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kmanning's picture

The tyranny of diagnosis

I found this article in the NYTimes (i don't think it's already been posted, but if so I apologize!) about how doctors are treating only illnesses and not whole patients.

http://www.nytimes.com/2008/09/19/health/chen9-18.html?_r=1&oref=slogin

It's so in line with our discussion as to almost not be new and exciting anymore, but one thing it does illuminate is that this problem of doctors only treating what is wrong or deficient - and not treating a person as a whole person - is not unique to mental health at all.

As I mentioned in class when Prof Grobstein was presenting the medical model of  cause - symptom - treatment, I dont think the mental health model needs to be different from this basic backbone of the "medical model". What does need to happen is that we expand the definition of cause to be more than biological. If a person presents with a symptom that is mentally unhealthy (by whatever standard of mental health we conclusively decide upon) the person who is helping them must then look to what could have caused this to be the case. Maybe it's social, maybe it's biological, maybe it's existential, etc. Then, a treatment plan is decided upon, to restore this person to mental healthiness (to being able to understand their current condition and how to change it, or whatever other definition we would like). This treatment plan might involve talk therapy, it might involve drugs, it might involve meditation. Most importantly, it must involve the patient's continuing involvement in self-assessing and assisting their helper is assessing them.

Like Ryan, I am struggling with coming up with step #2 of our mental health definition - how to use the definition to ACT. Somehow, the theory I outline above currently gives me comfort.

What I am not sure of yet though, is what exactly the ultimate "good" in mental health is. Prof grobstein said it is understanding oneself and how to change oneself. In my first definition that I posted I said it was being in a state where one is always seeking happiness/wellness (I believe all humans by nature strive to achieve a greater sense of happiness than that which they presently posses). I like how professor grobstein's definition does not involve an ideal, BUT i also think there can be many different kinds of definitions that dont involve ideals, and do involve the evolving of the patient. I would be very interested in discussing other possibilities for the ultimate "good" of mental health.

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