After my disastrous consultation with that psychiatrist I got chatting to my amazing therapist
Debbie Banks and she opened my eyes to a world that I was unaware existed. A world where notable, clever, informed psychologists and Doctors are challenging the world of psychiatry and psychiatrists. I was blissfully unaware, or perhaps just hadn't given it the rightful consideration that psychiatrists are purely work from a perspective of 'their opinion'. They have little actual proof of their diagnosis unlike medical doctors do. Blood tests, x-rays, etc do not come into psychiatry do they? Instead they rely on their own opinions as guided by a book commonly referred to as the DSM.
The DSM, or the American Psychiatry Association's
Diagnostic and Statistical Manual of Mental Disorders. classifies mental disorders. For example, in the current fifth edition of the book, the first new edition for two decades, it classifies manifestations of grief, temper tantrums and worrying about physical ill-health as the mental illnesses of major depressive disorder, disruptive mood dysregulation disorder and somatic symptom disorder, respectively.
The British Psychological Society's division of clinical psychology (DCP) has in the past issued statements declaring that, given the lack of evidence, it is time for a "paradigm shift" in how the issues of mental health are understood. Their statements have effectively cast doubt on psychiatry's predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs.
Dr Lucy Johnstone, who is a consultant clinical psychologist supports the DCP and says it is unhelpful to see mental health issues as illnesses with biological causes.
"On the contrary, there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse,"
Some of the fifth edition of the DSM's omissions are just as controversial as the manual's inclusions. The term "Asperger's disorder"does not appear in the manual, instead its symptoms now come under the newly added "autism spectrum disorder".
The DSM is used in a number of countries to varying degrees. Britain does use an alternative manual, the
International Classification of Diseases (ICD) published by the World
Health Organisation, but the DSM is still hugely influential – and controversial.
This perspective came as a bit of a revelation to me after I had endured Mr Psychiatrist labelling me as an alcohol dependant individual after I admitted drinking alcohol to him most evenings over the last six months. I have argued my case with him that I take drugs every day, co-codamol and antidepressants, therefore am I a drug addict? He never answered that question. But based on my responses to several very closed questions he concluded I was alcohol dependant.
I being indoctrinated, like a lot of you I'm sure, felt that someone of his standing and qualifications must know what they are talking about and I even started to doubt myself. Was I alcohol dependant? On the basis I haven't drunk since, (now 2 weeks) I sincerely doubt it but it did bring me around to thinking that if he can jump to that conclusion based on very little evidence then what other warped presumptuous conclusions can and do these so called professionals jump to?
I have to of course remember my psychiatrist was employed by the police service, at £350 an hour, to prepare a report for them as to my current mental health. Do we think he has therefore been entirely unbiased? Would his opinion do better to suit his employer or me I wonder? For instance he has concluded I have PTSD symptoms? I have asked for him to expand upon this and his answer was as follows,
" I feel that you have “PTSD symptoms (she may have historically suffered from the disorder but is improved but still has residual symptoms.)” I feel you have improved and thus the whole disorder is not currently present."
Now call me cynical but if I have PTSD symptoms do I not have a diagnosis of PTSD? I mean if I had chicken pox symptoms I would have chicken pox! If I was paying him I suspect he would have diagnosed PTSD but as the police service would prefer for me not to have that diagnosis he can skirt around it because he's an expert and only has to rely on his opinions.
As a cop this whole concept of being able to rely on opinion seems utterly bemusing. Can you imagine if each cop could arrest people based on their own opinions of what was right and wrong! We have the law and legal precedents what do the world of psychiatry have? The DSM?! A book which listed being homosexual as a mental disorder up until 1987?!
Yes you heard right until 1987!
Prior to seeing this psychiatrist I had a notion that he would be a paragon of mental health virtue, compassionate, unstigmatised and truly understanding. What I got was a bully with a fist class degree in 'I know better than you', pompous, arrogant and very quick to make assumptions based on limited information. How concerning is this when these so called professionals are dealing with the most vulnerable people in our society? I left his office feeling, ashamed, guilty and extremely low if not quite desperate. I have pulled through it and risen above his nonsense, but some people surely will not, some will accept his labelling of them as gospel and to what further cost to their health?
