The Myth of Mental Illness

escriptive criteria aside, what is the essence of mental disorders? Are they merely physiological disorders of the brain, or, more precisely of its chemistry? If so, can they be cured by restoring the balance of substances and secretions in that mysterious organ?

“You can know the name of a bird in all the languages of the world,Guest Posting but when you’re finished, you’ll know absolutely nothing whatever about the bird… So let’s look at the bird and see what it’s doing – that’s what counts. I learned very early the difference between knowing the name of something and knowing something.”

Richard Feynman, Physicist and 1965 Nobel Prize laureate (1918-1988)

“You have all I dare say heard of the animal spirits and how they are transfused from father to son etcetera etcetera – well you may take my word that nine parts in ten of a man’s sense or his nonsense, his successes and miscarriages in this world depend on their motions and activities, and the different tracks and trains you put them into, so that when they are once set a-going, whether right or wrong, away they go cluttering like hey-go-mad.”

Lawrence Sterne (1713-1758), “The Life and Opinions of Tristram Shandy, Gentleman” (1759)

I. Overview

Someone is considered mentally “ill” if:

His conduct rigidly and consistently deviates from the typical, average behaviour of all other people in his culture and society that fit his profile (whether this conventional behaviour is moral or rational is immaterial), or

His judgment and grasp of objective, physical reality is impaired, and

His conduct is not a matter of choice but is innate and irresistible, and

His behavior causes him or others discomfort, and is

Dysfunctional, self-defeating, and self-destructive even by his own yardsticks.

Descriptive criteria aside, what is the essence of mental disorders? Are they merely physiological disorders of the brain, or, more precisely of its chemistry? If so, can they be cured by restoring the balance of substances and secretions in that mysterious organ? And, once equilibrium is reinstated – is the illness “gone” or is it still lurking there, “under wraps”, waiting to erupt? Are psychiatric problems inherited, rooted in faulty genes (though amplified by environmental factors) – or brought on by abusive or wrong nurturance?

These questions are the domain of the “medical” school of mental health.

Others cling to the spiritual view of the human psyche. They believe that mental ailments amount to the metaphysical discomposure of an unknown medium – the soul. Theirs is a holistic approach, taking in the patient in his or her entirety, as well as his milieu.

The members of the functional school regard mental health disorders as perturbations in the proper, statistically “normal”, behaviours and manifestations of “healthy” individuals, or as dysfunctions. The “sick” individual – ill at ease with himself (ego-dystonic) or making others unhappy (deviant) – is “mended” when rendered functional again by the prevailing standards of his social and cultural frame of reference.

In a way, the three schools are akin to the trio of blind men who render disparate descriptions of the very same elephant. Still, they share not only their subject matter – but, to a counter intuitively large degree, a faulty methodology.

As the renowned anti-psychiatrist, Thomas Szasz, of the State University of New York, notes in his article “The Lying Truths of Psychiatry”, mental health scholars, regardless of academic predilection, infer the etiology of mental disorders from the success or failure of treatment modalities.

This form of “reverse engineering” of scientific models is not unknown in other fields of science, nor is it unacceptable if the experiments meet the criteria of the scientific method. The theory must be all-inclusive (anamnetic), consistent, falsifiable, logically compatible, monovalent, and parsimonious. Psychological “theories” – even the “medical” ones (the role of serotonin and dopamine in mood disorders, for instance) – are usually none of these things.

The outcome is a bewildering array of ever-shifting mental health “diagnoses” expressly centred around Western civilisation and its standards (example: the ethical objection to suicide). Neurosis, a historically fundamental “condition” vanished after 1980. Homosexuality, according to the American Psychiatric Association, was a pathology prior to 1973. Seven years later, narcissism was declared a “personality disorder”, almost seven decades after it was first described by Freud.

II. Personality Disorders

Indeed, personality disorders are an excellent example of the kaleidoscopic landscape of “objective” psychiatry.

