It's Much, Much Worse than a Trick
July 5, 2006
8:58 a.m., MT

Can a psychiatrist really tell what's wrong with you? That's the focus of a recent Slate article, discovered via Lew Rockwell. The tease under the link from LRC asks, Is it all a trick? It's actually much, much worse.

As suggested by the question, the article focuses on the famous Rosenhan experiment, written up and titled On Being Sane in Insane Places [PDF]. While there's still a lot to be discussed about that study and subsequent ones of the same type, it was another point the article made, almost as an aside, that redlined me this morning:

The sweeping conclusions that Rosenhan drew from his elegant hoax are debatable. But in her 2004 book, Opening Skinner's Box: Great Psychological Experiments of the 20th Century, journalist Lauren Slater claimed to have replicated Rosenhan's results to some degree. She said she visited nine psychiatric ERs incognito and reported having the same auditory hallucinations mentioned in Rosenhan's study. Although she was never admitted as an inpatient, she says she received multiple prescriptions and was diagnosed with "depression with psychotic features" every time.

This was not supposed to happen. In 1980, the field had overhauled the manual used to classify mental disorders, the Diagnostic and Statistical Manual. Speculative Freudian theories of disease etiology were discarded in favor of straightforward descriptions of pathological behavior and checklists of behavioral symptoms for each diagnosis. The goal was to increase the reliability of psychiatric diagnosis.

While it's true that one goal was to try to increase diagnostic reliability, what happened along with that was an increase in diagnosable conditions. That's continuing today, expanding from a brief list I put together a couple of years ago for Psychological Marginalization. Anyone else remember the news stories that floated the suggestion that people with certain political views or ideologies—ones that freedom-lovers tend to have—could be considered mentally ill? The real story behind this ever-expanding list has two faces, neither of which are pretty.

The first is straightforward expansion of the business model: more possible diagnoses means more people to be caught in the psychiatric dragnet; more people with more diagnoses means more money; and of course, it means greater dependence upon the increasingly fascist medical-pharmaceutical system. (If you think I'm overstating the situation by calling it fascist, reflect on the possible reasons why both mental health professionals and politicians are calling for increased psychological screenings ... of teenagers, of pregnant women, of job candidates, of people wanting to fly somewhere ...)

The second is control, pure and simple. Practically the entire history of psychology has included an element of trying to understand what's normal and what isn't in human functioning. Even before its formal establishment as a science [we can debate the merits of giving the field that label some other time], people were trying to change their own, as well as others', behaviors. Nowadays, with politicians wanting greater control over their worker bees [that's supposed to be us], and welfare-Ponzi schemes like Medicaid, Medicare, and state-mandated insurance coverage directing FRNs hither and yon, the field has become much more politicized—and politically sophisticated—than ever before.

We can debate the merits and demerits of labeling an individual mentally ill some other time. The important thing to keep in mind at all times, with respect to any kind of psychological test or evaluation, is that probably moreso than at any other time in recent history, the bottom line is control. Not self-control, not individual welfare—but the state's control over its hive. That's no trick. It's a deadly serious matter.

Sunni

Comments: 11 people have contributed to the conversation

On Wednesday, July 5th, at approximately 7:24 p.m. Mountain time, jeffrey smith said:

There is a third face (one that doesn't invalidate the other two one bit, btw). That's the idea that there is something called normalcy or normality, and that the closer a person is to being normal, the better off he/she is. The converse, of course, is that the farther one deviates from normalcy, the worse one's condition is.
A psychologist would say I have Pervasive Developmental Disorder Not Otherwise Specified or something else in the higher reaches of the autistic spectrum. (Yes, PDD-NOS is the actual clinical term, not one I've made up.) He would say I have significant "impairments" and need help. I don't think I need help. The impairments he would see are illusory or of no real consequence. The way I live my life, I'm probably better off than most of the people around me emotionally, financially, and spiritually. I don't need a doctor to tell me I should be unhappy even when I'm not. (Not to mention the fact that the two faces you bring up are also big motivations to avoid the MDs. At this point in my life, getting an official diagnosis would yield no benefit and might cause some harm.)

Abnormally yours...

On Thursday, July 6th, at approximately 7:45 a.m. Mountain time, PintofStout said:

..."So you're saying that if I don't want to fly, I'm sane and have to go. But if I don't ask to be grounded, I'm insane and have to go anyway?"

"Yeah, it's Catch-22."

"That's a good Catch."

On Thursday, July 6th, at approximately 7:47 a.m. Mountain time, Warren Bluhm said:

Maybe we need to agitate to make Herd Mentality a disorder - "You think a group of people, let alone two people, can agree on anything? What, are you nuts???" Heck, even the word "disorder" as a bad thing suggests a belief in "order" as a good thing. I have a point in there somewhere, but it's not coming to me yet ...

On Thursday, July 6th, at approximately 8:06 a.m. Mountain time, Sunni said:

Excellent points, Jeffrey. Your "third face" ties into something I've been thinking about a lot lately, but haven't worked through enough to write about yet.

Quite amusing, you other two chaps.

