Sunday, May 27, 2012
Brickabracked
It has been a good weekend for brickabrack.
Started off at Bourne Hall Library where I acquired two films and two books for the grand total of £3.27p. A good haul, with, for some reason, Bourne Hall Library offering far higher grade cast offs than Epsom Library. Half the haul was consumed last night. First, a German entertainment called 'Eden', a romantic tale involving a very talented, very fat but more or less asexual cook. Kept us happily engaged for a couple of hours with little recourse to either flesh or blood. Good sound track with real music and a good proportion of silence. All in all, excellent value for money. Second, a Chinese entertainment called 'UFI in Her Eyes', in the form of book tricked out to mimic the sort of file secret policemen might keep on a subject. A rather good bit of book production from Random House but flying the (at least once upon a time) very respectable Chatto & Windus flag. A cautionary tale, breezily covering some of the same ground as 'Country Driving' noticed on March 1st last year. Very good, if not quite excellent, value for money.
Then today was the first car booter of my season at Hook Road Arena. Spent rather more than at Bourne Hall, coming away with a fine wooden walking stick of the right length and made with the approved bent wood. Plus a large rubber ferrule. At £2, vastly superior value for money (VFM) to the new one sourced from Worcester Park. Then there were three 500 piece jigsaws, not all of recognised brand but one cannot be too picky at 10p each; a huge undercut of what seems to be the going rate at our local charity shops. Outing completed with 3lbs of quite respectable cherries, these at the full rate of £2.20 the pound.
By coincidence, I was moved this morning to take a look at my three volumes of statistical hubris called the CODOT classification, dating from the seventies of the last century and sourced at a previous Hook Road car booter. An enumeration of some 3,500 occupations, intended to support the central management of the UK labour market and the production of statistics thereabout, an enumeration which presumably drowned in the rapidly evolving labour market and the shrinking role for central management. I had been moved by reading an article in the TLS about what some might regard as a thousand pages of psychiatric hubris, the new and enlarged edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V (or DSM-5 for the less pretentious)) from the American Psychiatric Association. I wonder in passing whether this is a US association which by its name extends its jurisdiction to Canada, Central and South America? Not to mention the Falkland Islands and the Galapagos Islands.
The article has many words on how this latest edition seems to be in thrall to the pharmaceutical industry, the psychoanalytic industry being in decline. It notes in passing that the psychoanalytic people were not all that interested in this DSM sort of thing at all, whole person people before their time - with the result that the DSM committees were packed with chemical cure rather than talking cure people.
It explains how Big Pharma wants a stable classification to support its research, development and marketing activities, none of which is very easy if you do not have lots of handy pigeon holes into which people can be shoved after filling out a few pages of questionnaire. They want to be able to say if you have a patient with diagnosis A give him (or her) lots of our shiny new drug B - not forgetting that some of these shiny new drugs are, indeed, shiny. Let's not throw out the baby with the bathwater. Notice also that Big Pharma has plenty of incentive to bring all kinds of behaviours into the psychiatric net inside which chargeable treatment is applicable; behaviours which would once have been contained or managed by society at large more or less for free.
Along the way, it seems that in order to get the insurance money needed to pay for mental health treatment, you have to have been diagnosed to a DSM recognised disorder which is included in whatever insurance you happen to be carrying about. DSM brings order to the otherwise messy world of mental disorder insurance. For which purposes it is also good if diagnosis is repeatable. That is to say if psychiatrist A diagnoses disorder B in person C at time D, it is good if psychiatrist E comes to the same diagnosis B at time F where F is not that much bigger than D. All of which has conspired to encourage a tick box job on symptoms.
The trouble seems to be that mental disorder is a complicated beast, not presently reducible to a hierarchical classification which reflects facts on the ground in a scientifically or medically satisfactory way. We do not yet know enough about mental processes or disorders to be able to do this - and it may yet turn out that the brain is sufficiently plastic to make cut and dried diagnoses at the DSM level of detail inappropriate and unhelpful.
A different sort of trouble seems to be that one has to pay to look at DSM IV TR, this being the current version. It might have been mainly produced by people on the public payroll but the public does not get to look at it without flashing the plastic again. See, for example, http://www.appi.org/Pages/default.aspx.