The classification of Axis II personality disorders – deeply ingrained, maladaptive, lifelong behavior patterns – in the Diagnostic and Statistical Manual, fourth edition, text revision [American Psychiatric Association. DSM-IV-TR, Washington, 2000] – or the DSM-IV-TR for short – has come under sustained and serious criticism from its inception in 1952, in the first edition of the DSM.

The DSM IV-TR adopts a categorical approach, postulating that personality disorders are “qualitatively distinct clinical syndromes” (p. 689). This is widely doubted. Even the distinction made between “normal” and “disordered” personalities is increasingly being rejected. The “diagnostic thresholds” between normal and abnormal are either absent or weakly supported.

The polythetic form of the DSM’s Diagnostic Criteria – only a subset of the criteria is adequate grounds for a diagnosis – generates unacceptable diagnostic heterogeneity. In other words, people diagnosed with the same personality disorder may share only one criterion or none.

The DSM fails to clarify the exact relationship between Axis II and Axis I disorders and the way chronic childhood and developmental problems interact with personality disorders.

The differential diagnoses are vague and the personality disorders are insufficiently demarcated. The result is excessive co-morbidity (multiple Axis II diagnoses).

The DSM contains little discussion of what distinguishes normal character (personality), personality traits, or personality style (Millon) – from personality disorders.

A dearth of documented clinical experience regarding both the disorders themselves and the utility of various treatment modalities.

Numerous personality disorders are “not otherwise specified” – a catchall, basket “category”.

Cultural bias is evident in certain disorders (such as the Antisocial and the Schizotypal).

The emergence of dimensional alternatives to the categorical approach is acknowledged in the DSM-IV-TR itself:

“An alternative to the categorical approach is the dimensional perspective that Personality Disorders represent maladaptive variants of personality traits that merge imperceptibly into normality and into one another” (p.689)

The following issues – long neglected in the DSM – are likely to be tackled in future editions as well as in current research. But their omission from official discourse hitherto is both startling and telling:

The longitudinal course of the disorder(s) and their temporal stability from early childhood onwards;

The genetic and biological underpinnings of personality disorder(s);

The development of personality psychopathology during childhood and its emergence in adolescence;

The interactions between physical health and disease and personality disorders;

The effectiveness of various treatments – talk therapies as well as psychopharmacology.

III. The Biochemistry and Genetics of Mental Health

Certain mental health afflictions are either correlated with a statistically abnormal biochemical activity in the brain – or are ameliorated with medication. Yet the two facts are not ineludibly facets of the same underlying phenomenon. In other words, that a given medicine reduces or abolishes certain symptoms does not necessarily mean they were caused by the processes or substances affected by the drug administered. Causation is only one of many possible connections and chains of events.

To designate a pattern of behaviour as a mental health disorder is a value judgment, or at best a statistical observation. Such designation is effected regardless of the facts of brain science. Moreover, correlation is not causation. Deviant brain or body biochemistry (once called “polluted animal spirits”) do exist – but are they truly the roots of mental perversion? Nor is it clear which triggers what: do the aberrant neurochemistry or biochemistry cause mental illness – or the other way around?

That psychoactive medication alters behaviour and mood is indisputable. So do illicit and legal drugs, certain foods, and all interpersonal interactions. That the changes brought about by prescription are desirable – is debatable and involves tautological thinking. If a certain pattern of behaviour is described as (socially) “dysfunctional” or (psychologically) “sick” – clearly, every change would be welcomed as “healing” and every agent of transformation would be called a “cure”.

The same applies to the alleged heredity of mental illness. Single genes or gene complexes are frequently “associated” with mental health diagnoses, personality traits, or behaviour patterns. But too little is known to establish irrefutable sequences of causes-and-effects. Even less is proven about the interaction of nature and nurture, genotype and phenotype, the plasticity of the brain and the psychological impact of trauma, abuse, upbringing, role models, peers, and other environmental elements.

