# Is psychiatry dishonest? Is it better for everyone if keeps faking diagnostic assurance? **URL:** \ **Category:** Great Debates\ **Created:** [May 6, 2013, 2:45am UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596 "2013-05-06T02:45:42Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![HoneyBadgerDC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/honeybadgerdc/32/1033_2.png) [@HoneyBadgerDC](https://boards.straightdope.com/u/HoneyBadgerDC)\ **Post date:** [May 8, 2013, 11:06pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/81 "2013-05-08T23:06:11Z")
> [@Hentor\_the\_Barbarian](#): > > The most well established treatments for depression, anxiety and the behavioral disorders are cognitive behavioral therapies. Why would you assume that professionals were ignorant of such things? > > Also, people cannot will themselves out of psychopathology, or fake it til they make it. I believe they can fake it till they make it if someone else is writing the script for them. They can simply become actors and they begain to like the character they are playing they will become more like him or her. One of the big problems with borderline personality disorders is that they seem to lack an effective identitiy and tend to borrow identities from others as they interpet it. I have actually seen a few cases where the individual took after someone they knew and stayed that way effectively finding an identity that worked for them. ---
**Author:** ![deltasigma](https://avatars.discourse-cdn.com/v4/letter/d/e5b9ba/32.png) [@deltasigma](https://boards.straightdope.com/u/deltasigma)\ **Post date:** [May 8, 2013, 11:08pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/82 "2013-05-08T23:08:28Z")
> [@Hentor\_the\_Barbarian](#): > > The most well established treatments for depression, anxiety and the behavioral disorders are cognitive behavioral therapies. Why would you assume that professionals were ignorant of such things? > > Also, people cannot will themselves out of psychopathology, or fake it til they make it. I certainly agree with your last statement but have some questions about the first one. However for what little difference it will make, first this PSA. Many if not most people still seem to be of the belief, conscious or otherwise, that the mentally ill are somehow complicit either by virtue of just not trying hard enough to get better or by having caused their condition in the first place - if not both. I’m not sure how this logic works however I’m probably being too charitable by assuming that there actually IS any logic to it. While it’s true that depression can result from excessive stress over long periods and people may be complicit in that aspect, that is just one possible etiology for one of many possible disorders. For the most part, how these problems arise is still mostly unknown but what IS clear is that a patient’s control over the progress of the illness is limited and will depend to great extent on the precise diagnosis. With OCD for example, as a sufferer, I can tell you that I have developed many coping mechanisms over the years. However that is not the same thing as “curing” myself. I can also tell you that there have been periods when I was a complete thrall to the illness. Why I’m not now, I have no idea. It was certainly through no act of will. Now as to my questions. What is your source for saying that therapy is the best response to depression and anxiety. I have known too many people with both issues to accept that as fact without some further authority. I do however believe that to be the case with respect to things such as Borderline Personality Disorder - if that’s the sort of thing you had in mind - if for no other reason than the fact that no drug regime seems to have any significant effect. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 8, 2013, 11:58pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/83 "2013-05-08T23:58:50Z")
> [@pravnik](#): > > I used to think that, but now I’m not so sure. Wisdom begins when one questions their belief systems and begin to learn alternative possibilities. Their is never just one solution to our problems. Some solutions are better than others. If you can find no alternatives start asking others. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 12:02am UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/84 "2013-05-09T00:02:03Z")
I believe their are cures to all mental/emotional illnesses through understanding ---
**Author:** ![astro](https://avatars.discourse-cdn.com/v4/letter/a/9dc877/32.png) [@astro](https://boards.straightdope.com/u/astro)\ **Post date:** [May 9, 2013, 1:07am UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/85 "2013-05-09T01:07:43Z")
> [@lekatt](#): > > I believe their are cures to all mental/emotional illnesses through understanding Understanding what specifically? Being emotionally understanding of them or understanding the biological basis of the disease? ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [May 9, 2013, 2:57am UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/86 "2013-05-09T02:57:31Z")
> [@pravnik](#): > > I used to think that, but now I’m not so sure. ISWYDT **AHunter3** , so how would _you_ propose to treat people with genuine psychological problems? ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 1:51pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/87 "2013-05-09T13:51:59Z")