Messy old world out there.
Started off at Bourne Hall Library where I acquired two films and two books for the grand total of £3.27p. A good haul, with, for some reason, Bourne Hall Library offering far higher grade cast offs than Epsom Library. Half the haul was consumed last night. First, a German entertainment called 'Eden', a romantic tale involving a very talented, very fat but more or less asexual cook. Kept us happily engaged for a couple of hours with little recourse to either flesh or blood. Good sound track with real music and a good proportion of silence. All in all, excellent value for money. Second, a Chinese entertainment called 'UFI in Her Eyes', in the form of book tricked out to mimic the sort of file secret policemen might keep on a subject. A rather good bit of book production from Random House but flying the (at least once upon a time) very respectable Chatto & Windus flag. A cautionary tale, breezily covering some of the same ground as 'Country Driving' noticed on March 1st last year. Very good, if not quite excellent, value for money.
Then today was the first car booter of my season at Hook Road Arena. Spent rather more than at Bourne Hall, coming away with a fine wooden walking stick of the right length and made with the approved bent wood. Plus a large rubber ferrule. At £2, vastly superior value for money (VFM) to the new one sourced from Worcester Park. Then there were three 500 piece jigsaws, not all of recognised brand but one cannot be too picky at 10p each; a huge undercut of what seems to be the going rate at our local charity shops. Outing completed with 3lbs of quite respectable cherries, these at the full rate of £2.20 the pound.
By coincidence, I was moved this morning to take a look at my three volumes of statistical hubris called the CODOT classification, dating from the seventies of the last century and sourced at a previous Hook Road car booter. An enumeration of some 3,500 occupations, intended to support the central management of the UK labour market and the production of statistics thereabout, an enumeration which presumably drowned in the rapidly evolving labour market and the shrinking role for central management. I had been moved by reading an article in the TLS about what some might regard as a thousand pages of psychiatric hubris, the new and enlarged edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V (or DSM-5 for the less pretentious)) from the American Psychiatric Association. I wonder in passing whether this is a US association which by its name extends its jurisdiction to Canada, Central and South America? Not to mention the Falkland Islands and the Galapagos Islands.
The article has many words on how this latest edition seems to be in thrall to the pharmaceutical industry, the psychoanalytic industry being in decline. It notes in passing that the psychoanalytic people were not all that interested in this DSM sort of thing at all, whole person people before their time - with the result that the DSM committees were packed with chemical cure rather than talking cure people.
It explains how Big Pharma wants a stable classification to support its research, development and marketing activities, none of which is very easy if you do not have lots of handy pigeon holes into which people can be shoved after filling out a few pages of questionnaire. They want to be able to say if you have a patient with diagnosis A give him (or her) lots of our shiny new drug B - not forgetting that some of these shiny new drugs are, indeed, shiny. Let's not throw out the baby with the bathwater. Notice also that Big Pharma has plenty of incentive to bring all kinds of behaviours into the psychiatric net inside which chargeable treatment is applicable; behaviours which would once have been contained or managed by society at large more or less for free.
Along the way, it seems that in order to get the insurance money needed to pay for mental health treatment, you have to have been diagnosed to a DSM recognised disorder which is included in whatever insurance you happen to be carrying about. DSM brings order to the otherwise messy world of mental disorder insurance. For which purposes it is also good if diagnosis is repeatable. That is to say if psychiatrist A diagnoses disorder B in person C at time D, it is good if psychiatrist E comes to the same diagnosis B at time F where F is not that much bigger than D. All of which has conspired to encourage a tick box job on symptoms.
The trouble seems to be that mental disorder is a complicated beast, not presently reducible to a hierarchical classification which reflects facts on the ground in a scientifically or medically satisfactory way. We do not yet know enough about mental processes or disorders to be able to do this - and it may yet turn out that the brain is sufficiently plastic to make cut and dried diagnoses at the DSM level of detail inappropriate and unhelpful.
A different sort of trouble seems to be that one has to pay to look at DSM IV TR, this being the current version. It might have been mainly produced by people on the public payroll but the public does not get to look at it without flashing the plastic again. See, for example, http://www.appi.org/Pages/default.aspx.
Messy old world out there.
# posted by Jim @ 3:28 AM 
