By Doctor Tom (MD)
Of all medical specialties, the one most bereft of an objective system for classifying the conditions it treats is Psychiatry. That should not be difficult to understand; the human brain has been aptly described as the most complicated machine in the universe, thus psychiatrists could be forgiven for their inability to classify “mental illness” with the same precision as cancer or infectious disease can be diagnosed. But they should not be excused for pseudoscientific mumbo-jumbo that pretends to be as objective and reproducible as the anatomy-based specialty of pathology developed by Rudolph Virchow, a Nineteenth Century German physician and near-contemporary of Charles Darwin.
In fact, Virchow’s influence on Medicine has been as important as Darwin’s on the larger issues of Biology and Cosmology. More specifically, Virchow’s remarkably prescient insight; namely that changes in the microscopic anatomy of diseased cells accurately reflect the disease processes affecting them- provided modern somatic Medicine with an essential conceptual framework in much the same way that the Periodic table provided Physics and Chemistry with substrates to study and discuss in a common language.
Unfortunately, aberrant human behavior, although undoubtedly a brain function, has not yet been shown to be recognizable by microscopic changes in that organ.
That does not mean that some behavioral aberrations are not manifestations of “organic” disease: delerium can be produced by high fever; emotional lability is a classic manifestation hyperthyroidism, and several other conditions. However, Schizophrenia cannot be diagnosed either by biopsy or at Autopsy, nor can “Bipolar Disorder.” Although both conditions are commonly recognized by experienced observers, neither exhibit specific diagnostic changes in the brains of afflicted patients.
The most troubling aspect of Psychiatry’s lack of an objective system of classification is how quickly psychiatrists embraced the drug war and its bogus theory of “addiction” after passage of the Mitchell-Nixon Controlled Substances Act in 1970.
The easiest way to understand Psychiatry’s near total acceptance of the drug war has been its continuing endorsement of “drugs of abuse” as a valid concept and their acceptance of the idea that their use or possession should remain criminal matters. Finally, that the DEA is the Agency of choice for deciding the proper diagnosis and treatment of “addiction.”
In that connection, Nora Volkov MD, a Psychiatrist and the current Director of NIDA, recently provided a justification of the federal position on addiction at the Commonwealth Club in San Francisco.
Needless to say, I don’t buy it.
