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by dragonwriter
3886 days ago
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> You can thumb through the DSM V and find countless seemingly well-defined "diseases" described using the language of science, yet for few is any underlying cause known That's fairly common in medicine even outside of psychiatry: typically, a set of related symptoms are identified and named, then later -- often many years later -- mechanisms that appear to occur with and likely generate the symptoms are identified and then later -- often many years later again -- root causes are identified for what causes those mechanism to begin operating. And quite a lot of non-psychiatric medicine is at the first or second stage (and even lots that gets portrayed as being at the third stage sees frequent revisions to the ideas of the "root causes", so its only really at the second stage with efforts being made at the third stage.) The idea that the absence of knowledge of root causes is something that distinguishes psychiatric medicine from the rest of medicine is only possible in complete ignorance of the rest of medicine, even if it is very commonly the basis of politically motivated rants against psychiatry on the internet. |
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Sure, that's still useful. But then it should be used as a catalogue for further study, not a diagnostic tool and certainly not the basis for prescribing treatments that often do more harm than good. And above all, by no means is such an incomplete catalogue appropriate basis for forcibly detaining someone or otherwise dictating what they must or must not do.
Other physicians have, slowly and with difficulty, come to terms with the limits of their knowledge and sometimes even how to communicate those limits to patients. When diagnosis is uncertain or the effectiveness and side effects of treatments poorly understood, advice is (among the better physicians) tempered by an honest effort to convey the risks and benefits given the unknowns. If nothing else, the guidance of Hippocrates still prevails. I don't see that from psychologists or psychiatrists, and the DSM and its current uses form a perfect case study in their hubris. When in doubt, diagnose; when in doubt, treat, whether the patient wishes to be treated or not, with whatever is handy regardless of whether there is any basis to expect it to work. Again, all traits of pre-modern medicine.
If you think I'm being too hard on these disciplines, consider that medicine as a whole -- while I acknowledge its many faults and would not pretend that its understanding or attitudes are anything resembling perfect or complete -- has at least in principle advanced beyond these particular errors. That should offer hope that someday psychology and psychiatry will advance similarly.