Head games

Is political dissidence a sign of mental illness?

Back when the USSR was a going concern, political dissidence was, in fact, treated as a mental illness. Dissidents were regularly confined to psychiatric hospitals. The government wasn’t necessarily being malicious; the apparatchiki who sent them there really did believe that opposition to Marxism was a sign of mental or emotional instability. But could that happen here?

There is a recognized psychological disorder in children called Oppositional Defiant Disorder. And now there’s a movement in the mental health community to expand the ODD definition to include adults. In children, calling this behavior a pathology is understandable. This is defiance for its own sake; where the child might even admit that they’re harmed by their own behavior. And there can be adults who similarly show defiance for its own sake rather than as a reasoned response. But what about defiance to authority based upon deeply held personal conviction? No one would call that a pathology; even if the individual suffers harm for his belief.

…unless, there were some other motivation to do so.

Adult ODD isn’t a real diagnosis that a health care provider can submit a bill for. There is no ICD-10-CM code for it. There is, however, a broad, catch-all diagnosis for adults called “Personality disorder, unspecified“. The description is:

• A diverse category of psychiatric disorders characterized by behavior that deviates markedly from the expectations of the individual’s culture; this pattern of deviation is pervasive and inflexible and is stable over time. The behavioral pattern negatively interferes with relationships and work.
• A major deviation from normal patterns of behavior.
• Personality disorders are long-term patterns of thoughts and behaviors that cause serious problems with relationships and work. People with personality disorders have difficulty dealing with everyday stresses and problems. They often have stormy relationships with other people. The exact cause of personality disorders is unknown. However, genes and childhood experiences may play a role. Symptoms vary widely depending on the specific type of personality disorder. Treatment usually includes talk therapy and sometimes medicine.
• When normal personality traits become inflexible and maladaptive, causing subjective distress or impaired social functioning, they can be considered disorders.

One can see how, with a little creative license, motivated clinicians could tar many an RKBA or TEA Party activist with this diagnosis. We’ve also discussed how Obama’s latest executive orders remove legal impediments to sharing formerly confidential patient information with the Federal government. And indeed, this may the “the long game” the president is playing where the States (read: Blue states) are not simply given permission to share this data, but are encouraged to do so. Congress has been a dead end for his schemes, but he has his loyalists in many State governments. His orders and new rule making may be an end-around to nullify Congress’ authority by pushing action down to the State level. Is there any possibility that legislatures in places like Sacramento or Albany wouldn’t rubberstamp this President’s demands?

There is a serious need to improve reporting of adjudicated mental defectives to the NICS system. But there must also be due process involved; clearly defined ways to get on to and off of the Government’s list of prohibited persons. There must also be a nearly fanatical dedication to doctor-patient confidentiality by all concerned. There are already people out there avoiding help with mental or emotional conditions out of fear of being stripped of their rights. Obama’s orders to State level apparatchiki are not improving this situation.