I have been wondering how much of liberty can be taken with regard to ‘labelling’ deviant behaviour as psychiatric illness. The latest edition of the DSM-IV has incorporated a new diagnosis into its classification of mental illness. It goes by the name ‘Oppositional defiant disorder’ (ODD).
As stated in this article, what were in the past labelled as personality traits are now increasingly being pushed into the category of mental illness.
This reminds me of a question a professor once posed to us in class: ‘What defines normal?’ To the answer, ‘Majority defines normal’, his reply was a question: ‘What if the population of reference is a mental asylum?’
It has taken me all these years to realize the profundity in that question. With reference to the human mind, when the paths available for it to traverse are infinite, is it really possible to define normal? I am reminded of Nietzsche’s words:
“Digressions, objections, delight in mockery, carefree mistrust are signs of health; everything unconditional belongs in pathology.”
If we go by the current attitude of the psychiatrist community, we would be branding majority of the population as abnormal and certainly all the geniuses as mentally ill! As stated in a Washington Post article: ‘If Mozart were born today, he would be diagnosed with ADD and medicated into barren normality.’
The argument offered with respect to labelling is that it would guide treatment, make it more evidence-based and enable standardization. But with the human mind, is it really possible to have one common solution for the multitude of deviations it resorts to? The only outcome of this labelling has been to overdiagnose mental illness, and of course, to make drug marketing a profitable endeavour.
In my opinion, deviant behaviour that poses difficulty to the self or to others should still be the realm of psychology, rather than psychiatry. It should be viewed as a personality evolved from a multitude of factors in the background. These background factors have to be extensively explored, insights drawn as to how they have contributed to shaping the individual’s personality and these insights used for cognitive therapy, which has to be highly individualistic.
There was a time when I wanted to be a psychiatrist. But today, I wish to be a psychologist. I want to intervene much before the mind has resorted to an extreme coping mechanism for survival. I want to work with children, adolescents, parents and teachers and in association with psychologists and psychiatrists in the creation of a social environment that is conducive to promoting and sustaining a healthy mind.
I remember the words of my professor: ‘Psychiatry is not really an independent discipline. It is something we need to practise in every other discipline…every day of our life!’