What do you think a police officer should do if he sees a joy-rider overtaking several vehicles from the wrong side, and spitting invective at drivers who resist this aggressiveness? Refer him to the traffic department? Call him to the police station and reprimand him? Neither. According to American experts, you should refer the driver to a psychiatrist who will treat him for a leading psychiatric affliction of the nineties -- road rage!You raise your eyebrows? But wait, there are a few more surprises in store for you. Look at these examples of mental illness:The inability to give up smoking, a tendency to frequently think of a love-affair of the past, watching too much TV, a refusal to give up alcohol despite your doctor's warnings, a temptation to make foul telephone calls and an addiction to the Internet.
Of course you think most people may have one or two of these and to brand them as mentally ill is pure nonsense. And you're absolutely right, because these are just figments of the imagination putout by the American media to ridicule psychiatrists. The provocation: the latest revision of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. The accusation: the DSM, which is the holy book to psychiatrists the world over, is calling almost all bad habits `mental disorders', and labelling nearly everything that we think, feel or do as symptoms of some mental disease like schizophrenia. In the now-popular book Making Us Crazy, the sarcasm goes of the extent of accusing the DSM authors of enlisting even anxiety about delivering a speech as a symptom. Finally, the media insinuate that all this is the result of a conspiracy that psychiatrists and pharmaceutical companies have undertaken against the unsuspecting public because of their greed for more patients or better sales graphs.
To some extent, the accusations seem justified. For example, a few years ago, if a teacher reported that a child was disruptive and inattentive in class, his father probably boxed hisears, told him in plain language what sort of behavior was expected of him, and warned him that further complaints would mean more severe punishment. Today, psychiatrists would brand this punitive action as child abuse and say that the child is not naughty, but ill, suffering from ADHD -- Attention Deficit Hyperactive Disorder. The media says this is stupidly giving infinite elasticity to the concept of abnormality.
How do shrinks react to all this? They just turn round and ask: Do we not include the common cold and even the mildest skin rash in the International Classification of Diseases along with cancer and coronary heart disease? If we do, then why can't ADHD be presented on par with schizophrenia or paranoia?
The American public may not be very unhappy with the DSM because the minute a malady features in it, treatment becomes either fully or partially covered by insurance. But in other countries like India, the DSM may be an embarrassment. One could be afraid of taking even about one's minorbehavioral problems lest one is stigmatized as a fruitcake.
Prospering psychiatrists and drug firms, and insured people mopping up more benefits are superficial aspects of this issue. There are more basic questions involved.
One such is simply this: Can a person misbehave and then beg for immunity on the ground that he is ill? If the answer is yes, then all criminals will take refuge under this umbrella. And if we ask where mental diseases arise from, and blame it on heredity and environment, we will have funny situations like having to punish Peter for the misconduct of Paul, for providing innocent Paul with a poor environment or defective genes, or both. What a congenial state of affairs for criminals and crime!
Copyright © 1998 Indian Express Newspapers (Bombay) Ltd.
