Treating the Person, Not the Diagnosis, Part III

This post is my reply to the previous two days of posts from
Richard F. Gottlieb, MSW, Pediatric Care Manager/Medical Social Worker, Holland Hospital Rehabilitation Services, whom I met at Dr. Peter Breggin’s Empathic Therapy Conference.

(Continued from 6/4/11)
In regard to the mother’s message, did you notice that she capitalized “Clinical Psychologist?” We live in a society that thinks
doctors are more important than nuclear physicists, and so we capitalize them.  In fact, honorific titles are only capitalized when they precede a person’s name—CEO Bill Gates, President Obama, Dr. Deleted—otherwise, job designations are not capitalized—teacher, plumber, researcher—but we live in a culture that
gives extraordinarily high status to anybody connected with the “health care” industry.

Our local newspaper wrote a story about a person whom they repeatedly called “a schizophrenic.” I wrote to the editor and noted
that the fellow was a full person, engaged in a variety of relationships and having multiple skills and attributes—and he had an illness diagnosed as schizophrenia. I said, “If he had pneumonia then you would not call him a pneumonic, so why do you call him a schizophrenic?” He is not his disease; he is, at worst, a person with a disease.

To take a peek into the fallacies of the diagnostic process in mental illness, see “How I got Diagnosed with Unconscious Paranoid Schizophrenia,” (
)in which I was diagnosed by an internist while I was unconscious, and “How I got Diagnosed with Narcissism, parts I-V” (
) in which I was diagnosed by a psychologist based on her secretary’s complaint that I ignored her. If that doesn’t make you forever distrustful of the mental illness diagnostic process then nothing will.

Diagnoses of mental illness are simply this: a collection of categories for people who bother us, made up by people
whom we view as having high status. This, compared to diagnoses of physical illness that have objective, quantifiable, repeatable test results, i.e., a urinary white blood cell count of 525 is a guarantee that you have a kidney infection.  People Who Bother Us include people who are selfish, spit in the street, don’t help with the dishes after supper, and have body odor.  Psychiatric diagnoses have little more validity than that.

The only thing you can be certain sure that a psychiatric diagnosis means is that somebody finds you annoying and wants you to be different.  If I want you to stay sober all the time then I can get you diagnosed with alcoholism. If I want you to pay attention to my needs instead of your own then I can get you diagnosed with narcissism. If I am tired of hearing about all the people who
come into your apartment at night and steal things then I can get you diagnosed with paranoia.

And the diagnoses are always negative and usually based on somebody’s moral code. If you are diagnosed with pneumonia
then you are treated with antibiotics; you are not blamed for your disease. If you are diagnosed with depression then you are blamed for not trying hard enough, having a bad attitude, not working well in therapy, and lacking a positive attitude. The message is always the same: you are not acting the way we want you to.

Recently I heard a comment, made in the context of the Civil Rights movement and racism, in which a black woman said, “Of course I’m all right—I’m a child of God!” We are all on a journey to become who we are meant to be in the eyes of God, not the eyes of our family or neighbors. It is very, very, very important that nonsignificant others get out of the way and let people grow as they were meant to. Interfering by the use of diagnoses and drugs only accomplishes one thing:  to some degree, however minor, the “patient” becomes more tolerable to others. The person/patient does not become the person s/he was meant to be. I say this from
the perspective of having taken antidepressants every day for twenty-six years and not having taken them for ten years: I know stuff you can’t imagine.

‘What we call it is what it becomes”: In the early days of America’s
manned space exploration program, reporter Frank McGee
was interviewing one of the first astronauts. When asked how astronauts cope with fear, the fellow replied, “We start by calling it apprehension.” How we name things matters. When a child is identified by a string of initials then one of the things we know is that the parents are hip-deep in a culture that is breaking little kids down into boxes of badness.

In physical medicine if you are sick then it is a problem that resides in you: your broken arm, your pneumonia, your cancerous gut. The treatment must, therefore, be focused on how to make you
better: apply a cast, administer an antibiotic, cut it out. This same medical model is being used on distresses of the soul when, in fact, these distresses are not ever, ever in the patient: they are interactive between the patient and others—family, employer, government. Post traumatic stress disorder does not occur within the patient; it occurs when a person is trapped in a life-threatening situation and can neither fight nor run.  It is between the person and the world around him.

We keep trying to make depressed people better by giving
them pills or shock treatment or locking them away from the world. What we should be addressing are issues of the absence of spiritual growth—you are not depressed because your wife died; you are depressed because you don’t have a personal theology that encompasses death. What we should be addressing are
issues of how to sustain happy, healthy relationships—you are not depressed because your husband left you; you are depressed because between the two of you, you lacked the skills for a long relationship. What we should be addressing are issues of the economy—you are not depressed because you don’t have a job; you are depressed because there are no jobs to be had.

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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