Sunday, February 28, 2010

Curing Character

I recently read that the Diagnostic and Statistical Manual of Mental Disorders (known in shorthand as the "DSM"), the bible by which psychiatrists identify and characterize mental disorders and their treatment, is in the process of being updated. Then this morning I read this interesting OpEd piece by George Will: A "Cure" for Character. My mind being what it is, I next made the connection to this Cartoon Saturday offering from a month or so ago:

What my parents might have called laziness in the 50's, and cured with a swat on the fanny or a few nights banned from TV-watching, might today be called laziness syndrome and cured with drugs. Is this progress?

Mr Will suggests in his article that the proliferation of behaviors that are characterized as mental disorders reflect deviations from a perceived normality, and that this characterization could be dangerous in the long run. He writes, "...childhood eccentricities, sometimes inextricable from creativity, might be labeled 'disorders' to be 'cured.' If 7-year-old Mozart tried composing his concertos today, he might be diagnosed with attention-deficit hyperactivity disorder and medicated into barren normality."

So, what's normal, what's eccentric, and what's a dangerous psychiatric disorder that requires treatment? I think of myself as more or less normal, although I'm realistic enough to recognize that I'm also a bit eccentric. But where do we as a society draw the line between harmless eccentricities and conditions that require treatment?

As an alpha geek in grade school and high school, I met my share of bullies who might have been normal, or who might have been serial killers in training. A psychiatrist might refer to the DSM to help him (or her) tell the difference. But would he or she judge these individuals as patients to be cured or as potential criminals to be judged? As Mr Will writes, "Today's theraputic ethos, which celebrates curing and disparages judging, expresses the liberal disposition to assume that crime and other problematic behaviors reflect social or biological causation. While this absolves the individual of responsibility, it also strips the individual of personhood and moral dignity."


Is Bilbo lazy or does he suffer from laziness syndrome?

Is it right to replace judgment of bad behavior with curing of a perceived disorder?

I wish I knew. Then I could make lots of money by writing a book and selling it to psychiatrists...who could then include it in an upcoming edition of the DSM.

In the meantime, I still think there's a place in this world for punching out bullies.

Have a good day. More thoughts tomorrow.



The Mistress of the Dark said...

I love that we have to blame something that's normal on a prefabricated illness.

Mike said...

DSM IV is the standard now. They are actually looking for input from the public on DSM V. I called them. They are now in a mad rush to get DSM VI going.

Wv: defiero - Where the firemeno go.

Jean-Luc Picard said...

Syndrome apparently answers everything.

Amanda said...

There is so much overanalysis on normal-ness by the professionals and non-professionals. Even my mother is falling victim to Dr Google. She worried that Adrian might be Autistic because he wasn't making eye contact. It was just his normal development schedule and he just wasn't ready at 3 weeks to look at her. He's fine now and 'chatting' with her daily.

SusieQ said...

I respect George Will, but I can't agree with him entirely here. I do agree that it is not necessary to label as a mental disorder every departure from normal behavior. If we continue down this road, someday there will no longer be any normal people left. We'll all be labeled dysfunctional.

We do rely on drugs too much in this country to control the behavior of some of our children when behavior modification alone would be a much healthier alternative treatment, in my opinion, for some of these children. But behavior modification requires a lot more time and effort from parents and teachers...and time is money. Drugs are faster and less costly to society. These drugs very well may cost in other ways though.

We are drugging our children, whose brains are in the process of developing, with powerful medications and we do not know for sure how these drugs will impact their developing brains in the end. I hate that this is happening. I can speak about this from experience.

I have a thirteen year old grandson with behavior problems. He has been on one cocktail of drugs or another since he was five years old. I worry that it has damaged his brain or will in the end. But his doctors have not been concerned. They have prescribed drugs for him as if they were little more than candy. Most of the drugs he has been on are outlawed in Great Britain for use with children under 18. I think he would have been better off without the drugs and behavior modification used entirely with him instead.

Where I disagree with Mr. Will is on the responsibility aspect. It is not true that persons diagnosed with a mental disorder are not likely to be held responsible for their actions. My grandson attends a special school for children who have behavior problems. Indeed these children are held responsible for their actions. There are consequences for these children when they misbehave. Good behavior is encouraged with positive incentives or rewards. So behavior modification is used with these children. Character building is done at this school as well. So I think Mr. Will is not well informed in this instance.

For more on this subject and society's unwillingness to go easy on persons with mental disorders, watch the movie The Informant.