I hate diagnosing clients. I work in Private Practice and if a client is paying me out of pocket then I do not have to give him/her a diagnosis. I deal with a lot of relationship issues and sexual stuff, and our ails are fluid and ever changing. We may be depressed one day, anxious the next and failing to orgasm the next. Sure these ails can all be tied up into one (or several for that matter) neat little diagnosis package/s if you really want a label, but as a therapist who works with you mentally and emotionally by talking things out with you tohelp you figure out and get through your situational ails, and who doesn't prescribe medication nor give you a pill or pill cocktail to fix your ails either, I really do not have to give you a diagnosis. This should work out perfect then for me and you. Thank goodness, right? However, when and if a client chooses to get reimbursed by his/her insurance company, then the insurance company asks me for a diagnosis. I have to comply with my client who wants his/her money back from their insurance company. I hate it on so many levels. First of all, when you are dealing with insurance companies you're info is no longer 100% confidential. Your diagnosis and info is all over some insurance companies computer network which can be 1) shared with other insurance companies and 2)hacked into. Second of all, I hate labels. And in our country, our insurance companies and our health policies will force you to carry your label, your diagnosis with you throughout your lifetime. It's your call. But, I will always tell you, if you ask, keep your insurance company out of it.
Yesterday Dr. Zur wrote in his email newsletter in reference to the DSM (Diagnostic and Statistical Manual of Mental Disorders):
IF THERE IS A PILL, THERE IS A DISORDER
Laughing too much, or too long, is the primary symptom of a proposed new disorder. It is referred to as "Emotional Incontinence," and labeled Involuntary Emotional Expression Disorder (IEED).
There follows, of course, a pill to fix just that.
The proposed new disorder is one more illustration of how the DSM is primarily driven by the psychopharmacological industry. As we have reported in past Clinical Updates, the DSM pathologizes normal behavior, such as grief, sadness, shyness, healthy rebelliousness, and now...laughter.
The Question:
* Which comes first: chicken or egg? New medication or new disorder? Does the disorder create the need for the pharmaceutical intervention or does the pharmaceutical invention create the need for a new diagnostic label?
Old News:
* Drug companies fund, and reap the benefits of, research that is used to advocate new DSM diagnostic categories that can be treated by...pills.
This is No Joke:
* The stock of Avanir Pharmaceutical, a psychopharmacological company. gained 14% when they announced that they have a pill to treat "Emotional Incontinence," labeled: Involuntary Emotional Expressions Disorder (IEED).
* Avanir Pharmaceuticals has received priority review status for Neurodex from the US Food and Drug Administration (FDA).
* More Details
Warning 1
The latest "news" of a new proposed disorder supports the analysis offered
in our online course:
DSM: Diagnosing for Money and Power (4 CEUs)
Research on IEED claims the following:
"Patients may find themselves laughing uncontrollably at something that is only moderately humorous, being unable to stop themselves for several minutes. Episodes may also be mood-incongruent: a patient might laugh uncontrollably when angry or frustrated, for example."
"IEED is also currently being considered for inclusion in the upcoming DSM V as one of two symptoms (of five possible) which must be present for a diagnosis of ADHD in adults."
"Treatment for labile affect is usually pharmacological."
[Sources: IR, or simply Google "IEED"]
Your comments are welcome on our DSM Blog.
Warning 2
As our online course, DSM: Diagnosing for Money and Power, documents:
* Most texts and graduate and postgraduate courses present the DSM as an objective, valid, and scientific document. It is none of these.
* DSM-based research has repeatedly been shown to be of questionable validity and is, in fact, very unreliable.
* For example:
o Existential anxieties are sometimes labeled as "Anxiety Disorder"
o Shyness can too easily be seen and treated as "Social Phobia"
o Lasting grief becomes "Complicated Grief Reaction"
o Spirited and strong-willed children are afflicted with "Oppositional Disorder or ADD"
o Those experiencing spiritual events as labeled "Delusional".
* The DSM is primarily driven by the psychopharmacological industry, which reaps huge profits from each new diagnosis that can be treated with medication.
* According to the NY Times, more than half (56%) of the upcoming DSM V task force members, who oversee the next edition of the DSM, have ties to the drug industry. The percentage was high - 100% in some cases - for experts who worked on sections of the manual devoted to severe mental illnesses.
The upcoming DSM V is due to be published in 2012. I propose a new title:
DSM I: If there is a pill, there is a disorder."
Dr. Zur offers hundreds of CEU's for therapists. Inexpensive and independent. Visit his site here: Zur Institute
