add to the pity-party of pain, for secondary and primary gains. Excuses for taking sick days, conversations on the sidelines while holding ice bags as some sign of courage for not having to do. Dr. Sarno's call on the growing epidemic of TMS pain is absolutely right. I'm thinking about going into a new business, selling furniture for doctor's offices waiting rooms. Dear Doc, my restless leg keeps getting bruised from knocking into all the stuff I'm hoarding, can I get a script for a dozen acupuncture sessions and some oxy please?
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DR. SARNO'S 12 DAILY REMINDERS:
http://www.youtube.com/watch?v=F8D7w0IUIPU
www.youtube.com/watch?v=r0dKBFwGR0g
TAKE THE HOLMES-RAHE STRESS TEST
http://en.wikipedia.org/wiki/Holmes_and_Rahe_stress_scale
Some of my favorite excerpts from _THE DIVIDED MIND_ :
http://www.tmshelp.com/forum/topic.asp?TOPIC_ID=2605
==================================================
"It is no measure of health to be well adjusted to a profoundly sick society." Jiddu Krishnamurti
"Pain is inevitable; suffering is optional." Author Unknown
"Happy People Are Happy Putters." Frank Nobilo, Golf Analyst
"Be careful about reading health books. You may die of a misprint." Mark Twain and Balto
"The hot-dog is the noblest of dogs; it feeds the hand that bites it." Dr. Laurence Johnston Peter
"...the human emotional system was not designed to endure the mental rigors of a tennis match." Dr. Allen Fox
======================================================
"If it ends with "itis" or "algia" or "syndrome" and doctors can't figure out what causes it, then it might be TMS." Dave the Mod =================================================
TMS PRACTITIONERS:
John Sarno, MD
400 E 34th St, New York, NY 10016
(212) 263-6035
Dr. Sarno is now retired, if you call this number you will be referred to his associate Dr. Rashbaum.
"...there are so many things little and big that are tms, I wouldn't have time to write about all of them": Told to icelikeaninja by Dr. Sarno
Here's the TMS practitioners list from the TMS Help Forum:
http://www.tmshelp.com/links.htm
Here's a list of TMS practitioners from the TMS Wiki:
http://tmswiki.org/ppd/Find_a_TMS_Doctor_or_Therapist
Here's a map of TMS practitioners from the old Tarpit Yoga site, (click on the map by state for listings).:
http://www.tarpityoga.com/2007_08_01_archive.html |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 07:21:45
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pspa123,
I get that you and many people think there's a problem with saying a lot of people have mental disorders. What I want to know is why you think that's a problem. Is it because these things really aren't "disorders"? I think that's arguable, but you have to make a list of the one's you would address. I have picked a couple hoping to get your opinion but you don't seem interested in that discussion.
Or do you have a problem with it because, as you have previously referenced, it is a non-neutral term in some ways. If that is the case we aren't talking science but politics. How do you think a mild "disorder" like caffeine withdrawal is different from twisted ankle? What is your argument for skewing language over educating the populace to understand the terminology? |
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tennis tom
USA
4749 Posts |
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pspa123
672 Posts |
Posted - 06/12/2013 : 07:59:51
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In my opinion, like that of the eminent psychiatrist whose article I posted, DSM 5 (if not its predecessors) turns many normal conditions into disorders/illnesses. Like kids with temper tantrums (intermittent explosive disorder), people who are grieving, and so on.
In the brave new world of DSM 5, everyone will get a diagnosis (or several) and a script. 10 percent or more of teenage boys are on stimulant medication already, how great is that? |
Edited by - pspa123 on 06/12/2013 08:13:05 |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 10:02:37
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quote:
Originally posted by pspa123
In my opinion, like that of the eminent psychiatrist whose article I posted, DSM 5 (if not its predecessors) turns many normal conditions into disorders/illnesses. Like kids with temper tantrums (intermittent explosive disorder), people who are grieving, and so on.
In the brave new world of DSM 5, everyone will get a diagnosis (or several) and a script. 10 percent or more of teenage boys are on stimulant medication already, how great is that?
Normal grieving isn't a disorder in the DSM-5 and "Uncomplicated Bereavement" continues to be listed as a V code only (used for reference, research and billing, as often people come for counseling after a death or are grieving but also are visiting a providor for another reason to which it is relevent). Normal grieving is not only not considered a disorder, but is explicitly listed as an exclusionary criteria from diagnosis in several disorders to be sure people aren't mistakenly misdiagnosed when only grieving. Are you objecting to something regarding the thesholds or talking about the theoretical discussions that took place before the DSM-5 was published?
Intermittent explosive disorder only applies to people over 6 or at an "equivalent developmental level". Are you saying you think this age threshold is too young or that even adults with these behaviors don't have problems? That age specifier was added to clear things up in this edition, so maybe you are referring to an older edition? Note that even for kids over 6 this isn't diagnosed if they have an adjustment disorder (another good topic for debate) such as might occur with a recent move or divorcing parents.
For ADHD I'm inclined to agree it's overdiagnosed, though the DSM-5 actually tightens criteria for kis in some areas (though the age of onset is raised). This seems to be the most controversial diagnosis in the DSM, but I'm not sure whether we really want to remove it or just tighten the criteria or treatments. ADHD diagnoses are highly predictive of other behaviors and problems and this is more than just a diagnostic issue. Is there a particular criteria you'd change or would you want to see the whole category dropped? |
Edited by - alexis on 06/12/2013 13:21:29 |
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alexis
USA
596 Posts |
Posted - 06/12/2013 : 12:03:27
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By the way, it's stated in the Mother Jones article that the NIMH has renounced the whole DSM system. Here, in fact, is a quote from the official NIMH statement from which you can see they did no such thing. I used to get Mother Jones way back in college, but it's hardly an objective resource and has a definite axe to grind.
quote:
Today, the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM), along with the International Classification of Diseases (ICD) represents the best information currently available for clinical diagnosis of mental disorders. Patients, families, and insurers can be confident that effective treatments are available and that the DSM is the key resource for delivering the best available care. The National Institute of Mental Health (NIMH) has not changed its position on DSM-5. As NIMH's Research Domain Criteria (RDoC) project website states, "The diagnostic categories represented in the DSM-IV and the International Classification of Diseases-10 (ICD-10, containing virtually identical disorder codes) remain the contemporary consensus standard for how mental disorders are diagnosed and treated."
http://www.nimh.nih.gov/news/science-news/2013/dsm-5-and-rdoc-shared-interests.shtml
One thing I do agree with, however, is that publication should not be the responsibility of the American Psychiatric Association, and if that doesn't change I think it likely it will be replaced eventually, either by the RDoC, which will have its own political and agenda problems, or by the IDC, which is almost identical to the DSM at this point (something to consider when blaming the US political and cultural climate for the structure of the DSM).
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Edited by - alexis on 06/12/2013 12:36:48 |
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DSM 5 out -Somatic Symptom Disorder
