Helping to find the most accurate diagnosisBMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f2228 (Published 16 April 2013) Cite this as: BMJ 2013;346:f2228
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The plain fact that the issue of pain, as but one symptom that may not be currently explicable in a particular individual, is included in Manuals of Mental Disorders tells us that we are overmedicalising the human condition, whilst simultaneously continuing to delight in the naming of parts based on the non-existent divisions between brain and mind and mental from physical.
How could mental functions be delivered in ways that are governed in ways that are not in accord with the physical laws and processes that govern all physical functions?
Equally time expired is the division of diseases into 'organic' and 'functional' - how could there be any process going on without it being 'organic' even if we cannot "see what it is yet"?
We are condemning thousands in the NHS everyday to out-dated thinking and processes that lever them into non evidence-based schismatising paradigms when we should be assisting in ways that help people to understand that nothing is "all in the mind".
If pain is experienced at all it is entirely and physically in the bodymind and increasingly we should be able to explain this in ways that do not derive from external taxonomic systems based on the needs and requirements of particular professions and ways of reimbursing them but from deeper understandings of pain processing within the ecosystem that is a human being. (1)
General psychiatry and distress are not confined to the Mental Health Trust, but are to be found spread far more liberally on the general wards.Our minds are not confined to our brains either; the human mind is embodied - the heart is not just a pump, but an endocrine organ and the intestine prepares us for fight/flight/freeze, not just the digestion of a gourmet dinner or a hospital canteen meal - which may, of course, induce all three.
As a delightful ticket inspector once said to me: "the brain - makes you think dunnit?" But where is it in so much NHS work and practice; let alone all its attendant connectedness? I attend numerous 'mental health' events in the charity sector too and no-one ever seems to mention it?
Fascinating - "the organ that dare not speak its name?"
Dr Chris Manning MRCGP
(1) BMJ 2013:368:1388-97
Competing interests: I have had episodes of 'major depression' since 1986 - the most physical experience of my life.