> [@astro](#): > > Understanding what specifically? Being emotionally understanding of them or understanding the biological basis of the disease? There is no biological basis for mental illness. That is my belief, and I have seen many with so-called mental illness cured by an understanding empathic friend or counselor. It usually takes a teaching of the principles of living in this physical environment. If the patient is willing to accept spiritual concepts the cure comes faster. All mental problems arise from one thing – fear. Fear they can’t cope with because they lack the tools of coping. They usually dislike themselves and others. In its extreme they hate themselves and want to die sometimes taking others with them. They are withdrawn with no passion for some some hobby, they think constantly about death. They fear relationships. It takes a special person to help them not just someone that goes through a counseling course. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [May 9, 2013, 2:08pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/88 "2013-05-09T14:08:27Z")
> [@lekatt](#): > > It takes a special person to help them not just someone that goes through a counseling course. Are you a “special person”? ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 2:19pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/89 "2013-05-09T14:19:39Z")
> [@Czarcasm](#): > > Are you a “special person”? The best counselor for those who are fearful and anxious is a person who went through the same thing and was cured. Yes I am a special person. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [May 9, 2013, 2:26pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/90 "2013-05-09T14:26:46Z")
> [@lekatt](#): > > The best counselor for those who are fearful and anxious is > a person who went through the same thing and was cured. > Yes I am a special person. Ever hear of “The Tommy Syndrome”? In the rock opera _Tommy_, a young man is, through unusual circumstances, struck deaf, dumb and blind. He goes through many trials, tribulations and treatments before finding a way to cast off these conditions, and thinks that he has found “The Way” to cure people of their various afflictions. He starts up a health camp where people in need of help go through the same trials, tribulations and treatments he went through…and fails miserably. ---
**Author:** ![Human\_Action](https://avatars.discourse-cdn.com/v4/letter/h/ac91a4/32.png) [@Human\_Action](https://boards.straightdope.com/u/Human_Action)\ **Post date:** [May 9, 2013, 3:35pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/91 "2013-05-09T15:35:40Z")
> [@lekatt](#): > > There is no biological basis for mental illness. That is my belief, and I have seen many with so-called mental illness cured by an understanding empathic friend or counselor. > It usually takes a teaching of the principles of living in this physical environment. Then how do you account for the genetic component of, say, [schizophrenia](http://en.wikipedia.org/wiki/Schizophrenia#Genetic)? > [@](#): > > The greatest risk for developing schizophrenia is having a first-degree relative with the disease (risk is 6.5%); more than 40% of monozygotic twins of those with schizophrenia are also affected. A child of two parents with schizophrenia has a 46% chance of developing the disorder. And the observable biological effects: > [@](#): > > Schizophrenia is associated with subtle differences in brain structures, found in 40 to 50% of cases, and in brain chemistry during acute psychotic states. Studies using neuropsychological tests and brain imaging technologies such as fMRI and PET to examine functional differences in brain activity have shown that differences seem to most commonly occur in the frontal lobes, hippocampus and temporal lobes. Reductions in brain volume, smaller than those found in Alzheimer’s disease, have been reported in areas of the frontal cortex and temporal lobes. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 4:05pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/92 "2013-05-09T16:05:18Z")
> [@Czarcasm](#): > > Ever hear of “The Tommy Syndrome”? In the rock opera _Tommy_, a young man is, through unusual circumstances, struck deaf, dumb and blind. He goes through many trials, tribulations and treatments before finding a way to cast off these conditions, and thinks that he has found “The Way” to cure people of their various afflictions. He starts up a health camp where people in need of help go through the same trials, tribulations and treatments he went through…and fails miserably. No I have not heard of the Tommy Syndrome, but I understand why Tommy failed. One is not cured by the trials and tribulations, one is cured by love. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 4:12pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/93 "2013-05-09T16:12:19Z")
> [@Human\_Action](#): > > Then how do you account for the genetic component of, say, [schizophrenia](http://en.wikipedia.org/wiki/Schizophrenia#Genetic)? > > And the observable biological effects: I have read all that data that you post here. I don’t doubt brain changes in persons with schizophrenia. There is also brain changes in Yoga Masters, people who are obese and many other things. Brain changes are symptoms not causes. Genes are turned on or off by the consciousness. That would be you. ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [May 9, 2013, 4:24pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/94 "2013-05-09T16:24:43Z")
