Diagnosis and forums.
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Diagnosis and forums.
Ok - I'm going to stick my neck right out because there's something that deeply concerns me.
I visit SR and a mental health forum in both places you often hear medical terms being carelessly used, of which people diagnosing others they haven't met worries me the most.
It worries me because often the prognosis is common knowledge, sometimes frightening, sometimes soul destroying. Surely it would be wiser to redirect people to proffessionals or up to date criteria?
It is fair to say that something sounds like it needs checking out. Even to warn that not doing so could cause future problems. It also seems fair when people are asking about others to redirect them to an accurate up-to-date diagnostic criteria. Then if they want to make their own mind up they can but at least doing it from first hand info and it isn't us telling them what the medical problem is.
Below are the reasons why I think it's dangerous to diagnose each other on the net.
Diagnosis even done by proffessionals is not an exact science, terms such as alcoholism or depression can be redifined over time and these changes DO matter.
If I wanted to suggest XXXX was a new disease I would have to show that it's valid - ie that enough people showed that distinct group of symptoms and the general poulation didn't. If my new disease is valid then people like the World Health Organisation, British Medical Ass, International Disease Control all start to show an interest. However it's validity (that such a distinct group is exists) will be constantly retested.
With validity testing what tends to happen is that diseases become sub-divided as we know more. Once upon a time cancer, TB, (and on occassion a bad cough) were all thought to be 'Consumption'. Once upon a time Aspergers and Retts syndrome were both classed with Autism. As this happens proffessionals are aware of the changes FIRST. In normal speech the OLD words last for years even though they are no longer valid - ie a new set of distinct differences have been found but the bloke in the street doesn't know that yet!
Secondly my disease XXXX would be tested for reliabilty - ie I must be able to give a prognosis (in effect tell the future), I must be able to show treatment or the lack of it and this must be found to be true repeatedly. AGAIN - this will be tested and retested over time. The reliability can effect the validity - if some people are found to respond to X treatment and others don't then you have to ask if these two are actually suffering from the same condition. Research takes place, and often subdivision follows.
Alcoholism like every other disorder on the planet is inside this process - try reading research and you soon find distinctions and sub-groups emerging.
Alcohol Dependency
Alcohol Abuse.
Even a type 1 and type 2 are begining to arise.
Surely we can't take the responsibility of saying to someone your .... is an alcoholic? Surely we can't say ..... has a progressive and often fatal disease? That should be the job of proffessionals.
I realise there are reasons why many people would need to be aware without diagnosis - legal reasons, health insurance in the USA and a multitude of other repercussions. I agree that then it seems reasonablr for someone to doiagnose themself or family member - BUT from the currently accepted criteria. The most INFORMED decision they can make.
Lastly there is a difference in treatment and outcome between acohol abusers and those physically dependent on alcohol. Mistaking the two could actually do damage.
Ok - maybe my neck is stuck out too far but I have in mind a good post about people standing by and doing nothing - together with another post which caused me real concern. Sorry if this has caused any offence or hurt.
I visit SR and a mental health forum in both places you often hear medical terms being carelessly used, of which people diagnosing others they haven't met worries me the most.
It worries me because often the prognosis is common knowledge, sometimes frightening, sometimes soul destroying. Surely it would be wiser to redirect people to proffessionals or up to date criteria?
It is fair to say that something sounds like it needs checking out. Even to warn that not doing so could cause future problems. It also seems fair when people are asking about others to redirect them to an accurate up-to-date diagnostic criteria. Then if they want to make their own mind up they can but at least doing it from first hand info and it isn't us telling them what the medical problem is.
Below are the reasons why I think it's dangerous to diagnose each other on the net.
Diagnosis even done by proffessionals is not an exact science, terms such as alcoholism or depression can be redifined over time and these changes DO matter.
If I wanted to suggest XXXX was a new disease I would have to show that it's valid - ie that enough people showed that distinct group of symptoms and the general poulation didn't. If my new disease is valid then people like the World Health Organisation, British Medical Ass, International Disease Control all start to show an interest. However it's validity (that such a distinct group is exists) will be constantly retested.
