Psychiatrists under fire in mental health battle

There is no scientific evidence that psychiatric diagnoses such as schizophrenia and bipolar disorder are valid or useful, according to the leading body representing Britain’s clinical psychologists.

In a groundbreaking move that has already prompted a fierce backlash from psychiatrists, the British Psychological Society’s division of clinical psychology (DCP) will on Monday issue a statement declaring that, given the lack of evidence, it is time for a “paradigm shift” in how the issues of mental health are understood. The statement effectively casts doubt on psychiatry’s predominantly biomedical model of mental distress – the idea that people are suffering from illnesses that are treatable by doctors using drugs. The DCP said its decision to speak out “reflects fundamental concerns about the development, personal impact and core assumptions of the (diagnosis) systems”, used by psychiatry.

Dr Lucy Johnstone, a consultant clinical psychologist who helped draw up the DCP’s statement, said it was unhelpful to see mental health issues as illnesses with biological causes.

“On the contrary, there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse,” Johnstone said. The provocative statement by the DCP has been timed to come out shortly before the release of DSM-5, the fifth edition of the American Psychiatry Association’s Diagnostic and Statistical Manual of Mental Disorders.

The manual has been attacked for expanding the range of mental health issues that are classified as disorders. For example, the fifth edition of the book, the first for two decades, will classify manifestations of grief, temper tantrums and worrying about physical ill-health as the mental illnesses of major depressive disorder, disruptive mood dysregulation disorder and somatic symptom disorder, respectively.

Some of the manual’s omissions are just as controversial as the manual’s inclusions. The term “Asperger’s disorder” will not appear in the new manual, and instead its symptoms will come under the newly added “autism spectrum disorder”.

The DSM is used in a number of countries to varying degrees. Britain uses an alternative manual, the International Classification of Diseases (ICD) published by the World Health Organisation, but the DSM is still hugely influential – and controversial.

The writer Oliver James, who trained as a clinical psychologist, welcomed the DCP’s decision to speak out against psychiatric diagnosis and stressed the need to move away from a biomedical model of mental distress to one that examined societal and personal factors.

Writing in today’s Observer, James declares: “We need fundamental changes in how our society is organised to give parents the best chance of meeting the needs of children and to prevent the amount of adult adversity.”

But Professor Sir Simon Wessely, a member of the Royal College of Psychiatrists and chair of psychological medicine at King’s College London, said it was wrong to suggest psychiatry was focused only on the biological causes of mental distress. And in an accompanying Observer article he defends the need to create classification systems for mental disorder.

“A classification system is like a map,” Wessely explains. “And just as any map is only provisional, ready to be changed as the landscape changes, so does classification.”

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Hypnosis, No Anesthetic, For Man’s Surgery

A British man who hypnotized himself before hand surgery last week so he could skip the anesthetic says he was fully awake and pain-free during the 83-minute procedure.

Professional hypno-therapist and psychotherapist Alex Lenkei, 61, put himself into a deep trance so he wouldn’t feel the pain — he says it took him only 30 seconds to put himself under.

During the surgery, some bone at the base of his thumb was removed, and some joints were fused in an attempt to improve his arthritis.

Lenkei says anesthetic has gotten him nauseous before, and he just feels avoiding it is healthier than using it, in part because it takes awhile to get it out of your system.

Doctors “were using a chisel, hammer to basically break a sort of walnut-sized bone in the hand to take it out. They also used small medical saw to attach tendon to the thumb,” he told Early Show co-anchor Maggie Rodriguez Tuesday.

“I didn’t feel anything at all,” Lenkei says. “There was no pain, just very deep relaxation. I was aware of everything that was going on in the (surgical) theater. I was aware of the consultant tugging and pulling during the operation. But there was no pain.

“And at the same time, the anesthetist had my vital signs monitored all the time. They were fully in control of everything. They hooked me up with reference to anesthetic if I needed it, but it was not necessary.”

This wasn’t the first time Lenkei went that route, he says: “In 1996, I had a hernia operation with no anesthetic. But at that time, I had a colleague with me to stand by with hypnosis. And, being a professional, I know how to go into what they call deep hypnosis. And the local hospital was kind enough to actually allow me to use hypnosis for the operation.”

Lenkei says there’s a lesson to be learned here for the medical profession, “basically, that hypnosis can be actually used post- and pre-operation to actually help the patient (relax) for a much better successful operation. And I feel that doctors ought to investigate this in a lot more detail and actually use it for the benefit of the patient.”

Lenkei says people can heal more quickly if hypnosis is used, and patients are more relaxed.

A doctor was in the operating room says only a small percentage of people would be able to put themselves into such a deep trance, so it wouldn’t work for large numbers of people.

However, it’s interesting to note that hypnosis was used quite widely before anesthetic was developed.

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