The triple f**k syndrome: medicine and the systemic oppression of people born into poverty

[摘要] A HARMFUL LABEL The ‘triple f**k disorder’ describes a triple interlocking societal oppression where medicine holds the key for the final padlock. The first f**k occurs by exposing children to trauma caused by poverty; the second is created by blaming those children as they grow into adults for displaying behaviours caused by that trauma; and the final f**k is the pseudo-scientific medical construct of personality disorder (PD). This final f**k belongs to the cruellest of oppressions, as it robs the victim of both their core existential selves and the one factor that could allow them to resist oppression: the social perception of their sanity.This article argues, first, that PD is a confused and confusing medical construct that has no demonstrable pathological disease basis; second, that the behaviours associated with both borderline and antisocial PDs (BPD and ASPD) may be caused not by internal dysfunction but just as plausibly by the effects of childhood adversity and poverty; and, third, that the diagnosis of PD is harmful to the health of those so labelled.1. Personality disorder is a nebulous illness and arguably not a disease at all‘Diseases exist when underlying natural pathological processes produce particular sets of symptoms.’1 These pathologies are identified pre-mortem using scans, microscopes, or laboratory evaluation of blood or other bodily fluids; or post-mortem on the mortuary slab. Many, if not most, psychiatric diagnoses are based on symptoms and have no identifiable pathology.The diagnostic criteria for PD are nebulous. Aside from the uncommon PD post-brain injury, there is no proven pathology associated with any PD variants. The diagnosis is often made without complaint of distress or malaise by the patient. The physician must identify a combination of vague, difficult-to-define, cognitive, and emotional social constructs (for example, markedly impoverished self-identity/deceitfulness/interpersonal hypersensitivity/manipulativeness/instability in goals, aspirations, values, or career plans/callousness) that depend on subjective evaluation and lack any element of objectivity required by a scientific-based discipline.

[学科分类] 卫生学