The disease of alcoholism...

[MikeWaters]

I just read this descripton of alcoholism. It's not terribly scientific, but brings up a useful analogy.

Would one argue that Obsessive-Compulsive Disorder is not a disease? I'm wondering if there are still strains of academia out there that would make this argument.

I would make one other point. To say that Alcoholism has in some part a genetic basis for many people is not to make a deterministic statement. I think people get upset because they think that we are trying to say that there is an inevitablility about it, that there is no choice. Nothing could be further from the truth.

Science tells us that people with equal risk exposures, that have specific susceptibility genes, are much more likely to become alcoholics. That is, to use alcohol in a destructive way.

Even if you don't have this genetic susceptibility, you may end up an alcoholic. Alcohol, very clearly, has a terrible impact on the brain when used in large amounts. Acute intoxication can kill. Chronic intoxication can be reinforcing, leading to larger and larger amounts. It alters behavior--people lose their jobs and relationships due to excessive time and energy dedicated to drinking. It alters your brain cells, it alters the receptors on your brain cells, it can lead to seizures and death.

We find it useful, in medicine, to think of this as an actual condition where treatment can be useful. We know what causes it, we know what can treat it. In such cases, these conditions are called diseases.

Let's look at a different kind of example:
asbestosis def. Fibrosis of the lung as a result of the chronic inhalation of asbestos fibres.

We sure know this is preventable. A toxic substance has been ingested. It alters the body and causes dysfunction. It leads to medical treatment. We call it a disease.

[OhioBlue]

Originally Posted by MikeWaters

There are plenty of folks who don't believe in the disease model of the brain. Some of these we call psychologists. The types that argue bad moms cause schizophrenia. They are gradually going the way of the do-do bird.

Nice try, but your intentional mischaracterization of my argument and attack of my profession just makes you look silly. I have yet to meet a single person in my field that actually believes the things you just offered as a nice straw man argument to my point.

It would be just as easy for me to say, "There are plenty of folks who look only to the brain to explain all human distress. Some of these we call psychiatrists. The types that throw medications at everything and that argue bad chemical balances actually cause all emotional pain. They have gradually lost complete touch with the reality of human existence and medicalized everything to the point that their only existing niche is the severely mentally ill; no one else with half a brain will see them."

The disease model of alcoholism, of anything, is not without serious argument. The argument is that 'disease' hardly captures it, and only looks at one part of a complicated picture. The practical implications of calling something like that a disease are sketchy at best, counter to recovery at worst. The disease model, therefore, is woefully inadequate, and is mostly attributable to the pervasiveness of the medical model in our culture.

By the way, if you want to respond and discuss this in an intelligent manner, I'd love to. I very much enjoy these kinds of discussions. But if you want to arrogantly presume a high and mighty stance and mock my profession, then I'm not the one with my head in the sand.

[MikeWaters]

you could start by defining "disease" and then arguing how it doesn't fit your definition.

as I have.

if you are going to say that the disease model doesn't account for the nuances of human experience, I am not going to agree with you. That would be your straw man.

If your argument that psychiatrists only see the severely mentally ill is true, then the explanation for that would be that the mentally ill are being treated by their family doctors. I don't think you can make a cogent argument that the disease model of mental illness isn't taking over in the United States. You are arguing the opposite?

You are doing everyone a disfavor by implying that thinking alcoholism ISN'T a disease is any way shape or form mainstream thinking.

Even AA says that drinking is not a choice for these people.

We admitted we were powerless over alcohol--that our lives had become unmanageable.

Powerless. Is that powerlessness useful to conceptualize in the disease model, such that we pursue medical treatments? It will be the very small minority that says "no."

So small that I doubt their numbers exceed those that believe schizophrenia is the result of upbringing.

[MikeWaters]

Here is a psychologist who is a proponent of the idea that alcoholism is not a disease.

http://www.peele.net/7tools/index.html

I can't tell what his exact argument is. This may be it:

The dominant contemporary American view of alcoholism is that it is a disease. This position holds that alcoholism is innate and genetic, that its course is progressive and irreversible, that abstinence is the only solution to drinking problems and that Alcoholics Anonymous is the best — perhaps the only — means for an alcoholic to achieve sobriety.

http://www.peele.net/lib/vaillant.html

This is the sort of straw man that psychologists of this particular ilk like to throw out.

What I don't particularly care for is the notion that one can generalize from a patient that comes into therapy once a week, to an entire condition or population.

The guy who comes in once a week
1) probably has a car
2) can afford the therapy
3) can afford the car
4) is highly motivated to get better
5) highly amenable to therapists direction/redirection

And then suddenly it becomes "you don't need medication" "you don't need AA" "just follow my therapy program."

Whereas the psychiatrst deals with this person described above, as well as the guy who has been brought in my police, is mad drunk, is screaming and cursing you, and requires medication to not go into a seizure.

In other words, we see people that do not seek treatment, and do not want treatment. and have had a much more severe course.

Why is that psychiatrists will say that Peele's approach of using therapy isn't wrong and will probably work just fine with a subset of patients, but Peele would say that the medical model is completely wrong, and no one should be on medication?

Psychiatry accepts both medical and non-medical models. Whereas guys like Peele are zealots and only accept the non-medical.

[Archaea]

I have a question:

For me, a nonphysician, I was accustomed to classifying diseases as those human circumstances where bodily functions are disrupted by virtue of unwanted foreign bacteria or viruses. Because alcoholism seems to stem from genes and response to chemical changes, I would have called it a condition.

Is Parkinson's a diseaser or a condition?

[FMCoug]

Sweet! It's a psychobabble fight! Can we get an MD and a Chiropractor going in another thread?

[MikeWaters]

I could give you a large list of diseases caused by chemicals/toxins.

In fact some Parkinson's is caused by the chemical MTPT. The shorthand for Parkison's is "PD." Which is "Parkinson Disease."

[FMCoug]

How did we make the leap of logic to call something a disease = no personal responsibility?

Are STD's not diseases? How about heart disease caused by obesity? Adult onset diabetes?

Are you going to argue that none of those are diseases becasue they are brought on by choices the suffereres made?

[Archaea]

How does one define disease?

And is that distinguishable from a condition?

[MikeWaters]

a disease is necessarily a condition. but a condition is not necessarily a disease.

good physical fitness is a condition. it is not disease.