Diagnoses and Stigmatization in Mental Health

January 25, 2017 § 2 Comments

Today is Bell Let’s Talk Day in Canada.   For every Tweet and Instagram post with the hashtag, #BellLetsTalk Bell (a major telecommunications corporation in Canada) will donate $0.05 to to Canadian mental health programs. For every txt and long distance call made on Bell’s cell and land line networks, it will donate $0.05.  And for every view of a video about the initiative on Bell’s Facebook page, and every use of the Bell Let’s Talk geofilter on SnapChat, Bell will donate $0.05.  See the theme here?

We can debate the fact that this is a corporate-sponsored thing.  Personally, I don’t care. I am more interested in the donations to mental health programs and ending the stigma about mental health. I find it shocking and depressing that in 2017, there still exists a stigma surrounding mental health.

As I noted in a previous post, I am reading Bessel van der Kolk’s The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma for a new research project on childhood, memory, and trauma.  Van der Kolk is a psychiatrist and, it would appear, a pretty good one.  One thing that has really captured my attention in reading this book is his argument about the power of diagnosis.  In particular, he is concerned with Post-Traumatic Stress Disorder (PTSD), which arose out of his work with Vietnam veterans at the VA in Boston in the late 1970s.  Since then, he has worked with probably thousands of children and adults suffering from PTSD and other ramifications of trauma.

I have long been sceptical of diagnoses in mental health, as they can also lead to a stigmatization of the individual in question.  This is certainly an issue, and van der Kolk notes it.  But he also argues that diagnosis is very important because it allows for a systematic plan to deal with mental health issues.  It allows practitioners and patient/clients to draw on a great deal of expertise from researchers, clinicians, and patients/clients and a variety of treatment models that have been theorized and tested.  And, he also notes, there’s the question of research and funding.  For example, he notes, between 2007 and 2010, the US Department of Defence spent over $2.7 billion USD on treatment and research of PTSD in combat veterans.

In other words, there is something very valuable in the diagnosis of mental health problems.  I still have serious problems with the stigmatization of diagnoses.  And I still have a serious problem with the ‘disorder’ terminology used in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatry Association (APA).  The term ‘disorder’ is a dangerous one in mental health precisely because of the stigmatization that comes with it.

Van der Kolk, to be fair, is aware of this and is also leery of what he dismisses as pseudo-scientific diagnoses.  In fact, he goes on the attack of DSM-V, which was published in 2013. He recalls how before the likes of Louis Pasteur and Robert Koch, doctors were limited to treating physical symptoms, that which could be seen.  Koch and Pasteur, however, pointed out that bacteria, unseen by the naked eye, caused many diseases.  Thus, physicians changed their tactics to treating underlying causes, rather than the symptoms of illness.  The problem with DSM-V, he argues is that with over 300 diagnoses in 945 pages, it offers ‘a veritable smorgasbord of possible labels for the problems associated with’ severe early-life trauma.  He dismisses many of these labels, such as Oppositional Defiant Disorder, Intermittent Explore Disorder, and Disruptive Mood Regulation Disorder, as ‘pseudo-scientific.’

Fundamentally, he argues that the problem with all of these labels is that they are symptoms, not the actual problem.

The Cubs Win the World Series?!?

November 4, 2016 § 2 Comments

I grew up as a fan of the Montreal Expos, or ‘Nos Amours,’ as they were known.  I went to my first game with my dad in 1978, not long before my sister was born, when I was 5 years old.  I was transfixed by the experience at Olympic Stadium in Montreal.  It was still new, it had not yet become the albatross hanging around the neck of the franchise. It was glorious.  So were the hot dogs, consistently ranked amongst the best in Major League Baseball.  I don’t remember who the ‘Spos played that day, I don’t remember the score.  But I remember the centrefielder, Andre “The Hawk” Dawson.  He quickly became my favourite player.  Others loved Gary Carter, the charismatic catcher. Or Tim Raines, the left fielder.  And eventually, ‘Le Gros Chat,’ first baseman Andres Gallarraga.