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Nursing: Know all about this Hallowed Institution

Take for instance the word ‘nurse’. A nurse is a person trained to care for the sick or infirm and assist doctors or dentists. One also refers to a nurse as a nursemaid. The singular verb form of the word ‘nurse’ means to work as a nurse or to attend to a sick person. The other verb forms of the term mean feeding or to be fed at the breast; to hold or to treat carefully.

TRACING THE ROOT OF NURSE

Take for instance the word ‘nurse’. A nurse is a person trained to care for the sick or infirm and assist doctors or dentists. One also refers to a nurse as a nursemaid. The singular verb form of the word ‘nurse’ means to work as a nurse or to attend to a sick person. The other verb forms of the term mean feeding or to be fed at the breast; to hold or to treat carefully. The word also means a foster (mother); The term also means to promote the development of something. Yet another meaning is to harbor a grievance etc.). The root is from the Latin term pointing to nourish.

FLORENCE NIGHTINGALE

British nurse Florence Nightingale established the foundations of modern nursing with her treatment of the sick and injured during the Crimean War of 1853 to 1856. Once back in London after the war,Guest Posting she founded the Nightingale School and Home for Nurses using money donated in tribute to her services. The school marked the beginning of professional education in the nursing field. Her book Notes on Nursing became the first definitive textbook for the field.

THE ROOT OF SCRUB

The keyword ‘scrub’ also has several meanings. As a verb it refers to the cleaning process especially with a hard brush and water. The medical connotation is different of course. The word scrub is usually followed by the subject who uses it, as for instance, a surgeon; in this sense the term means the apparatus used by a surgeon to clean and disinfect the hands and arms prior to operating. The colloquial meaning is to scrap or cancel. The noun form of the term is to use water to remove impurities, say from gases etc. Another noun meaning of the term is scrubbing or being scrubbed. The root of the word is traced to Low German or Dutch. There is another noun connotation which points to a brushwood or a stunted forest growth. It also refers to any land covered with this type of shrub. Yet another attribute of the term is a small or a dwarf variety of the scrub pine). The adjective form is scrubby.

WHAT EXACTLY IS NURSING SCRUB?

Nursing scrub means the different types of equipment used in the medical institutions. This article aims at providing a one-window stop for any person wishing to find anything about nursing scrub. Significantly, even the web does not have a proper answer to the queries pertaining to nursing scrub. A nursing scrub is a vital means to bring in hygiene in the hospitals. Nursing scrub is used for disinfecting purposes either before or after any operation process. The term nursing scrub is a combination of two terms, viz., nurse and scrub. Hence, it would be pertinent to first know the various meanings of these two terms. It would also be helpful to also trace the roots of these two terms.

MERCANTILE VALUE OF NURSING SCRUBS

In the recent times, various companies have come up to manufacture, and market the nursing scrubs. Taking into consideration the immense potential market for nursing scrubs and its never saturating prospect, nursing scrub manufacturing and marketing have combined to form a viable industry.

SURFING FOR NURSING SCRUBS

When one surfs the internet for the nursing scrubs, one will definitely get the feel of the huge mercantile impact of this ancillary medical sector. Be it the quality or the material or the price, one would have to patiently log on to the different sites dealing with nursing scrubs to get the best among them. Of course, patience will ultimately pay off. You would ultimately lay your hands on the reasonably priced quality nursing scrubs.

DIFFERENT TYPES OF NURSING SCRUB

Nursing scrubs vary in shape, size, color and material. Nursing scrub can be a simple safety pin and can also be a pair of scissors or a pair of gloves for that matter. The only connecting links among these various nursing scrubs are that they are sterilized and ready to use.

WHERE TO FIND NURSING SCRUB

The internet is the ideal place to find for answers to immense queries of mankind. However, with reference to nursing scrub, the different sites provide very limited scope. One can, of course, find the lists of various sites selling with the nursing scrubs or their prices. But then, one has to keep on constantly move form one site to another to seek the apt answer. This becomes rather tedious and cumbersome.