Even I felt like I was taking on a giant when I challenged his opinions of me, he did however soon back down and altered what he was planning to say about me, which begs the question as to its validity in the first place surely?
Dr Thomas Szasz's is an American doctor who is an advocate for the idea that psychiatry is currently way off the mark and that human behaviour has reasons, not causes.
Dr Szasz says:
"Myth of mental illness." Mental illness is a metaphor (metaphorical disease). The word "disease" denotes a demonstrable biological process that affects the bodies of living organisms (plants, animals, and humans). The term "mental illness" refers to the undesirable thoughts, feelings, and behaviors of persons. Classifying thoughts, feelings, and behaviors as diseases is a logical and semantic error, like classifying the whale as a fish. As the whale is not a fish, mental illness is not a disease. Individuals with brain diseases (bad brains) or kidney diseases (bad kidneys) are literally sick. Individuals with mental diseases (bad behaviors), like societies with economic diseases (bad fiscal policies), are metaphorically sick. The classification of (mis)behavior as illness provides an ideological justification for state-sponsored social control as medical treatment.
"If you talk to God, you are praying;
If God talks to you, you have schizophrenia."
(Quote from Dr Szasz)
Dr Szasz believes that in recent decades, American medicine has become increasingly politicised and politics has become increasingly medicalised. Behaviours' previously seen as virtuous or wicked, wise or unwise are now dealt with as healthy or sick--unwanted behaviours' to be controlled as if they were health issues. The modern penchant for transforming human problems into diseases and judicial sanctions into treatments, replacing the rule of law with the rule of medical discretion, leads to the creation of a type of government that Dr Szasz calls pharmacracy. Medicalising troublesome behaviours and social problems is tempting to voters and politicians alike: it panders to the people by promising to satisfy their needs for dependence on medical authority. Dr Szasz believes people thus gain a convenient scapegoat, enabling them to avoid personal responsibility for their behaviour.
The government in turn gains a rationale for endless and politically expedient wars against social problems defined as public health emergencies. The health care system gains prestige, funding, and bureaucratic power that only an alliance with the political system can provide. However, Dr Szasz warns, the creeping substitution of pharmacracy for democracy--private medical concerns increasingly perceived as requiring a political response--inexorably erodes personal freedom and dignity. Pharmacracy a word created by Dr Szasz to encapsulate his beliefs:
"In as much as we have words to describe medicine as a healing art,
but have none to describe it as a method of social control or political rule,
we must first give it a name. I propose that we call it pharmacracy, from the
Greek roots pharmakon, for ‘medicine' or ‘drug,' and kratein, for ‘to rule' or
‘to control.' ... As theocracy is rule by God or priests, and democracy is rule
by the people or the majority, so pharmacracy is rule by medicine or physicians."
Another advocate of this way of thinking is a Dr Terry Lynch who has over 30 years experience as a medical doctor; 15 years as a psychotherapist; 15 years as the provider of a recovery-oriented mental health service; and is the author of three books on mental health, including one bestseller.
Over the years he states:
"I have learned that the prevailing understanding of depression is seriously misguided, seriously flawed"
Dr Lynch states that there is much myth, mystery and misinformation surrounding what we have come to call “depression”.
He says that there are facts not commonly understood in relation to depression and that this is primarily due to the fact that misinformation has regrettably been regularly churned out regarding depression for over 40 years, and he feels this is a pattern that needs to stop.
Dr Lynch makes ten assertions about depression in this regard which I find wholly fascinating:
1. Depression DOES NOT meet standard medical
criteria for a disease.
The
criteria for and the definitions of disease which have been employed by the
medical profession for decades are well established. Depression does not meet
these standard medical criteria for a disease.
2. Depression IS NOT a known brain
disorder.
