American Medicine Is Still Stuck in the 1950s!

In the musi­cal Guys and Dolls, the char­ac­ter named Ade­laide has a psy­cho­so­mat­ic cold. As she explained,

The aver­age unmar­ried female
basi­cal­ly inse­cure
due to some long frus­tra­tion may react
with psy­cho­so­mat­ic symp­toms
dif­fi­cult to endure
affect­ing the upper res­pi­ra­to­ry tract.

Guys and Dolls is a quaint arti­fact from the 1950s. Nev­er­the­less, the Amer­i­can Psy­chi­atric Association’s Diag­nos­tic and Sta­tis­ti­cal Man­u­al still gives doc­tors per­mis­sion to say, “It’s all in your head” if they can’t imme­di­ate­ly fig­ure out what’s wrong with you. An arti­cle of mine that was pub­lished in the jour­nal Med­ical Hypothe­ses says that doc­tors can­not make that kind of diag­no­sis with­out mak­ing an error in rea­son­ing. For that rea­son, I argue that the APA should remove con­ver­sion dis­or­der and som­a­ti­za­tion dis­or­der from the DSM. The fifth edi­tion of the DSM (DSM-5) is due in 2013.

Con­tin­ue read­ing “Amer­i­can Med­i­cine Is Still Stuck in the 1950s!”

Coronary Artery Disease Is Not a Mental Disorder

Many lay­men and even many doc­tors like the idea that peo­ple can give them­selves a seri­ous phys­i­cal dis­ease just by hav­ing bad thoughts, unpleas­ant feel­ings, or annoy­ing per­son­al­i­ty traits. Yet it’s hard to find any sci­en­tif­ic evi­dence that these psy­cho­log­i­cal phe­nom­e­na have any real effect on health. Nev­er­the­less, the attempt to “psy­chol­o­gize” phys­i­cal ill­ness per­sists.

Although many peo­ple like the idea that their thoughts can influ­ence their health, peo­ple can be amaz­ing­ly resis­tant to the idea that their food choic­es mat­ter. If I were a psy­chol­o­gist, I would use my train­ing to fig­ure out why our doc­tors in the Unit­ed States ignore the over­whelm­ing evi­dence that the stan­dard Amer­i­can diet is the under­ly­ing rea­son for our major caus­es of death and dis­abil­i­ty. I’d try to fig­ure out ways to help peo­ple real­ize that they’re eat­ing their way into an ear­ly grave. I’d try to find ways to help peo­ple improve their diet, so that they can improve their health. Instead, psy­chol­o­gists have been try­ing to prove that coro­nary artery dis­ease is a men­tal dis­or­der. It would be fun­ny if it weren’t so trag­ic!

By the end of World War II, any­one with com­mon sense and access to the sci­en­tif­ic lit­er­a­ture should have real­ized that coro­nary artery dis­ease results from the foods that peo­ple eat, not from the kinds of thoughts and feel­ings that go on in their minds. For exam­ple, heart dis­ease became rare in Nor­way after the Nazis stole their farm ani­mals and the Nor­we­gians had to switch to a low-fat, plant-based diet. Rich, fat­ty foods were also in short sup­ply for the civil­ian pop­u­la­tion in Ger­many dur­ing the war. As a result, Ger­man civil­ians stopped dying of heart attacks, despite all the stress and ter­ror of Allied bomb­ing raids.

After see­ing these data, Nathan Pri­tikin real­ized that heart dis­ease results from the foods peo­ple eat, not from the emo­tion­al stress in their lives. When he got a diag­no­sis of coro­nary artery dis­ease, he cleaned up his own diet and encour­aged oth­ers to do the same.

Nev­er­the­less, Amer­i­cans still clung to the idea that heart dis­ease is a men­tal dis­or­der. First, peo­ple thought that the cause was “emo­tion­al stress.” Then they blamed “type A per­son­al­i­ty.” Then they blamed “pes­simism.” It’s all a crock. Lots of peo­ple in Chi­na had emo­tion­al stress, type A per­son­al­i­ties, and pes­simism. Yet research showed that they weren’t dying of heart attacks, because their aver­age cho­les­terol was shock­ing­ly low by Amer­i­can stan­dards, thanks to their low-fat, high-fiber diet.