On Thursday, July 6th, at approximately 9:04 a.m. Mountain time, Pagan said:

It’s difficult to discuss this /without/ defining “mentally ill”.

The question was, “ Can a psychiatrist really tell what's wrong with you?” No -- not without having his finger on the parameters of normalcy. And what is “normal”?

“Normal” is what everyone else (society, and frequently the psychiatrist himself) is comfortable with. No matter what his education, professional experience or attempt to be objective, we can usually find a certain degree of bias and social assumption in the psychiatrist’s interpretation of the patient’s mental condition; and, in any case, he rarely disagrees with his referral’s suspicions -- whether that comes from another doctor, the school system, or some organization that has its own agenda re the patient’s future.
A “nutcase” is more often than not how the antagonist sees it -- and the psychiatrist will quite often find the ‘nut’ in the case because he is looking for it.

I know a patient many years ago who believed he was Jesus Christ. He wore a long robe and sandals and went around preaching love, kindness, patience, and tolerance to all...by all. The man was not dangerous, just different -- not “normal” perhaps, but very confused and unhappy. But he was the gentlest of souls, he did not deserve to be locked in a mental hospital and force-fed medication and electric shock treatments.
Yet society didn’t know what else to do with him -- EXCEPT control.

Psychiatry itself is a form of control, a “professional”, “legal”, “accepted” form of mental bias. By diagnosing a person with a psychiatric problem, you can pigeon-hole him, place him in a mental box away from society, so others can feel secure that /they/ are the norm.

Psychiatrists frequently cannot tell what’s wrong with you, cannot distinguish normal from abnormal, because we as individuals are ALL “abnormal” -- i.e. different from each other. This makes it difficult for psychiatrists to get a diagnosis right.
But it also makes it easier for controllers to settle any parameters of abnormalcy they wish on the patient, in order to effect the diagnosis they are seeking.

On Friday, July 7th, at approximately 6:20 a.m. Mountain time, jomama said:

Sanity is lonely.

Never let 'em see ya smile. Then they think you know something they don't and that may not be good for your health.

On Friday, July 7th, at approximately 7:05 a.m. Mountain time, Sunni said:

Pagan, your insightful comments dance ever closer to that essay that's still inchoate in my mind; thanks for sharing them here.

Jomama, I think you've hit on one of my problems—they've seen me smile. But I'm not interested in joining the puppet theater of pretense, so I'll just keep taking my chances.

On Saturday, July 8th, at approximately 10:36 p.m. Mountain time, Michael said:

I'm coming to this one late and not even talking about myself. Well, not much anyway...I ran across a libertarian blogging from my area who's piling up med bills and has managed to get herself ensnared in the federal medicare system. Now, aget reading her blog entries at mywaronpoverty.com all I could come up with is that she suffers from depression and something called "schizotypal personality disorder". I looked this "disorder" up at the wikipedia link and, lo and behold...I have this, too! So does my wife, my in-laws, numerous acquaintaces and friends, even my kids have it. At least according to the descriptions of this "disease". This is a typical case of what you guys have been talking about. Jeeez! Someone's convinced this poor girl she's insane. Depression is one thing, it's a familiar old friend/foe of mine, something I've dealt with successfully for 20+ years without medications, but what this kid has been handed as a diagnosis...man. While some folks do need meds more folks out there don't.I'm not looking forward to the day "normalcy" comes in a capsule and it's manditory.

On Sunday, July 9th, at approximately 6:13 p.m. Mountain time, Herself said:

I have been loopy for years -- depression, mostly, compounded by a real physical problem akin to trigeminal neuralgia; and I did not get better until I gave up on the high-and-mighty pshrinks and stopped taking pills. They were giving me selective serotonin uptake inhibitors for chronic pain! No doubt with the most noble of intentions but it was doing me no good.

These days, I find productive work and interesting hobbies work wonders, with ibuprophen for pain. And it's all a lot more affordable, too!

Does it work? Well, I broke my right knee (one of the knobs at the bottom of the thighbone, actually, and yes, it was a motorscooter wreck, all part of the learning process) a month ago and I have been in hospital, at my parents, and finally, these last few weeks, home, though in a brace and doing a number of painful little exercises daily, and I haven't started to wallow in self-pity yet! YMMV -- but I'd advise you read the fine print.

Herself

On Monday, July 10th, at approximately 4:59 a.m. Mountain time, Sunni said:

What I wonder, Michael, is what that "normal" will be—aside from predictably passive and boring, that is.

Herself, good to hear from you again! Just as you said, I too find diversions quite helpful. Hope your recuperation continues well.

On Tuesday, July 11th, at approximately 7:46 a.m. Mountain time, Michael said:

What will "normal" be? You just have to look around in the schools to see one version. Obedient, submissive and accepting. Look into the living rooms around the nation and see "normal" as the populace slips into a Montel/DrPhil/CSI/24 induced coma. Ever notice how many "good cop" shows there are on TV? Or "good lawyer" shows? The message for normality lies in the circuses we consume. Submit, comply and ask no questions.

Normality used to be a subjective matter. Now...not so subjective, is it? And less so every day.

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