Psychiatry as a malingerers heaven is no myth. The reality of how modern medicine has turned psychiatry into a place for malingerers to flourish has become very evident.
M. Scott Peck in his book “The People of The Lie” describes malingering as a side effect of our modern approach to medicine and a blight on psychiatry as it encourages and supports the practice of lying for some gain.
According to Wikipedia “Malingering is the fabricating of symptoms of mental or physical disorders for a variety of reasons such as financial compensation (often tied to fraud); avoiding school, work or military service; obtaining drugs; or as a mitigating factor for sentencing in criminal cases. It is not a medical diagnosis. Malingering is typically conceptualized as being distinct from other forms of excessive illness behaviour such as somatization disorder and factitious disorder, e.g., in DSM-5 , although not all mental health professionals agree with this formulation”
Malingering then is the faking of a physical illness for some other gain. This phenomena was first observed, or defined, in battlefield conditions going back thousands of years where a soldier would invent an illness to keep himself from being exposed to imagined or actual death. It is a defence reaction of the mind brought about by the desire to avoid some consequence or situation where a fear would have to be faced.
As opposed to a psycho-somatic condition involving a Conversion Reaction where a person’s unconscious mind creates physical symptoms as a result of a reaction to some traumatic event that the person is unwilling to face, or the mind is unable to deal with. These symptoms are very real. A person will actually go blind or paralysed without the actual physical injury to cause such a condition. Many soldiers were regarded as malingerers in the 1st World War when they developed symptoms that could not be explained through physical injury. It has since been recognised that Post Traumatic Stress Disorder (PTSD) can manifest with very real physical symptoms.
This ability to create or dissolve physical symptoms is proven by the Placebo Effect which has been proven scientifically as being a very real ability within people to the point where science allows for the effect and discounts it as a distortion within statistical data. However, the Placebo Effect proves the mind’s ability to control physical states of existence.
Thomas Szasz in his book “Psychiatry: The Science of Lies” explores the idea that most people seeking help for physical illnesses are doing so out of some other psychological reason and are in fact malingering. He goes to the extent of saying that many people seeking help for mental health problems are doing so out of a desire for some other secondary gain not revealed to the treating physician.
The Diagnostic Statistical Manual (DSM) defines a condition known as Factitious Disorder as being ” the intentional production or feigning of physical or psychological symptoms with the motivation to assume the sick role, in the absence of external incentives (e.g., economic gain) for the behavior. There may be fabrication of subjective complaints, falsification of objective signs, self-inflicted conditions, and/or exaggeration or exacerbation of an actual medical condition. ”
The person may or may not be aware consciously of the intent to deceive as the motivating beliefs or thought patterns may be hidden in the sub-conscious mind. In its chronic form it is referred to as Munchausen Syndrome.
Many health professionals are either ignorant of this condition, are unwilling to cast doubt on reported symptoms or continue to encourage patients in reporting these symptoms for financial gain. Or, it could be that allowing the ‘sick’ person to act out their role is complimented by the ‘healer’ role. This allows people who are seeking ‘health care’, ‘attention’ or drug prescriptions to continue to return for bulk-billed consultations paid for by the government.
In other words, both the ‘sick’ person and the ‘healer’ are perpetrating a fraudulent claim for monetary gain from the government and justify their actions with a bogus science based on a myth.
At other times, it is used by mental health professionals to refuse treatment to people who have obvious and, at times, severe mental health problems. It appears to be a decision based on economics and personal belief rather than an objective examination of presenting facts. This confirms the psychiatry’s status as a bogus science.
As Thomas Szasz tells it, the medicalisation of bogus symptoms began with the widespread acceptance of Freud’s system of psychoanalysis as a science when it is nothing more than a belief system based on base rhetoric. It has less validity in the field of science than Astrology. The general population has fully embraced this bogus science because it validates their tendancy towards malingering.
The end result is that Emergency department waiting rooms are full of people with minor ailments that could be treated with first aid techniques, homeless people looking for a warm place to sleep on cold nights and people with addictions to illicit substances looking to make a ‘score’. The remainder are made up of people with genuine injuries requiring emergency treatment.
Acute psychiatric inpatient treatment facilities and emergency service first responders’ time and manpower is taken up with responding to people with imagined or feigned symptoms trying to manipulate the system for their own gain. Whether these symptoms are deliberately falsified or sub-consciously created through some underlying dis-ease process of the mind, the amount of resources dedicated to responding to their perceived ‘need’ is huge.
The people being neglected through this massive drain on resources are the people with serious mental health dis-ease conditions who are in spiritual crisis. The malingerers are using up valuable resources that should be channelled towards the people in real need. These people are often assessed with chronic conditions that don’t respond to pharmacological treatment and discharged to live with their ‘illness’. These people are usually viewed as being not worth spending time on.
Not only does the treatment system fail them in trying to treat a disorder of the mind with physical methods and then deems them unworthy of trying something different. Continuing to hold the position that a disorder of thought is caused by a chemical imbalance or genetic flaw rather than the more logical cause as being a mistaken belief or erroneous thinking pattern resulting in abnormalities in behaviour and function.
It seems that the malingerer fits more easily into the medical model as they too are looking for an answer that would absolve them of their responsibility for their own health. And so, creates the malingerers heaven that is our current general and mental health systems.
I’ll leave the last word to DJ Jaffe: