04. Objective Diagnosis or subjective opinion?

 

 

Psychiatry has classically been the domain of the study and treatment of mental abnormality. The bread and butter of psychiatric inquiry have been primarily schizophrenia, psychosis and bipolar disorder. Bio-psychiatry seeks ‘illness’ or ‘disorder’ within the brain and seeks to ‘fix’ the ‘illness’ with chemicals, medication, and electric shock.

 

But in reality there is no such thing as psychiatric diagnosis only psychiatric opinion.  Unlike physical illness where the locus of a problem can be empirically substantiated with blood tests or X rays etc, psychiatry relies on lists and clusters of symptoms to categorize patients.  Ultimately, however, the final classification is highly dependent on the opinion of the psychiatrist, and thus can never truly be objective.

 

It is estimated that 50% of survivors can get better relatively easily.  The other 50% suffer long term consequences.  These figures are often commensurate with the degree of trauma sustained, duration and degree of isolation of the child amongst other factors.

 

There is a number of patients who confound the psychiatric profession and are thus classed as “treatment resistant”.

 

It is no coincidence that between the overwhelming majority of these have been the victims of childhood sexual, emotional and physical trauma and also prolonged psychiatric abuse.

 

First of all the term “treatment resistant” often accompanies an assumption that there is pathology or disordered personality within the patient that needs fixing or modifying.  My contention is that “symptoms” of trauma are natural reactions to trauma.  Denise Russell states “ there is little room to express dissatisfaction with one’s lot without being regarded as impaired”

 

Severely psychiatrically injured abuse victims are often labelled ‘treatment resistant’, ‘incurable personality disorder’ or misdiagnosed with a myriad of conventionally accepted mental disorders. Psychiatrists become frustrated when they see little improvement in the patient. The blame tends to be placed on the patient not ‘trying hard enough’ or being ‘incompliant’.  The very approach to the patient by psychiatry goes unquestioned.  Many argue that when patients fail to respond to a pyschitrists particular method of treatment – or moreover when a patient questions the validity of a pyschiatrists technique – this affects the opinion the pyschiatrist has of that patient and thus the ultimate diagnosis. 

 

For example some say “If a pyschiatrist doesn’t understand you they will label you Manic Depressive, If they fear you they will label you schizophrenic and if they hate you they will label you Borderline Personaility Disorder”