Friday, March 16, 2012

SOCIAL CANCER AT WORK AGAIN

An article in this week’s New Scientist (http://www.newscientist.com/article/dn21580-many-authors-of-psychiatry-bible-have-industry-ties.html) is headlined “Many Authors of Psychiatry Bible Have Industry Ties.” You may remember that I scooped this very story a month ago on this blog; see http://healthcareasthoughpeoplematter.blogspot.com/2012/02/do-we-have-pill-for-you.html.

Here’s the gist: the American Psychiatric Association committee charged with revising the profession’s manual, the Diagnostic and Statistical Manual of Mental Disorders, has recommended changes that will summate in greater use of psychiatric drugs.

I’ve witnessed this tendency for decades. Into the 1960s, psychotherapy—that is, conversations between people and their therapists—was psychiatry’s main tool, but it’s been gradually displaced by drugs. Certainly drugs have been of some benefit, particularly the phenothiazines for schizophrenia, but more and more, drugs have become psychiatry’s almost exclusive tool. Pharmacology has so widely evicted psychotherapy from training that—to use this blog’s terminology—people matter little there now.

The New Scientist article points out that the DSM-revision committee is populated largely by people with ties to the pharmaceutical industry. Well, that’s to be expected these days, I suppose, and I suspect they’ll deny that their ties influence their revision decisions. But maybe the public’s not all that stupid. As the old Yiddish saying goes, “You can’t pee on my back and call it rain.”

I think a lot about the field in which I work, cancer—what it is, what it means, how it affects people. I suggest we have a social cancer here, malignant greed metastasizing into organs like economics, education, politics, and healthcare. We need a treatment for it. Maybe government regulation or criminal prosecution would be a kind of chemo, but I think we can get at it more elegantly through increased personal responsibility. We can no longer believe that government or professional agencies are looking out for us. We need to do it ourselves. 

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