Hearts Beat As One

It is common knowledge that we can slow our heart rate by slowing our breathing. Breathe is arguably the most important tool in the whole recovery toolbox for relieving stress and staying in the here and now. The folks in Sweden have taken this data a step further, into building community for common action.

Having taken a leave of absence just as DSM-5 was published, I have a backlog of posts on diagnosis to write. But let's break it up, shall we? This one gets filed under both recovery and political action.

It would take researchers from outside of the United States to think of examining the physiology of a group activity. Swedes, with their solid background in hymn singing, did just that, using group singing as a stand-in for group action.

Doctors' Prejudice Against Mental Illness

One in four people in the United States meet the criteria for a diagnosable mental illness in any given year.  About half will develop a mental illness sometime in their life.  Allen Frances, editor in chief of DSM-IV wants fewer people, only those with the most serious illness, to be diagnosed to spare them the stigma of the diagnosis.  The chief mechanism to achieve his goal would be to change the DSM criteria, so that fewer people qualify.

This series began by introducing Dr. Frances, whose work has inspired it.  It continues to address the topic of stigma, what it means, where it comes from, how to respond.  Last week I defined terms, adding one that expands our frame.  Briefly, Merriam-Webster says that stigma is a mark of shame or discredit; while prejudice is injury or damage resulting from some judgment or action of another in disregard of one's rights.

I think it is important to distinguish between the two.  To do so, one has to clarify the context.  Stigma, when used by somebody who is the object of stigma, is the internalization of somebody else's prejudice. When it is used by somebody else, stigma is a mechanism of diversion that calls on the object of one's own prejudice to bear the responsibility of that prejudice.

So is Allen Frances trying to protect those whom he calls the worried well from being marked with shame or discredit?  Or is he creating a diversion that calls on people who are suffering to bear the responsibility for somebody else's prejudice?

Silence Kills - The Stigma of Mental Illness

I don't use the s-word.  I hate this title.  I use it only because people who need this post will use it when they google.

I don't use the s-word.  But here it is.

First from Google:

Definition of STIGMA

Noun A mark of disgrace associated with a particular circumstance, quality, or person: <the stigma of mental disorder>.

DSM-5 - Passé Before Published

Most of Allen Frances' ranting against DSM-5 bounces back to hit his own DSM-IV just as well.  He acknowledges this in the preface of Saving Normal, which he says is part mea culpa.  You could sum his argument against DSM-5 as It's DSM-IV, only more so!  We could all find some consensus around that line.

So while I am not pleased with this man's rants [did you pick up on that last week?], I do not come to praise DSM.  To keep us all on the same page, I am reposting my piece from November, 2011.  What I wrote below referred to DSM-IV.  Most of it applies to DSM-5, as well.  The differences between the two do not a difference make in my own critique.  The fatal flaw in DSM-5 is that it is DSM-IV's little brother.  That's what Thomas Insel is talking about...