Intermittent Explosive Disorder II

As a follow up to Sally's post below giving the link to the article "'Road rage' gets a medical diagnosis" http://msnbc.msn.com/id/13152708/from/ET/, I would like to make some observations about what this article presents.


First, note that a single study is used to establish a basis for taking a common occurence and making it a full-blown mental illness. Licensed professionals are then quoted to show that this single study is being used to support the latest up-to-the-minute diagnoses. Then, by extrapolation, this single study is used to assert that as many as 16 million Americans are affected by this mental illness. This is astounding.


Dr. Emil Coccaro, a study co-author, is quoted as saying that this "disorder" is more than just "bad behaviour", but it includes biology and cognitive science. Wow, what had we missed before? If we cloak our problems of living with scientific terms, we can say that adrenaline rushes and thoughts flying back and forth across the synaspes of our brains are really mental illnesses.


When a person goes to a basketball game, sees an exciting play, leaps off his seat and yells out loud...what is happening? Well...biology and cognitive science is what is happening. It is well known that during such excitement, brain chemicals are present that are not normally there in more sedate settings. But the question is, did the chemicals cause the excitement, or did the excitement cause the chemicals?


It is okay to yell at a tense basketball game, but not to yell in a tense traffic situation. The potential of danger makes one a mental illness and the other a part of normal life. Is it not the same chemical reaction?


Dr. Coccaro makes the assertion that the disorder involves "...inadequate production or functioning of serotonin...." How is it that such an assertion can be made from a survey that is reported to be a "face-to-face survey...[using] diagnostic questionnaires...." How is it that a cause and affect relationship can be established between brain chemicals and behavior based on subjective answers to a subjective questionnaire and not based on objective scientific testing of the chemical / behavior process?


Hmmm...perhaps the basketball game involves adequate production or functioning of serotonin and the traffic situation does not. Take your pill for traffic, but not for basketball games.


Admittedly, temper outbursts that are way out of proportion to the situtation are not a good thing and are a common occurence. And I would suggest that they are much more common than this article suggests. Let us dispense with statistical analysis and make a giant leap, using common sense and common observation and boldy assert that every living human being has had such outbursts at some time in life...at least during those first months and years of life. Thank God for parents who promptly meet those outbursts with loving discipline.


But notice that such infantile outbursts are not included in the study and the more juvenile type are mentioned as the onset of this dreaded mental affliction. That provides more interesting rabbit trails to investigate...but also allows the entrance of more body chemicals as a causation - hormones.


Think of it...face to face surveys...people talking to people. Both the questioners and and questionees affected by honesty, morality, pride, depression, happiness, inattentiveness, poor memory, indigestion, full stomach after lunch, apathy, enthusiasm, etc., ad infinitum. And here we are, relying on memory, in the middle of this sea of human subjectivity, to establish frequency of occurence and extent of property damage.


I'm afraid that I don't remember how much it cost to replace the bedroom window that I broke when I threw my baseball mitt at my older brother. But I do remember that he ducked, and I had poor aim, and that neither I nor my parents had the money to replace the glass. I learned the hard way that throwing things was not a good way to go.


And then we read that the existence of such a disorder is actually breaking news to mental health specialists. What??? Where have they been all these years?


How many attacks does it take to determine that a person has this mental illness? Do the same cognitive and biological processes take place in all explosive anger situations? Or is there a class of afflicted which experience a different and truly explosion which could be labeled as a mental illness?


And why is it that we need licensed professionals to tell us that inappropriate outbursts of anger have a "profound and ongoing impact on a person's life"? When have we not known that?


We get to the real heart of the matter when we read that the problem is "treated" with a combination of antidepressants and behavior therapy. Of course, this is why the words "biology" and "cognitive science" were used...they establish the foundation for the "treatment". Yes, drugs to mask (not cure) the emotions, and behavior therapy to address the...well...bad behavior. But wait a minute, that is the very same treatment given for depression! What is going on?


Psychologist Jennifer Hartstein is quoted as saying that "many people are not aware of the disorder." This is ludicrous. What she really means is that people are not aware that the psychological industry has slipped another one into the bag, making yet another category of helpless sufferers, assuring itself of additional patients on which to practice, sucking in insurance payments, and prescribing yet more antidepressants.


It is significant that every one of the sins listed in the New Testament is now classified as some kind of mental illness, disease, disorder, etc., in the Diagnostic and Statistical Manual, Fourth Edition (DSM - IV), the current edition of the catalog of psychological disorders published by the American Psychiatric Association. This manual is compiled by consensus voting, meaning that if the majority of association members VOTE to make some behavior a mental illness, it goes into the book. So much for the rigorous and critical scientific examination of proposed theories which is the foundation for all good medical practice and scientific understanding. So much for protection from charlatans and quacks. So much for the real science.


A few years ago, I was startled to read, from a highly respected psychiatrist, about the reality of these psychological pronouncements. He said that most of today's mental illness are not diseases at all and are diagnosed only by subjective lists of symptoms. These symptoms are grouped into packages in order to fit the diagnostic manual, even though these groupings have no scientific foundation or validity. So in effect, these things have no known cause, no predictable course of illness, no specific and reliable treatment, and no reliable response to treatment. Their diagnoses by therapists is not based on blood chemistry, scientific testing, or any objective observation. Diagnosis is strictly based on the subjective judgment of a "trained" individual applying "experience" in the use of arbitrarily composed lists of symptoms.


A few years ago the newspaper recorded that the US Congress was debating whether to allow full Medicare coverage for every disorder listed in the DSM - IV or to continue limited coverage (limited to the most serious). The article listed jet lag, caffeine addiction, and religious problems among the "diseases" which might now be funded by Medicare (by default, this would extend to many insurance programs). It concerns me that you and I are considered mentally ill by these professionals because they would say that we have "religious problems". Are jet lag and caffeine addiction really mental illnesses? The extent to which psychological thinking has enveloped our culture and even percolated among us is astounding.


Scott Parish