The above NPR clip discusses the ongoing conflict occurring in the psychiatric field regarding definitions and diagnoses of mental disorders. The American Psychiatric Association’s Diagnostic and Statistic Manual (DSM) is the ultimate and widely accepted manual used by healthcare professionals for mental illness diagnosing. The publication of new mental disorders such as Asperger’s can create a sudden boom in diagnosis of the disorders, which some attribute to a new answer to old symptoms. This can lead to over diagnosing and also overtreatment. The second article from the Baltimore Sun by Richard Vatz addresses the issue of over diagnosing. The author expresses the issue he has with the diagnostic techniques used that consists primarily of general population surveys and not what he calls “medical diagnosing” which I will assume to be Positron Emission Topography (PET), Magnetic Resonance Imaging (MRI) scans and other similar tests. The fact that the author is so upset with the statistic that 55 percent of the American population was suffering from mental illness at one time seemed bothersome to me. What was it about that fact that he found so unbelievable?
Allan Young’s article “Description of How Ideology Shapes Knowledge of a Mental Disorder (Posttraumatic Stress Disorder)” is a thoughtful analysis of how the production of knowledge, in terms of PTSD, is constructed through ideology, in this case The Institute observed. The Institute creates a “highly structured social environment in which correct behavior is a precondition for continued treatment” (Young 112) and Young brings up the idea that efficacy in treatment is not in part because of the treatment program itself, but due to the rigid structure that is placed on both patients and therapists. The construction of knowledge as an actual “product” that is manufactured by all of the “workers”, positions ideology as “a medium that ensures the Institute’s knowledge producers are integrated into the detail division of labor” (Young 116) that allows patients to begin to gain a tangible grasp on their disorder. This seems to be the crucial aspect in the treatment of a disorder that is “undiagnosible without evidence of the etiological trauma…[and]… that the content of the etiological events is embedded in the disorders symptoms” (Young 109). PTSD is still largely stigmatized in our culture, especially currently with the national unrest regarding the still recent wars and even those in the past. Soldiers return to a nation that held them in contempt for what they did, pushing them into the margins without any tools to begin to deconstruct their experiences. This stigma felt towards mental disorders is how I read Vatz’s disbelief that so many Americans suffer from mental disorders. Perhaps it is because we as a culture place much more emphasis on internalizing an “internal disease” that citizens aren’t given the tools to begin working their issues like the PTSD patients. There seems to be a feedback loop from patient to therapist in terms of interpretation that is structured around The Institute’s ideology. Not only are patients held responsible for their end of the loop, therapists are also held accountable for how they reciprocate information given to them. This relationship could be applied to patient and the world they live in, both must reciprocate what the other is voicing.
In shifting from ideology, Simon Cohn’s “Picturing the Brain Inside, Revealing the Illness Outside: A Comparison of the Different Meanings Attributed to Brain Scans by Scientists and Patients” focuses on a more technologically focused way of understanding mental disorder. Cohn describes illness as having “a precarious status for many patients, not in terms of the on-going distress and suffering caused by in terms of their existence-as a thing, or entity” (Cohn 65). The article articulates the opposing views biomedicine and mental disorder sufferers interpret body and brain. The example of the two researchers joking that they could give research volunteers a generic picture of the brain and pass it of as the volunteer is a great demonstration of the impersonal view most workers have been trained to have. That the researchers “only in terms of work in the lab” (Cohn 67) is deceptively simplistic as Cohn argues that the objectification of patients in deeper and “the role of technology is crucial to mask the very human processes involved” (Cohn 67). Can the shift towards a more biomedical diagnosing of mental illnesses place diagnosing illnesses through symptoms into a more “non-medical” field? Such as what Vatz describes to be the cause of overdiagnosing, will technology rob some mental illness sufferers of their disease because an MRI shows no visible signs of illness? The patients who volunteered for the study almost all asked for a copy of their brain scan and in the article are described as having deeply personal attachments to their brain scans, going so far as to manipulate them.
The act of placing their brain scans on t-shirt reminded me of art therapy, which has become popular in mental health treatment. The video above voices similar themes that I found in Cohn and Young’s articles in that it is a way for patients to begin materializing and constructing their disorder. Technology has still not seen advancement in true understanding of the brain, there is no prototypical “normal brain” that one can compare all other brains to and so sometimes it feels as if we’re ultimately repeating history and attributing the disease to an unknown being/source. This does little in helping patients, who as has been shown, greatly value and benefit from some construction of their illness. To materialize a sometimes still-unexplainable occurrence, regardless of how it is diagnosed in science, is advantageous to those who need it.
Works Cited
Cohn, Simon. 2010. “Picturing the Brain Inside, Revealing the Illness Outside: A Comparison of the Different Meaning Attributed to Brain Scans by Scientists and Patients.” Pp. 65-84. IN Technologized Images Technologized Bodies. Edited by Jeanette Edwards, Penny Harvey and Peter Wade. New York: Berghahn Books.
Vatz, Richard. "Brain Disease vs. Mental Illness”. The Baltimore Sun January 27, 2011
“What’s a Mental Disorder? Even Experts Can’t Agree”. All Things Considered. National Public Radio. December 29, 2010. Radio
Young, Allan. 1993. “A Description of How Ideology Shapes Knowledge of a Mental Disorder (Posttraumatic Stress Disorder).” Pp. 108-128. IN Knowledge, Power and Practice: The Anthropology of Medicine and Everyday Life. Edited by Shirley Lindenbaum and Margaret Lock. Berkeley: University of California Press.
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