Person Taxonomy Disorder (PTD) is a condition which affects many professionals but it seems to be particularly prevalent within the mental health field. The major characteristic is an assumption of intellectual or moral correctness or superiority frequently held in spite of the presence of evidence to the contrary. Signs and symptoms of PTD include:
* sufferers often have major difficulties when it comes to dealing with their own and others’ emotions.
* they have a pathological inability to acknowledge their own distress and a denial of vulnerability.
* they have an inability to display empathy with others in distress.
* they have a compulsion to analyse and compartmentalize the experiences of others.
* they show impaired social and interpersonal functioning communication with others, which is frequently characterised by an unusual rigidity. In particular the acknowledgement of the other is frequently missing and often manifests itself in lack of common courtesy and impaired listening.
* they have rigidly held beliefs (which they often present as ‘facts’). Such beliefs are not affected by empirical evidence from the real world.
* they ask strange questions which seem to have no relevance to the context within which they are asked.
* they tend to see themselves as important, gifted and beneficent. A particularly frequent delusion is that the sufferer deserves to be trusted by others prior to exhibiting any behaviour which would make trust appropriate. These delusions are maintained by hostile labelling of anyone who challenges these self concepts. One consequence of this is that the worth and abilities of the other are frequently unacknowledged.
* the sufferer is unable to distinguish their own wishes and impulses from those of the people they believe themselves to be helping. This is assumed to be the reason why they so often “act out” this confusion by behaving in ways which provoke anger in other people and then punitively label this anger as a sign of pathology in that other.
* sufferers do not, or are unable to recognise that they have a problem.
* much of the sufferer’s disturbed behaviour is positively reinforced by the surroundings they develop for themselves.
* the main harm caused by PTD is not experienced by the sufferer but by those they are meant to help. This limits the motivation for change.
Originally published in a British mental health consumer oriented magazine ASYLUM
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Although originally published as somewhat tongue-in-cheek this description is surprisingly accurate when it comes to many of our colleagues in the mental health field. These colleagues do not appear to have embraced the paradigm shifts brought about in the twentieth century by systems theory, social constructionism, and more recently ‘E-cognition’ (enactivism, embodiment, extended, embedded); and still take a positivist view that like the rest of medicine there are biological markers (a physical test) just waiting to be found that will provide the pathophysiological correlates to support their diagnoses. But as many have noted, Kraepelin was simply wrong in his belief that there was an underlying brain disease for psychiatric problems. As Duncan Double (Nov 12th 2015) says, “psychiatric diagnoses are simply categories justified by clinical utility”. That is to say they are social constructs, like money is; tacit agreements we have made to treat this as a ‘reality’. Social constructs are to be judged on their utility; and there is a growing agreement that these psychiatric diagnoses are more harmful than useful. As Sami Timimi (2014) has pointed out, besides validity and reliability problems, “there is little evidence to show that using psychiatric diagnostic categories as a guide for treatment significantly impacts on outcomes”. The stigmatizing effects and debilitation such invitations to a flawed identity make are now extensively researched and documented; they do far more harm than good (Read et al, 2006). Those accepting these diagnoses found their self-esteem lowered, with a greater sense of despair and hopelessness (Bassman, 2000).
Critics of this iatrogenic diagnostic juggernaut dominating mental health note the strong collusion between the pharmaceutical industry, the healthcare industries (including insurance), and political forces wanting to contain anyone who might potentially be dang erous (e.g. Moncrieff, 2010). Some of those on task forces producing these manuals and best practice guidelines have exposed the fraudulent politics in play as these ‘truths’ are constructed and put into public circulation (Kutchins & Kirk, 1997; Frances, 2010; Moncrieff & Timimi, 2014). The fact that such thinking leads to a form of myopia or tunnel vision is evidenced by the reviews of the outcome literature, which shows that there has been no improvements in outcomes for SMIs (Serious Mental Illnesses) since the 1930’s in Western countries, despite markedly better outcomes in poor nations which cannot afford mental health services (Hegarty et al, 1994; Hopper et al., 2007; Whitaker, 2002). Not only that but we have been disabling increasingly larger numbers of our population, judging by the massive increases in numbers of people on sickness and disability benefits due to mental health reasons over the past thirty plus years (Whitaker, 2010; Viola & Moncrieff, 2016).
There is no doubt that it is high time those perpetuating this epidemic are brought before the courts for the harm they are doing in the name of health.
References
Bassman, R. (2000). Agents not objects: our fight to be. Journal of Clinical Psychology, 56, 11: 1395-1411.
Double, Duncan. Critical Psychiatry Blogspot. http://criticalpsychiatry.blogspot.co.nz
Frances, A. (2010). It’s not too late to save ‘normal’. Los Angeles Times, March 01, 2010. http://articles.latimes.com/2010/mar/01/opinion/la-oe-frances1-2010mar01
Hegarty, J.D., Baldessarini, R.J., Tohen, M., P.H., Waternaux, C., & Oepen, G. (1994). One hundred years of schizophrenia: A meta-analysis of the outcome literature. American Journal of Psychiatry, 151, 10: 1409-1416. (Harvard psychiatric research that finds no better outcomes now than in the first third of the 20th century.)
Hopper, K., Harrison, G., Janca, A., & Sartorius, N. (2007). Recovery from schizophrenia: An international perspective: A report from the WHO Collaborative Project, The International Study of schizophrenia. New York: Oxford University Press.
Kutchins, H., & Kirk, S. (1997). Making us crazy. DSM: The psychiatric Bible and the creation of mental disorders. New York: Free Press.
Moncrieff, J. (2010). Psychiatric diagnosis as a political device. Social Theory & Health, 8, 370-382.
Moncrieff, J., & Timimi, S. (2014). The social and cultural construction of psychiatric knowledge: an analysis of NICE guidelines on depression and ADHD. Anthropology & Medicine, 20, 1: 59-71.
Read, J., Haslam, N., Sayce, L., & Davies, E. (2006). Prejudice and schizophrenia: A review of the Mental illness is an illness like any other approach. Acta Psychiatrica Scandinavica, 114, 5: 303-318.
Timimi, S. (2014). No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished. International Journal of Clinical and Health Psychology, 14, 3: 208-215.
Viola, S., & Moncrieff, J. (2016). Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014. British Journal of Psychiatry Open, 2, 1: 18-25. (As in the US and NZ, the number of claimants for welfare due to MH reasons continues to climb – by 103% in the UK between ’95 and 2014.)
Whitaker, R. (2002). Mad in America. New York: Basic Books.
Whitaker, R. (2010). Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the astonishing rise of rise of Mental Illness in America. New York: Crown.