There’s a pretty common view that as a society we’re inappropriately overmedicalising ourselves in terms of psychological and psychiatric disorders. Some of the reasons given include:

  • We’re self-centred and whiny first worlders who all have comfortable lives and therefore invent problems.
  • To give people excuses for bad behaviour (they’re not a CPOS, they’re a sex addict!)
  • As a conspiracy by psychologists, psychiatrists, Big Pharma and so on.
  • As a way to control people and present our social disapproval as objective.
  • As a form of coddling and political “correctness gone mad”.

One of the most expressive examples of the whole attitude is a by philosopher called Tony Soprano:

Nowadays everybody’s got to go to shrinks and counselors, and go on Sally Jesse Raphael and talk about their problems. Whatever happened to Gary Cooper, the strong, silent type? That was an American. He wasn’t in touch with his feelings. He just did what he had to do. See, what they didn’t know is once they got Gary Cooper in touch with his feelings, that they wouldn’t be able to shut him up. And then it’s dysfunction this and dysfunction that and dysfunction va fa culo!

It’s interesting that this attitude doesn’t just come from people who are explicitly anti-science but often can come from those who are pretty reasonable in most respects. Now, it’s true that some of the above points are true some of the time. There is a long history of diagnosing mental illness as a form of social control (for example, read about forced institutionalisation in the USSR in the 70s). And you can certainly find examples of the others. But the point is that as a whole, these are failed, anti-science explanations. Also, they betray a hidden dualist assumption.

What made this apparent was a podcast that mentioned DSM-V. The Diagnostic and Statistical Manual is used to catalog all the official mental diagnoses. The V is the upcoming edition which will be expanded a lot. The host them mentioned that under this edition, over 50% of the US public will be diagnosable with some condition or other.

I think he was saying this as a way to portray how ridiculous the expansion is: “look at the absurdity, it’s defining more of us as sick than well!” But the important thing is that such a comparison just wouldn’t fly for physical illness. We would not think it strange that more than 50% of the population have some physical condition. In fact that would probably be a lowball. I’m sure a much larger percentage have something that’s a condition. But a mental illness? That’s a big deal. That’s Who You Really AreTM, and if you’re diagnosed then you must be crazy. But you can’t have so many crazy people, right?

The idea that most people must be healthy is reminiscent of the mental illness denialism of Thomas Szasz, where mental illness is almost defined out of existence. Just as being physically well is not all or nothing, having a mental condition does not somehow invalidate a person’s mental health or change some essence behind the person. The only real way to make sense of such a view is if we all had souls which had essences — then the Real You would either be Sick or Well.

So if you think something to the tune of “diagnosis is making us all victims,” consider if you’d have the same attitude to physical disease. The pushback is likely to diminish once the dualistic assumptions are examined.

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