The Baked Potato Taco

Playing Devils Advocate

Although I'm sure this article was written to send a light-hearted message, I cringe at the anticipated popular responses that it's readers may have. I anticipate such a response to be a negative one towards the field of psychology, mental health diagnostics, and mental health services in general. Thus, I want to play devil's advocate in response to such. (NOTE: I am not arguing against the basic message that points at the power of suggestion and the role that expectations play in the development of one's perceptions. I agree that there is still a problem with over-diagnosis of certain mental disorders, although I believe the reasoning for that calls for an in depth discussion and should be saved for another day.)

The first passage that I take issue with is the following: “As soon as they were admitted to the hospitals, they stopped simulating any symptoms at all, and whenever they were asked they all said they felt fine and that their brief hallucinations were gone. They were cooperative a patients and behaved completely normally. The only symptom they might then have shown was a little nervousness about the possibility of being found out.” Just because they felt fine and reported to the staff that they felt fine, does not mean that they would or even should be immediately discharged. It’s probably not that uncommon for people who have actually experienced auditory hallucinations to report to others that they are fine if 1.) the voices they hear are not bothersome to them, 2.) they are being treated with antipsychotic medications that are in fact mitigating such symptoms, or 3.) they have learned that when they report being “fine” that they are left alone and not bothered with further questioning, medications, or other procedures that they may find disruptive or unpleasant. In other words, what do you expect that the staff would say? “Oh, okay, so you feel okay and don’t hear voices anymore?? Great! Let’s discharge you into society immediately with no diagnostic information that notes a history of abnormal psychological experiences (i.e. hearing voices)!” Just something to consider.

A second passage I’d like to comment on is the following: “And when they were released, they were described as “improved,” or “in remission,” but no doctors listed any of them as ‘cured.’” While I understand that they should not have been diagnosed in the first place, I wish to point out that once someone is diagnosed and treated for a disorder like schizophrenia, it is highly unlikely that it would ever be noted as being “cured”. Such expectations are unrealistic since that language (i.e. being “cured”) would not be used in a mental health setting even if the symptoms have mitigated or are under control as a result of treatment.

Another statement that I have trouble with (among the many) is: “They were admitted and diagnosed as insane.” I question and challenge this statement vehemently because there is no such diagnosis of “insane” in the DSM-IV. So, it is possible that either 1.) the published study was not using DSM/common language used in the professional field, 2.) the study was conducted many years ago at a time when the DSM was not used or the term insane was used in the DSM, 3.) the writers who wrote this article (that I am replying to) did not properly report the research findings. I think the point here is to emphasize that we all must be critical thinkers and consumers of the things we read. Especially when the statements or messages that the author wishes to make have so many implications. In this case, the implications or messages being conveyed are reinforcing the stigma associated with mental health services, diagnoses, and the profession at large. I am not arguing that the field is perfect, nor am I attempting to argue against the actual research findings (because without reading the research article itself, there is no way to critically assess its validity, generalizability, implications, limitations, etc.). I am merely trying to highlight the importance of thinking critically about statistics, data, and general “findings” that are reported in the media in general. For example, if this research was conducted nearly 40 years ago, we need to be open-minded to the likelihood that research, mental diagnoses, diagnostic measures/assessments, and mental health care services have changed (a lot) since then. It makes for an interesting read and something to think about but I would encourage fellow readers to be sure to be educated consumers of such information before spreading the ‘news’.

On a final note, I think it’s important to highlight that there are in fact that there are people who malinger. Malingering is hard to catch sometimes. Fortunately, there are assessments used today to help determine one’s likelihood of feigning mental illness. One thing that this article certainly highlights is the value of proper psychological evaluation by a psychologist using a battery of assessment tools.

Other similar studies, for example:

DIFFERENTIAL FUNCTIONING OF LAY AND PROFESSIONAL HELPERS. By CARKHUFF, ROBERT R.
Journal of Counseling Psychology, Vol 15(2), Mar 1968, 117-126.

- "EVIDENCE INDICATES THAT WITH OR WITHOUT TRAINING
AND/OR SUPERVISION THE PATIENTS OF LAY COUNSELORS DO
AS WELL OR BETTER THAN THE PATIENTS OF PROFESSIONAL
COUNSELORS."

I recommend reading the research summaries in such books as "The Art of Helping", or "Helping and Human Relations" in so much as they give a long list of research done that details, in part, how dysfunctional professionals can be. I thought this was all known. It can't be a surprise, given all the work that was done in the past to research this.

Restless legs does not mean people who nervously bob some body part all the time, it's a condition that makes them jerk and move without their control especially at sleep. My hubby has it and it is sometimes triggered when we lay close together in bed. The touch triggers it and I get dry humped with one bump about every three seconds. Moving away doesn't help and waking him doesn't anything, too.

My uncle worked at a mental facility and he used to say sometimes he's not sure, whether he's staff or patient or at least should be one.

@geebus: restless legs is un ugly problem that I have to live with. No much explanation about its origins, no medicine really works. It runs in the family. Not always bothers me, but man, think that suddenly to lay in bed is a problem. It's uncomfortable. It's not the bed, not the temperature. Sometimes you're not even concious that you are moving your limbs until somebody ask you to stop. Now tell me a solution to it.

I am not offended by your ignorance, don't worry. I just want to point that some sickness are just discovered, which doesn't mean that they are not real.

My dad was a shrink, who found many people diagnosed as "mentally ill" really were NOT, and they didn't need to be addicted to meds or institutionalized.
Nowadays everything must be diagnosed as an "illness", like kids who can't sit still in classrooms all day, people with "restless legs".
Sadly, all of medicine has been corrupted by monstrous greed.
The best medicine isn't even available at the pharmacy!

I always have this recurring dream that I'm a doctor in a mental institute only to find out later that I'm actually a patient.

Not much money in madhouses.. More a power and authority thing...

Follow the $.

I recommend Ken Kesey's 1962 novel One Flew Over the Cuckoo's Nest, based on his experiences working at a mental health facility.
http://en.wikipedia.org/wiki/One_Flew_Over_the_Cuckoo%27s_Nest_%28novel%29

Yes that was back in the day, today you can be really ill and not get admitted as your insurance will want to deny it.

I recommend reading "ten days in a madhouse" from Nellie Bly.
It ssems there was not that much changed since the 1890s...

Don't know if it makes a difference, but the experiments were actually done in 1973, not exactly "a few years ago".