Following on from yesterday’s post, Healthy Eating, Psychiatry and the Collapse of Industrial Society, the discussion I had on FaceBook with a couple of friends reminded me how much I hate society’s love of labelling people.
Briefly, in my post yesterday, I linked to an article at Living Traditionally that comments on a push by some psychiatrists to have healthy eating treated as a mental disorder, using the label ‘orthorexia nervosa.’ This is pretty serious stuff, and I immediately realised it’s part of a wider campaign to force people to conform, which is why I shared it on FaceBook, and why I was so shocked that none of friends realised why I shared it.
Anyway, since I studied psychology, back in the early 2000s, I’ve developed very strong feelings against labelling people in a mental health context. This is for a number of reasons:
- Giving someone a label gives them a reason to say, “I’m sick, there’s something wrong with me, and there’s nothing I can do about it.”
- It gives health professionals the opportunity to screw up people’s heads even more by treating them as a label rather than a complex and unique human being.
- Labels are often used by society to marginalise people.
- Being diagnosed, and labelled with, a mental health condition can affect future job prospects.
- An individual with a mental health label in their medical notes is at risk of being treated differently by professionals in the future, when they see them for the first time.
My friend, the mental health professional, argued that giving something a name enables us to provide clear guidelines on how to treat it, so it isn’t left up to the whim of the practitioner. I get this, but whatever happened to the idea of caring and compassionate health professionals treating each patient as an individual with very specific needs? (Perhaps that should have said ‘ideal’ rather than ‘idea’ because it may be one of those things that works well in theory, but doesn’t translate so well into practice. And it is true that the current system is an improvement on the not so distant past, when someone who was caught talking to herself in public (see my post from a few days ago) could have ultimately ended up in the madhouse.)
The point is, we have a flawed system that encourages health professionals to rely on knowledge, rather than experience, to treat patients. (I love reading and expanding my own knowledge, but I’ll take a doctor with real world experience rather than one who is book-smart, thanks.) The American Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organisation’s International Classification of Diseases (ICD), in their 5th and 10th incarnations respectively, are heavily relied on by doctors and other health professionals when it comes to diagnosis and treatment, which can easily lead to a simple 2-step process being followed.
- What condition (label) do these symptoms point towards?
- What are the recommended treatments for the condition?
Nowhere in that process is the patient treated as a person, with their own ideas, opinions, concerns and fears.
I will admit to some personal experience of being a patient in this system, and this probably gives me a negative bias. Not as a psychiatric patient, I might add. If anyone in the mental health profession found out about the close and companionable relationship I have with my OCD (Obsessive Compulsive Disorder) and the arguments my multiple personalities have in the supermarket, I’m sure they could find all sorts of things wrong with me that I’ve never even guessed at. My experience happened when I was admitted to hospital because a chest infection triggered an (apparently) life-threatening asthma attack. Of all the people I encountered during my week in hospital – the specialists, junior doctors, nurses, and other staff – the only person who treated me as anything other than a diagnosis was the caterer who delivered my meals.
It could be argued that the UK’s National Health Service is under pressure, and time constraints don’t allow doctors and nurses to sit and talk to patients, except that I had insurance and was on the private ward, so there was really no excuse for treating me like a non-person.
The experience left me with mental scars. Twelve years later, when a careless driver knocked me off my bike, I refused to get in the ambulance until the paramedics agreed I would be taken to the town’s community hospital to be checked over rather than the main hospital in Malaga. Handing control of my body over to doctors is no longer something I will do lightly.
Imagine, then, how much worse it is if it’s your mind that’s malfunctioning. Most people find even the idea of mental illness frightening, and what we need most when we’re afraid is for someone to sit down with us, communicate with us, take time with us, and demonstrate that they care. In fact, most mental illness can be dramatically helped, if not completely resolved, by treatment methods that involve human contact rather than drugs. But the system we have is based on making a diagnosis and writing a prescription that puts money into the hands of powerful, multinational drug companies.
Who benefits most from creating another new label?