A Comparison of Psychiatry in the Biomedical Model and the Traditional Chinese Medicine Model: Part 1

                Hi everyone! This is Megan, and I want to share some very new research with you, as well as discuss a little bit about the treatment of mental-emotional disorders in Chinese medicine. Apparently I’ve got quite a bit to say (bear with me please, I have a lot of feeeelings about this), so for your sake I am going to split this into two posts over the next couple of days. Please feel free to reach out with any questions or comments!

                The treatment of mental-emotional disorders, or of the Shen (‘spirit’), was perhaps the first ability of Chinese medicine which captured my attention. I had been disillusioned for years by the current Western psychiatric model. This was largely due to 1) a sort of disconnect I felt (feel) between the fact that patients must receive a medical diagnosis in order to receive insurance coverage and that patients so often experience a deep, personal identification with their diagnoses and 2) the seemingly apparent prevalence of mental illness- or shall we say, mental disharmony- in the everyday person, despite a societal stigma against these conditions.
                Often we become uncomfortable or resistant when faced with problematic truths about ourselves, and as a result of that, there is a tendency to demonize and marginalize others in an attempt to distance oneself from culturally taboo behavior. To quote one of my personal heroes, Dr. Gabor Mate, “Which addiction is greater: the addiction to oil or to consumerism, [or to drugs]? Which causes the greater harm? And yet we judge the drug addict because we actually see that they are just like us, and we don’t like that, so we say, ‘You’re different than us. You’re worse than we are.'”           

                OK, so I’m gonna try to sum this up quickly: A study by the University of Liverpool published just earlier this month (July 2019) has found that many psychiatric diagnoses in the biomedical model of health are “scientifically meaningless.” Researchers at the university analyzed five chapters of the latest edition of the DSM (Diagnostic and Statistical Manual), the standard text used to diagnose Western psychiatric disease. The chapters examined were ‘depressive disorders,’ ‘bipolar disorder’. ‘schizophrenia’, ‘anxiety disorders’, and ‘trauma-related disorders.’

                THE MAIN FINDINGS OF THIS STUDY:

  • Psychiatric diagnoses have different decision-making requirements.
  • There is excessive overlap in symptoms between diagnoses.
  • The role of trauma and adverse events is almost entirely absent from any diagnosis.
    • Sidebar: consider the fact that PTSD is the first (and possibly only) diagnosis which acknowledges trauma as a main contributing factor, and it did not exist as a diagnosis until the ‘80s when soldiers returned from Vietnam. We know today that trauma nearly always plays a significant role in mental illness; we know this because of contemporary, published research. And yet clinical practice does not reflect the research.
  • And finally, the diagnoses themselves do not provide information about patients as individuals or what treatment they may require.

                Here is a link to the research article– which unfortunately is closed source- and here is a link to a nice summary of the research with some choice quotes.

                First of all, I strongly believe speaking to a trained counselor- whether that be a psychiatrist or social worker- can provide enormous benefit to an individual’s mental well-being by equipping patients with methods to improve their quality of life and allowing space to process intense emotions. Realistically, every single human being could benefit from professional therapy (assuming that each person was paired with someone they felt comfortable confiding in). Additionally, some people do need treatment with pharmaceuticals in order to maintain a reasonable quality of life.

               Also, it should be noted that many professionals in mental health fields today are already intimately aware of the shortcomings of diagnosing via the DSM, and remain excellent healers despite this. But we must ask ourselves: what use is a diagnostic model unsupported by real life, pragmatic evidence?
               As a Chinese medicine practitioner, I do not take the place of any of these specialists; “alternative” medicine practitioners should be educated in Western biomedical diagnostics to know when to refer out to other healthcare providers and collaborate in care with said providers. Holistic, traditional, patient-centered medical models can and do work alongside Western, biomedical models in other parts of the world. Why? Maybe because integration of multiple perspectives and techniques is ideal when treating complicated diseases…

                Tomorrow I will be posting part 2 of this topic, which will be discussing the Traditional Chinese Medicine (TCM) psychiatric perspective and treatment of the Shen, or ‘spirit.’ I will also discuss the fundamental theoretical model of pattern diagnosis, which is absolutely central to determining treatment strategy! Thank you for tuning in!!

Megan

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