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In 1987, Dawson left the Expos. His knees were bad and the notoriously horrible artificial turf at Olympic Stadium made them worse.  He signed with the Chicago Cubs.  For a brief moment, I shifted my allegiances.  It made sense to me, I was a kid.  Plus, I was a Chicago Bears’ fan, and had been since I first discovered the beauty that was Sweetness, the Bears running back, Walter Payton, 4-5 years earlier.  So I got a Cubs cap.  And I was a Cubs’ fan. But old allegiances die hard, and in my heart, I remained an Expos fan.  Imagine my disappointment in 1994.

But, underneath, I remained a Cubs partisan, and experienced heartbreak after heartbreak.  But then Major League Baseball colluded and Nos Amours were stolen from Montreal in a skeezy deal that saw them move, eventually, to Washington and the horrible owners of the Expos, Jeffrey Loria, get the Miami franchise, while the owner of the Miami franchise, John Henry, moved up to Boston to take over the Red Sox.  I was angry and devastated.  I swore off baseball. Even today, I refuse to recognize the validity of the Washington team.

And then, in 2012, we relocated from Montreal to Boston.  And I needed to cheer for at least one Boston team.  See, the problem is this: I hate the fucking Boston Bruins. Hate them.  The only thing on God’s Green Earth I hate is that team. Cheaters. Liars.  Dirty SOBs.  Hate them.  And that deep, abiding hatred for the Bs seeped out to the other Boston teams, especially the Patriots.  But, when I was a kid, the Toronto Blue Jays and the Boston Red Sox tended to be the two teams that rivaled each other for the AL East title. And I always cheer against the Jays, so, by default, I kinda cheered for the Sox.  So, I took up a fandom for the Boston Red Sox.  The fact that they play in Fenway Park helped. I love that stadium.  And, they also won the World Series in 2013, which I appreciated, it being my first full year in Boston and all.

But I always kept an eye on the Cubs.  In 2015 I tuned into a baseball game and watched it start-to-finish, without doing something else, but actually watched it, for the first time in forever. On 30 August 2015, the Cubs, beat the LA Dodgers 2-0.  And pitcher Jake Arrieta got a no hitter.  The last time I watched a complete baseball game was on 28 July 1991, when those very same Dodgers were victim to another no hitter, this time a perfect game, against the Expos and the brilliant pitcher, Dennis “El Presidente” Martinez.  So I felt I had come full circle.  I was still a Red Sox fan, but my affection for the Cubbies remained.

I enjoyed the 2016 baseball season.  Both the Red Sox and Cubs were contenders, both won their division.  Both made the post-season, though the Sox crashed out in the ALDS to Cleveland (I will not use that team’s nickname, as it is racist).  The Cubs, on the other hand, made it to the World Series, against Cleveland.

On Wednesday night, the Cubbies won the World Series for the first time in 116 years.  The last time they won was 1908.  The last time they even made the World Series was 1945.  In my lifetime, since Dawson signed there, they had met heartbreak after heartbreak.  In 1989, they won the NL Central, but were easily defeated in the NLCS by the San Francisco Giants.  They made the playoffs a handful of times between 1989 and 2015, and each time came up short.  And let’s not get into that Bartman incident.

I was at a concert in Nashville Wednesday night, but kept checking my phone for the score.  I was really caught up in it.  I thought they had it in the bag when it was 6-3 in the 6th.  But then, all of the sudden, it was 6-6, after Aroldis Chapman gave up a homerun.  And it went to extra innings. And then there was a rain delay.  All of this meant that by the time we got back to the car for the drive home, the game was still going on.  We found it on the radio, and caught the final out and the victory.  And it happened.  The Cubs won the World Series.

I was down in Atlanta yesterday running errands.  Wearing my Cubbies hat. And had all of these conversations with people.  Everyone kept asking how it felt.  I felt a little bad, not being a die-hard Cubs fan, but, I still found myself saying that it didn’t feel real.  It doesn’t.  It doesn’t feel real. I can only imagine what a real Cubs fan feels.

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