HOSPITAL ROOT

Since nursing scrub is used in hospitals, it would now be necessary to know the meaning of the word ‘hospital’. It basically points to an institution providing medical and surgical treatment and nursing care for ill and injured people. Its root is ‘hospice’ – a Latin term meaning playing host to somebody. The noun form ‘hospitality’ means friendly and generous reception and entertainment of guests or strangers. The verb form ‘hospitalize’ or ‘hospitalise’ or hospitalizing or hospitalising means to send or admit a patient to a hospital. The noun form is hospitalization.

WHO EXACTLY IS A SCRUB NURSE?

The scrub nurse performs a vital function in any operation theatre. The nurse scrub, for instance, readies all operation instruments, ensures the sterility of the surgical field, and anticipates when instruments will be needed by the surgeon. The circulating nurse makes sure the operating room is adequately supplied and provides any additional supplies to the scrub nurse during the operation. Depending upon the hospital, surgical assistants, physician assistants, surgical residents, medical students, and nursing students may also attend an operation.

PRACTICAL & REGISTERED NURSES

The practical nurse has an education and license very different from that of the registered nurse. The program for practical nurses takes approximately one year and includes classroom work and practical training in a hospital. Such programs are usually offered through vocational or technical schools, and graduates must also take a licensing examination in order to practice. The test, however, is different from that taken by Registered Nurses. After passing the examination, these graduates may use the initials LPN (licensed practical nurse) or LVN (licensed vocational nurse) after their names. These nurses practice under the supervision of the registered nurse.

DELVING DEEP INTO NURSING

Nursing has a broad purview. Nursing, in general, is the process of caring for, or nurturing, another individual. More specifically, nursing refers to the functions and duties carried out by persons who have had formal education and training in the art and science of nursing. Professional nurses combine many different disciplines, including aspects of biology and psychology, to promote the restoration and maintenance of health in their clients. There are two major categories of nurses: licensed practical nurses and registered nurses. In recent years, efforts have been made by several professional nursing organizations to designate two categories of registered nurses, technical and professional, that basically reflect the educational preparation of the individual.

A HALLOWED ORGANISATION

The ANA is the professional organization for nurses in the United States of America. Only registered nurses are admitted to its membership. It is made up of state and local organizations, and its major purposes are to promote high standards of nursing care, to improve the quality and availability of health care, and to foster the professional development of nurses.

Another organization supporting the profession is the National League for Nursing (NLN); its membership includes nurses, persons from other health professions, and interested laypersons. One major function of the NLN is the accreditation of educational programs in nursing. It also offers testing and consultation services.

The International Council of Nurses (ICN) is a worldwide organization established as a federation of national nursing organizations. The ANA represents the United States in this council. In addition to the above organizations, a variety of professional groups focus on particular nursing specialties. The American Association of Critical-Care Nurses (AACN) is such an organization.

HISTORY OF NURSING

In earlier centuries, nursing care was usually provided by volunteers who had little or no training—most commonly men and women of various religious orders. During the Crusades, for example, some military orders of knights also provided nursing care, most notably the Knights Hospitalers. Toward the end of the 18th century nursing was considered an unsuitable occupation for “proper” young women, undoubtedly due to the fact that hospitals in those days were dirty and pestilent places where patients usually died. As a result, those who provided nursing care were commonly persons who had been imprisoned for drunkenness or who could not find work elsewhere.

MODERN NURSING

Modern nursing began in the mid-19th century with the advent of the Nightingale training schools for nurses. In the United States, the Spanish-American War and, later, World War I established the need for more nurses in both military and civilian life. As a result, nursing schools increased their enrollments, and several new programs were developed. In 1920 a study funded by the Rockefeller Foundation and known as the Goldmark Report recommended that schools of nursing be made independent of hospitals and that students must no longer be exploited as cheap labor. Following the publication of this report, several university schools of nursing were opened. During the depression of the 1930s, many nurses were unemployed, and the number of schools declined. World War II, however, brought about another increased demand for nurses. The Cadet Nurse Corps, established in 1943, subsidized nursing education for thousands of young people who agreed to engage in nursing for the duration of the war.

