DSM 5 Diagnosis: Psychiatric Institution Lockdown

You were right to warn people that this video moves fast. I had to stop it several times and jot down some notes.

What is not addressed in this video is the issue of quality. In the open source world (he refers to Linux) we have the case where a programmer may contribute a patch that, perhaps, may address a significant problem…and that constitutes the entire contribution of that programmer. We can judge the quality of that patch by the way it has solved a particular problem. But things become muddier once we move into the world of information in general, be it in the form of “amateur” journalism (the bloggers) or Wikipedia, where measuring quality is, to some degree, subjective, yet there is certainly an objective component to measuring quality. We are all familiar with the pseudo-journalistic websites that promote rumor as news, yet this “rumor” has often turned into “news” and has shaped dialog about the world. What an institution provides is a vetting process for information. I have more faith in something that comes out of an institution (interesting that he selected Judith Miller who was doing little reporting and more retelling of the Bush/Cheney/Iraq War talking points). Miller actually is a case of two problems with, as far as I’m concerned, the Shield laws being the less important issue. The MORE important issue is that we depended on the institution to assure the quality of the information and, in the case of Miller (and there have already been a few others), it has failed. But without an institution to vet the information, who am I to believe? And how do I judge one source of “news/facts” when compared to another? One more point concerning quality. I’ve used Wikipedia many times but I’ve used it to verify what I ALREADY KNOW to be true. When I want something that I can trust, I’ll turn to a recognized online encyclopedia or other authoritative source.

Now, there is the very important issue of how does an institution incorporate the insights of that solitary person who contributes that one “patch” that, perhaps, solves a major problem with DSM V. It’s a question mark as to whether institutions, in their current form, can adapt/evolve to be able to take advantage of this possibility. That’s the real problem to be solved. My worry, though, is that without an institution, be it the APA or the NY Times, I have no way to really know if the information provided is any good and I also have no recourse, no place to go to to complain when I believe such information is erroneous.

Finally, what is ignored is the issue of power. We have fooled ourselves into believing that because millions of us have access to the Internet, have access to blogging software, etc., that that somehow constitutes power and, through the miracle of sheer numbers, the “truth” will win out in the end. Where power is concerned, it is so widely distributed and thereby so diluted that all we really have is an illusion of power. The best example of that? The current administration in the White House. Millions and millions of people thought that they were contributing to real change when they harnessed the power of the Internet to get behind Obama. But what have we seen? The institutions, in the form of Wall Street (Goldman Sachs, etc.), the banks (Citibank, etc.) and so far, it seems, the health insurance companies (Wellpoint, etc.), are the ones calling the shots. You can only fight institutions with something equally powerful…namely…an institution. As for truth, well, we have a few websites that started out as amateur operations and have become quite impressive in the quality of the information (Talking Points Memo, for example), but we also have MANY websites that put forth junk information and which thereby promotes bogus information. My favorite example of this is the website http://jewwatch.com/ .

Final, final point. I don’t know what the future holds. My fear, though, is that as institutions that cannot remain profitable, like the NY Times, whither away, what will take its place is amateur, junk journalism. I fear that we will have the junk news and junk science (“let’s use crystals to cure your cancer!”) and no way to separate the wheat from the chaff. I can probably tell if a Linux patch has failed (and maybe I cannot). But how will I be able to determine whether crystals will cure my ills? I need an institution to perform those studies, those double-blind tests.