A number of sites include comprehensive lists of all known
brain disorders. One such example is the US National Institute of Neurological
Disorders and Stroke, a US government-backed Institute, an institute within the
umbrella US National Institutes of Health. Their list of neurological disorders
is so extensive that it includes many disorders I have never encountered in
more than thirty years as a medical doctor. Depression is not included in this
comprehensive list of all known brain and neurological disorders. Other sites
that contain lists and overviews of all brain and neurological disorders
include The Brain Foundation (Australia) and WedMD. Depression is not included
as a brain disorder on these sites either.
3. Depression IS NOT a chemical
imbalance.
Contrary to the common understanding, no pre-existing brain
chemical imbalances has ever been reliably identified in depression. It follows
that antidepressants cannot – and should not – truthfully be claimed to work by
correcting brain chemical imbalances. Some people report being helped by these
substances. But not by balancing brain chemicals.
4. Depression IS NOT a known genetic
disorder.
Within the medical profession, the acid test by which a
disease or disorder is concluded to be known to be genetic is the reliable
laboratory identification of a genetic abnormality. No such abnormalities have
been reliably identified in depression.
5. Depression IS NOT a medical illness
just like diabetes.
A common perception about depression is that is a medical
illness just like diabetes. Actually, from a scientific perspective, diabetes
and depression are poles apart. To give you just one example of why this is the
truth; while diabetes is never diagnosed without laboratory
investigations that confirm the diagnosis, depression is always diagnosed without
laboratory investigations that confirm the diagnosis.
6. The experiences and behaviours that
become labelled as “depression” are very real.
The five facts about depression I have listed above do not
in any way imply that the experiences and behaviours that become labelled as
depression are not real. They are very real. These experiences are often
excruciating.
7. Depression can be understood through
understanding how six important themes occur and interlink with each
other.
These themes are:- wounding; shock; distress in many forms;
defence mechanisms and coping strategies; choices and decision-making; and
trauma.
8. Trauma is often a core feature of
depression.
There is a strong link between psychological trauma and
depression. Because the importance of psychological trauma is regularly
underestimated, the frequency and extent of psychological trauma and its
relationship to depression is frequently missed or underestimated.
9. Some features of depression are coping
strategies.
Although not commonly recognised as such, many of the
experiences and behaviours that come under the umbrella term “depression” are
defence mechanisms and coping strategies. Shutting down and disconnecting, for
example, can be understood as a person’s attempt at what they see as their best
and most trusted available solution.
10. A reduced sense of self is a regular feature of
depression.
Throughout the
fifteen years in which I have provided a recovery-oriented mental health
service and even in the years before that when I worked as a GP (general
practitioner/family physician), I have consistently noticed that people who
become depressed and diagnoses with depression generally have a reduced sense
of self. They tend to have an often greatly reduced sense of self-empowerment;
self generated security (I use this term to describe our ability to make
ourselves feel safe and secure in the various situations we encounter);
self-expression; self-belief; self confidence; self-worth; self-belonging.
Another related consistent finding is patterns of feeling, expressing and
dealing with emotions that are frequently the person’s best solution as they
see it, but that often cause considerable difficulties and distress for them in
their lives.
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In summary then :-
I guess what all these experts are saying is that depression and it's symptoms are wholly real but are more likely the bodies response to trauma than they are as a result of any specific medical illness.
So by that reckoning we as a society in the west are currently medicating more and more people for depression which is probably becoming a self fulfilling prophecy isn't it? If we try throwing anti-biotics at infections constantly they cease to be effective and the body loses the ability to fight such infections on its own. By over using antidepressants our bodies and our emotions will never learn how to be at peace with themselves. Our current world is clearly traumatising us, our style of living is actually triggering our flight or fight response to such an extent that we are losing the ability to regulate ourselves.
So short of escaping to a desert island we all have to learn how to process traumatic events, or even accept the basic concept, especially us cops, that trauma needs decompressing somehow. Left alone trauma becomes like an infected wound festering in the brain causing no end of issues such as depression and PTSD.
With the police service in it's current state of decline, command teams around the country need to understand that without better mental health provisions the current epidemic of anxiety and depression will only increase.
De-moralised, depleted officers cannot and will not stay healthy for very long.
