Psychiatry’s poker hand

A few weeks ago Chris stopped by a display in a hotel lobby and purchased a copy of the following DVD entitled “Un Documentaire: Manuel Diagnostique et Statistique. Le coup de poker le plus funeste de la psychiatrie.” (The Diagnostic and Statistical Manual: Psychiatry’s biggest gamble).

You may have seen clips of this DVD posted on YouTube. As it happens, the Citizen’s Commission on Human Rights (CCHR) owns the video rights. The English title of the DVD is The Diagnostic and Statistical Manual: Psychiatry’s Deadliest Scam. The CCHR was founded in 1969 by the Church of Scientology and Dr. Thomas Szasz. The extent of the financial relationship now between Scientology and CCHR is unclear from the CCHR website.

I don’t really care about the relationship between these two organizations. Whatever CCHR is, it one one of only about two organizations critical of psychiatry and pharma (the other being the Church of Scientology) that has deep enough pockets to get the message out to the greatest number of people. Disclaimer: I am not a member of, nor have I ever been a member of, or contributor to, the Church of Scientology or CCHR, nor do I intend to be.

Here’s the take home message from the DVD, as you would expect

• mental illness has no diagnostic test
• psychiatry can’t agree on what defines mental illness
• DSM needs a diagnosis in order to bill insurance

There are some clever illustrations of how there is little agreement on what mental illness is. In one scene, a fictitious group of psychiatrists are the celebrity guests in an updated version of the 1950s television game show, “What’s My Line?”  The psychiatrists try to guess what diagnosis the contestants were previously given, and they all get it wrong, all the time.  In another, patients brought hidden cameras into their therapy sessions and tried to get the psychiatrists to explain what their diagnosis really meant. The wobbly and convoluted answers were hilarious.

There is an expensive French language voice-over that adds a bit of unnecessary, but comic Gallic emphasis  to what is already explained. “Non, c’est ridicule!” says a male voice in response to something the female French voice is explaining. He also responds with “C’est tellement incroyable!” (That’s truly unbelievable!)

A problem with the DVD is that it hardly mentions schizophrenia. I ‘m pretty sure I understand why. It’s because the public still believes that there is this horrible mental illness called schizophrenia that is a “true” mental illness. Schizophrenia still persists in being the one diagnosis where psychiatry and pharma hasn’t inflated the numbers by widening the catchment area, as it has done with bipolar, ADD, autism, and depression. There has been no Joe Biederman popularizing the schizophrenic child – the bipolar child is as close as psychiatry has gone so far.  Let’s assume CCHR, in the DVD at least, doesn’t mention that schizophrenia is manageable without drugs and not a real illness to begin with, because if it did, the public wouldn’t buy the rest of what it is saying. CCHR would prefer to work with the diagnoses that are becoming heavily criticized as being over-diagnosed. A rising tide lifts all boats, so any challenging of the the current treatment paradigm for depression and bipolar, with carry schizophrenia with it. There is a slight problem with my logic of a happy ending for all, and that is that psychiatry won’t give up schizophrenia without a fight.