Sunday, June 5, 2011

How Many Syndromes Do You Have

I wrote a recent post recapping an article about mental illness and using it as a basis for expressing some of my general criticisms of psychiatry. The fact that Wait, Wait, Don't Tell Me discussed the recent identification of "Hotness Delusion Syndrome" on this weekend's show brings back into focus one of my points of contention with the field.

The details behind HDS are that more men over the age of forty are single than women of that age, and therefore such men are pursued much more vigorously. The imbalance leads men in that stage of life to drastically overestimate their own attractiveness. I refuse to believe that I'm being unfair in saying that that could not possibly be rightly called a syndrome. If the failure to thoroughly and objectively analyze the consequences of statistical deviations is a syndrome, then the majority of all Americans must be very seriously afflicted.

I am completely in favor of endeavoring to explain all manner of human behaviors. It is good to know the circumstances and causes underlying people's judgments, beliefs, and actions, in order to help us to compensate for mitigating factors and to improve ourselves both personally and socially. The notion of diagnosis carries a different connotation, however. It is more excuse than explanation, and it diminishes the sense of agency in a person's actions, while still locating the problem almost exclusively in the mind of the individual.

And there is an ongoing impulse to provide virtually every bit of human activity with this kind of assessment. It leads, in my view, to absurd diagnoses of silly conditions, where it would be much more helpful to simply say, "You should work on this personality characteristic or that skewed perspective. It is not helpful to try to disembed these features from the person carrying them, and define them unto themselves. For when we do, we end up with things like Alexithymia - difficulty in understanding or expressing your emotions - which, surely, every last human being must have in some measure.

I understand that it is a matter of degree, and that some people experience serious psychological harm and social consequences of characteristics that are, on their surface, innocuous. That does not make it any more sensible to define those characteristics as syndromes and disorders. Saying that a diagnoses of Hotness Delusion Syndrome is absurd in all cases is no worse than saying it is wrong to apply it to some people who experience the same symptoms in a lesser degree. The dividing line for things like this could be nothing other than arbitrary.

The challenge here is that I must, and willingly do extend that analysis to more widely recognized conditions like bipolar disorder. When I think of what bipolar signifies at its absolutely most basic level of description, I think "A series of highs and lows? Isn't that just life?" And I think it is unfair that one person who experiences mild fluctuations of that sort might be denied a diagnosis, while someone else with very slightly more extreme or less ordered phases might be ascribed the title that provides him with both the stigma and the convenient explanatory function of a disorder.

Again, I understand that extreme bipolar disorder can be menacing to a person's well-being, and that therapy may be genuinely helpful in some instances, and medication in others. My own preferences, were I to be faced with a diagnoses of this sort, are defined, but irrelevant. I leave that decision as a matter of personal opinion in all cases. Severe interventions may be extremely helpful in some cases, but what I believe is never helpful is compartmentalizing a person's psyche and thus failing to treat them as a complete person.

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