Since the end of World War II, technological advances in medicine and health have required nurses to become knowledgeable about sophisticated equipment, to learn about an increasing number of medications, and to design nursing care appropriate for the health care delivery system during a period of rapid change.

FORMAL NURSING EDUCATION & NURSING SCRUB

Formal nursing education in the United States had its antecedents in Europe and England. One of the first formal training programs for nurses was begun in 1836 in Kaiserswerth, Germany, by Pastor Theodor Fliedner for the Order of Deaconesses. Other religious orders were also providing formalized training for nurses in Europe at that time, but Fliedner’s school is noteworthy for having given the British nursing reformer Florence Nightingale her formal training. Her experience at Kaiserswerth gave her the impetus to organize nursing care on the battlefields of the Crimean War and, later, to establish a nurse training program at Saint Thomas’s Hospital in London. In the late 1800s training schools patterned after this model were established in the United States.

HUMBLE BEGINNING

Originally, nurses received little or no classroom preparation. Most of the training was based on apprenticeship, with older students teaching the younger ones how to care for patients. All programs were directed by hospitals, and nursing students provided low-cost service to the institutions; upon graduation, most of them worked as private-duty nurses in patients’ homes. Hospital-based programs still exist today and are known as diploma schools of nursing. They offer a sound educational background for nursing practice in a program that contains both theoretical information and practical experience, but the diploma they grant is not an academic degree.

DIPLOMA NURSING SCHOOLS

Most diploma schools, however, are affiliated with a college where the nursing students can take courses for academic credit. In recent years, some hospitals have applied to their state boards of higher education for permission to award an associate degree in nursing. This trend has sparked debate within the nursing profession over the question of whether a hospital can qualify as an institution of higher education. The major focus of diploma education is to prepare nurses to give direct bedside care in hospitals, nursing homes, and other institutional settings. Graduates of these programs are eligible to take the licensing examination in the state in which they wish to practice. Upon passing, they may legally practice nursing and are allowed to use the initials RN (registered nurse) after their names.

Many diploma schools closed after 1965, when the American Nurses’ Association (ANA) published a position paper stating that all nursing education should take place in institutions of higher learning. The organization also recommended two levels of nursing practice: professional and technical; the professional nurse would have a baccalaureate or higher degree, the technical nurse would have an associate degree, and the technical nurse would work under the direct supervision of the professional nurse.

ASSOCIATE DEGREE NURSING PROGRAMS

Associate degree nursing programs were introduced in the United States in 1952. They are primarily offered by community colleges, although a number can be found in four-year institutions. It is a two-year program that strongly emphasizes technical skills supported by a basic foundation in biological and behavioral sciences. The associate degree graduate also takes the state licensing examination and can practice nursing using the initials RN. Baccalaureate degree programs in nursing are found in colleges and universities throughout the United States. The program takes four years to complete and provides a strong base of liberal education in the arts, sciences, and humanities. These programs also emphasize bedside patient care, and provide courses in community health nursing, leadership and management, and nursing research. Graduates take the same licensing examination as other graduates and also receive the RN designation.

MASTER’S & DOCTORAL DEGREES IN NURSING

Master’s and doctoral degrees in nursing usually require the applicant to be a graduate of an accredited baccalaureate nursing program. The emphasis of graduate programs is primarily on research, advanced clinical practice, and the preparation of nursing educators and administrators.

CONCLUSION

All in all, nursing today is a highly paying and professional vocation. A well-versed nurse can be the first step to the recuperation of a patient. The care and expertise that are the hallmarks of a well-trained nurse are the vital points that go a long way in the treatment of any individual suffering from any ailment. The psychological backup coupled with the

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