> [@deltasigma](#): > > Now as to my questions. What is your source for saying that therapy is the best response to depression and anxiety. I have known too many people with both issues to accept that as fact without some further authority. Specifically, I said that cognitive-behavioral therapy (CBT) is the best treatment for anxiety, depression and behavioral problems. The evidence for this is vast and robust. For anxiety, you can look at Compton et al (2004) in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), 43(8). Two meta-analyses, of many, that you could check would be In-Albon & Schneider (2007) in Psychotherapy and Psychosomatics, 76(1). Mitte (2005) in Psychological Bulletin, 131(5). For depression, again among many, there’s de Maat et al (2007) in European Psychiatry, 22. for behavioral disorders, Eyberg, Nelson and Boggs (2008) provide a comprehensive review. Chorpita et al (2011) in Clinical Psychology Science and Practice provide an overview across types of disorders. You can also check the Practice Parameter documents from JAACAP. Behavioral treatment is the only valid treatment established for autism. > [@](#): > > I do however believe that to be the case with respect to things such as Borderline Personality Disorder - if that’s the sort of thing you had in mind - if for no other reason than the fact that no drug regime seems to have any significant effect. Dialectic Behavior Therapy is the most well established treatment model for Borderline Personality Disorder. It’s essentially CBT with specific features developed for managing the issues that arise in therapeutic relationships with people with BPD. ---
**Author:** ![Human\_Action](https://avatars.discourse-cdn.com/v4/letter/h/ac91a4/32.png) [@Human\_Action](https://boards.straightdope.com/u/Human_Action)\ **Post date:** [May 9, 2013, 4:27pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/95 "2013-05-09T16:27:00Z")
> [@lekatt](#): > > I have read all that data that you post here. I don’t doubt brain changes in persons with schizophrenia. There is also brain changes in Yoga Masters, people who are obese and many other things. Brain changes are symptoms not causes. Genes are turned on or off by the consciousness. That would be you. Can my consciousness turn on genes to make myself taller, or have curly hair? ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [May 9, 2013, 4:39pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/96 "2013-05-09T16:39:35Z")
> [@lekatt](#): > > I believe their are cures to all mental/emotional illnesses through understanding If this were true then the Rogerian, or client centered model of treatment, developed by Carl Rogers in the 60s and practiced in the 60s and 70s would be the standard of care. Empirically, Rogerian therapy is inferior to other established treatment methods. ---
**Author:** ![hotflungwok](https://avatars.discourse-cdn.com/v4/letter/h/edb3f5/32.png) [@hotflungwok](https://boards.straightdope.com/u/hotflungwok)\ **Post date:** [May 9, 2013, 5:21pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/97 "2013-05-09T17:21:46Z")
Yeah, those claiming that mental illnesses have no biological basis are going to have to cough up more than ‘cuz I know’ as proof. There are lots of ways medications, among other things, have helped those with mental illnesses, which the least bit of actual research into the matter would show. Well, you know, except lekatt. For obvious reasons. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 5:25pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/98 "2013-05-09T17:25:29Z")
> [@Hentor\_the\_Barbarian](#): > > If this were true then the Rogerian, or client centered model of treatment, developed by Carl Rogers in the 60s and practiced in the 60s and 70s would be the standard of care. Empirically, Rogerian therapy is inferior to other established treatment methods. I don’t know of any standard treatment methods but they would fail to help everyone. People are unique and will not fit into methods or rituals of any kind. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 5:27pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/99 "2013-05-09T17:27:17Z")
> [@hotflungwok](#): > > Yeah, those claiming that mental illnesses have no biological basis are going to have to cough up more than ‘cuz I know’ as proof. There are lots of ways medications, among other things, have helped those with mental illnesses, which the least bit of actual research into the matter would show. > > Well, you know, except lekatt. For obvious reasons. I am talking about cures, I understand drugs can make you happy until they wear off. ---
**Author:** ![lekatt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lekatt/32/7269_2.png) [@lekatt](https://boards.straightdope.com/u/lekatt)\ **Post date:** [May 9, 2013, 5:28pm UTC](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596/100 "2013-05-09T17:28:25Z")
> [@Human\_Action](#): > > Can my consciousness turn on genes to make myself taller, or have curly hair? If you had those genes you would be taller with curly hair. [Previous page](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596.md?page=4) [Next page](https://boards.straightdope.com/t/is-psychiatry-dishonest-is-it-better-for-everyone-if-keeps-faking-diagnostic-assurance/657596.md?page=6)