Psychiatrists want to add “sex addiction” to the catalogue of psychological disorders that can be reliably diagnosed and treated. The Tiger Woods syndrome will be next in line, along with catastrophic views on the environment, an addiction to Starbucks, liking Barry Manilow and singing the praises of Rush Limbaugh. Soon all of our lives will be illness states, with some of us coping better than others in managing our daily diagnostics and treating ourselves through counselling, psychiatry and self-medication.
The quest to add sex addiction to the catalogue of recognized illness states is just a part of the desire of psychiatrists to identify everything as problematic. The handbook for diagnosis, what is known as the Diagnostic and Statistical Manual of Mental Disorders, known commonly as “the DSM”, now in its 4th edition, is the bible of mental illness. If you want to call in sick, go to the library and find a copy – it’s a treasure trove of sick-day opportunities. A new edition, the fifth, is due in 2013.
The DSM is problematic. Diagnoses like “homosexuality”, once classified as an illness, come and go depending on societal pressures. By no stretch of the imagination is it a scientific, evidence based document. This is not surprising. Freud was not a scientist who used evidence and data for his treatment. Now Freud’s ideas have been largely discounted and his diagnostic category of “neurosis” is no longer used. Indeed, several forms of therapy once popular have, on the basis of evidence been sidelined. What hasn’t been revised is the approach to the definition of mental illness.
There has also been a lot of psychiatric nonsense and billable rubbish, including the recovered memory craze, Satanic abuse confabulations, facilitated communication, multiple personality disorder with up to a hundred or more alternative personalities, including animals. Then there was Harvard psychiatrist John Mack’s gullible speculations about alien abductions – a suitable case for treatment in itself. Some psychiatrists are addicted to revenue and new illness categories “capture” more customers.
Thomas Szasz argued that there was no such thing as mental illness and that psychiatry is largely a fraud. He had many followers. Indeed, fraud and psychiatry sometimes go together. In the 1990’s the medical insurers in the US took Szasz’s claims seriously and started to investigate psychiatric fraud. They looked at 50,000 cases handled by the National Medical Enterprises Corporation’s psychiatric hospitals. What they found was startling: 32.6% contained a fraudulent diagnosis to match insurance coverage, while 43.4% of the cases were billed for services not actually rendered. Is systematic deception to be a new addiction and a new DSM category?
Millions of students are now sent to special education classes or given prescriptions for Ritalin and other powerful, addictive medications for conditions termed “learning disabilities”, dyslexia, attention deficit hyperactivity disorder (ADHD), and attention deficit disorder (ADD). Fred Bauman, M.D. , a specialist in child neurology for 35 years, contends that these children are said to have conditions that do not really exist: "I diagnose these children the same way that I diagnose real diseases, such as epilepsy, brain tumours, and so on, and I find that they are normal. I do not find that I can validate the presence of any disease in this population of children”, he said. Some of us went to school before Ritalin was available – when we found ourselves with ADHD we were reassigned to activities which demanded our attention. Now we administer drugs.
Its time to rethink mental illness and to challenge the assumption that everything we do as a form of illness – from eating well (dietary disorder), drinking good wine (alcoholism), needing three cups of coffee to kick start the morning (Starbucks addiction), sex two times a day (sex addiction), telling funny stories (humour addiction), not paying attention when the news is on (attention deficit disorder), having sex while the news is on and drinking wine at the same time (deviancy) and so on. While there are real mental illnesses – depression, schizophrenia, bipolar disease – not everything we do is “on the edge” of madness.
It may actually be the case that psychiatry itself is the new disorder in need of treatment.