(Quick post I might flesh out later: the Muses offer what they offer, on their own inexplicable schedule…)
I often counsel patients not to take psychiatric diagnoses quite so seriously as they do.
These scientific pronouncements sound so definitive and absolute, don’t they? All vetted by top men: top men. They’re even in a book. Written by top experts, no less!
Yet all diagnoses, throughout medicine, remain nothing more than ideas. The best we have in many cases, yet works in progress, all.
We know high blood pressure is bad, say, and we know some things that might (or might not) cause it, and some treatments that might (or might not) alleviate it. Such is medicine: we know much, yet it all adds up to a thin, VERY thin slice of the whole of reality.
Blood pressure amounts to pressure in pipes, rather simple stuff really. The brain is the most complex and mysterious entity humans have yet to meet in the entire universe. We know far more than we used to, yet it all remains a paper-thin slice of reality. Much of our knowledge will likely turn out to be not quite true in time: such is the nature of progress.
So our diagnoses by expert committee have far more in common with the expert past ‘certain knowledge’ about leaches, and blood-letting, and medieval humors, and so on, than most care to admit. Science is a process, not a fact. So it goes.
It’s comforting – SO comforting! – to revel in our knowledge and confidence and power. Yet wisdom, clearly, amounts to noticing how much delusion and fiction such confidence requires. True understanding requires much uncertainty.
I’d be the last to throw out all of Western medical knowledge. In quite a few situations, it’s far and away the best we’ve got and getting better over time. I see it help people every day.
But don’t worship it or take it too seriously. It’s all remains a work in progress, imperfect, subject to revision.
Every diagnosis remains an idea, imperfect and often enough inaccurate in a given case.
Even the most brilliant ideas fall prey to messy reality, and often.
Let the buyer beware…