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Why Psychiatric Disorders Are Not the Same as Physical Diseases

Even when their causes are organic. Our minds make us who we are.

by
Theodore Dalrymple

Bio

October 6, 2012 - 12:00 am
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Sacks was given the right of reply to the authors and he sticks by his original contention that the paralysis from which he suffered was not psychological in origin. One has the impression that he does not merely disagree with this idea, but finds it uncomfortable and does not like it. Even if hysterical paralysis existed, it would be confined to others.

A third paper in the same journal by the Professor of Cognitive Neuropsychiatry at the Maudsley Hospital Anthony David has an interpretation that might not have pleased Dr Sacks:

Is it not one of the mechanisms whereby a minor injury can lead to major disability that it sows the seeds of what it might be like to be disabled and hence to be looked after, pitied, lionised? None of us is immune to this but like Sacks perhaps, most having glimpsed what life might be like on the “other side” returns with haste to the land of the healthy.

We have two attitudes to psychological vulnerability: either we assume it to an extraordinary degree to demonstrate our superior sensitivity, or we deny it altogether, believing ourselves to be completely invulnerable.

I tend to the latter; but once learned differently when I was in a distant land famed for its inefficient bureaucracy. There was a problem with my ticket home and it took days to sort out. During those days I suffered from severe and almost incapacitating backache that I did not connect to the problem with my ticket. The backache, which was severe, disappeared, however, within minutes of the problem having been sorted out. As Dr. Chasuble put it in The Importance of Being Ernest:

Charity, my dear Miss Prism, charity! None of us are perfect. I myself am peculiarly susceptible to draughts.

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Theodore Dalrymple, a physician, is a contributing editor of City Journal and the Dietrich Weismann Fellow at the Manhattan Institute. His new book is Second Opinion: A Doctor's Notes from the Inner City.
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