The disease of alcoholism...

[UtahDan]

Originally Posted by OhioBlue

Haven't I made myself quite clear yet? Whether its warranted or not is hardly my concern. When I have a client in front of me who is eating less than 500 calories a day on top of at least 2 hours of hard exercise, purging daily, who is experiencing chest pains, hair loss, amenorrhea, etc, the last thing on either of our minds is whether or not we should call it a disease. We do... so what? We don't....so what? The call for help doesn't end with a label. "Yeah, so you have a pretty bad disease, go get yourself some fluvoxamine and I'll see you in a month."

I can't think of many more ways to try to make my point.

At this point he either isn't listening or is being intentionally obtuse. From where I'm sitting he is successfully antagonizing you. I know, hard to believe.

[MikeWaters]

Originally Posted by UtahDan

At this point he either isn't listening or is being intentionally obtuse. From where I'm sitting he is successfully antagonizing you. I know, hard to believe.

If it's not a disease, does your health insurance cover it?

If it's not a disease, do you see a doctor for it?

OhioBlue, you are the one challenging conventional wisdom by saying that these things don't matter. That the word "disease" is arbitrary. That, I suppose, we should not teach patients that the word "disease" applies to these conditions.

And please don't descend into your "I'm not going to talk to you because you never change your mind about anything" little rant.

Now if you are saying that YOU don't care if it's a disease or not, and that you are not advocating that others take your view, that's different. I know lots of people who do things and believe things I don't agree with.

And so we come to the point that you are saying "this is my view and I don't care about the distinction" when you in fact began by challenging by "polite company" assertion.

So which is it? That this is your personal view or that this is not a view that is hard to defend among educated people? And if its the latter, maybe you could start by actually stating your case.

[MikeWaters]

Originally Posted by OhioBlue

Oh please. You make it sound as though the disease model were universally accepted and agreed upon by everyone. If you had even a single course on substance abuse in your training you should know that's hardly the case.

I personally think it's more complicated than just calling it a disease, or not calling it a disease. My experience has been that our culture's present love affair with finding a genetic link for every possible piece of distress that a human being can experience is definitely a double edged sword, if not an exercise in blatant reductionism.

Did you know that eating disorders are now also being called a disease?

Who's antagonizing who?

I find it funny that OhioBlue thinks a condition with, what was it, 10-20% mortality, shouldn't qualify as a disease/syndrome (syndrome = presumed disease with unclarified etiology).

Folks, this is crazy talk. And I'm just saying, if you want to say this kind of stuff in polite, educated company, people are going to think you are crazy.

Severe anorexia nervosa is a completely irrational state, almost psychotic.

Yet it is not a disease?

I wish I could understand this perspective.

[MikeWaters]

Let me add that Eating Disorders have some very unique fascinating culturally-bound characteristics....where afflicted folks in other cultures may have a different disorder (perhaps severe OCD), meaning that it is expressed in a different way...

But to argue that it isn't a disease, argues that there is something terrible in this sort of conceptualization. That it is not useful at all.

[Jeff Lebowski]

Folks, can I just say again how much I love CG? Where else can you get ringside seats to an argument between a psychiatrist and a psychologist? This is great.

[FMCoug]

Originally Posted by SeattleUte

You shrinks are the experts but it seems to me that's the root of it and may be the best response to self-righteous FMCoug/Lingo types.

Where the hell did that come from?

[jay santos]

Disease is a technical term, I suppose, which I'm not qualified to evaluate.

But, generally, when I hear this argument, I feel like those that are stubborn in not allowing this to be called disease are hard asses that don't have compassion for those struggling with very difficult addictions.

On the flip side, I don't feel like those struggling with addiction are trying to absolve any guilt by calling it a disease. The weight is already crushing enough for these folks, can't we take a small portion off by allowing them to call it a disease?

[MikeWaters]

Originally Posted by Jeff Lebowski

Folks, can I just say again how much I love CG? Where else can you get ringside seats to an argument between a psychiatrist and a psychologist? This is great.

OhioBlue takes the vantage point of a dying tradition that hails back to Freud.

Modern science conceives of psychiatric illness as much more complicated than Freud realized. Some call this Biological Neuroscience. The belief that the brain and its disorders will give us critical insights into psychiatric illness. So we study neurons, circuits, brain morphology, medications, receptors, genes, gene expression, exposures to risk factors, etc. Modern biological psychiatry doesn't throw therapy into the toilet. Rather, it recognizes its value. But it's also interested in learning the biological basis for its efficacy (when in fact its efficacious).

Throwbacks like OhioBlue will try and maintain that Biological Neuroscience has thrown his great love of human relationships and therapy into the toilet. Which is simply not true.

So folks like OhioBlue will make outrageous claims, not because they really believe them, but because they feel that public opinion and mainstream science has abandoned them. Therefore they overcompensate. "If I shoot for the stars, maybe I will hit the moon."

It may be disturbing to know that our choices can be influenced by something as simple as our genes. An obvious example would be whether you have two X chromosomes or one X and one Y. But it is true. Folks like OhioBlue will say "the influence of genes are wildly overstated." But when you look closer you see that they really don't say who is doing the overstating, and that at the end of the day, they don't really dispute the essence of the science that says so.

So when someone like OhioBlue says condition X is not a disease, what he really means to say is "my kind is losing the battle of ideas, and I'm not happy about it." Or something like that.

[SeattleUte]

Originally Posted by FMCoug

Where the hell did that come from?

This:

Originally Posted by 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?

But now re-reading it I see I misread what you said. Apologies.

[MikeWaters]

I would also add that Freud would probably not be a Freudian if he were alive today. He was born too soon.