With validity testing what tends to happen is that diseases become sub-divided as we know more. Once upon a time cancer, TB, (and on occassion a bad cough) were all thought to be 'Consumption'. Once upon a time Aspergers and Retts syndrome were both classed with Autism. As this happens proffessionals are aware of the changes FIRST. In normal speech the OLD words last for years even though they are no longer valid - ie a new set of distinct differences have been found but the bloke in the street doesn't know that yet!
Secondly my disease XXXX would be tested for reliabilty - ie I must be able to give a prognosis (in effect tell the future), I must be able to show treatment or the lack of it and this must be found to be true repeatedly. AGAIN - this will be tested and retested over time. The reliability can effect the validity - if some people are found to respond to X treatment and others don't then you have to ask if these two are actually suffering from the same condition. Research takes place, and often subdivision follows.
Alcoholism like every other disorder on the planet is inside this process - try reading research and you soon find distinctions and sub-groups emerging.
Alcohol Dependency
Alcohol Abuse.
Even a type 1 and type 2 are begining to arise.
Surely we can't take the responsibility of saying to someone your .... is an alcoholic? Surely we can't say ..... has a progressive and often fatal disease? That should be the job of proffessionals.
I realise there are reasons why many people would need to be aware without diagnosis - legal reasons, health insurance in the USA and a multitude of other repercussions. I agree that then it seems reasonablr for someone to doiagnose themself or family member - BUT from the currently accepted criteria. The most INFORMED decision they can make.
Lastly there is a difference in treatment and outcome between acohol abusers and those physically dependent on alcohol. Mistaking the two could actually do damage.
Ok - maybe my neck is stuck out too far but I have in mind a good post about people standing by and doing nothing - together with another post which caused me real concern. Sorry if this has caused any offence or hurt.
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Join Date: Jan 2005
Location: Anaheim,CA
Posts: 549
If it walks like a duck....
I think that's the general feeling here.
If my BF is an example of most, the last thing he wants to do is see a doctor.
One of his fallback statements is: "I'm an alcoholic, get over it! Doesn't bother me, shouldn't bother you."
I see a man who drinks almost every night, but during the week it's rarely to excess. On the weekend he drinks until he is completely blotto, sleeps a bit and then does it again. He rarely eats on weekends and often does not even change his clothes. Drink, raise hell, sleep, repeat.
He walks like an alcoholic, talks like an alcoholic, smells like an alcoholic and acts like an alcoholic...i.e. walks like a duck and quacks like a duck, therefore, I declare him a duck!
I think the term "alcoholic" used here is a generic one, one most of us can relate to emcompassing a familiar set of behaviors we see in our SO's.
Just my two cents worth.
If my BF is an example of most, the last thing he wants to do is see a doctor.
One of his fallback statements is: "I'm an alcoholic, get over it! Doesn't bother me, shouldn't bother you."
I see a man who drinks almost every night, but during the week it's rarely to excess. On the weekend he drinks until he is completely blotto, sleeps a bit and then does it again. He rarely eats on weekends and often does not even change his clothes. Drink, raise hell, sleep, repeat.
He walks like an alcoholic, talks like an alcoholic, smells like an alcoholic and acts like an alcoholic...i.e. walks like a duck and quacks like a duck, therefore, I declare him a duck!
I think the term "alcoholic" used here is a generic one, one most of us can relate to emcompassing a familiar set of behaviors we see in our SO's.
Just my two cents worth.
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Join Date: Dec 2004
Location: over the rainbow
Posts: 487
i found this board when searching for al-anon. i presumed it was based on the al-anon forum. to be a member of al-anon all you need is to be someone who is having a problem with someone else's Use of alcohol. for all i know they are not drunks, i am just overreacting to their drunkenness.
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I think there's a vast difference between an individual saying they feel a loved one is an alcoholic and ME saying YOUR loved one is an alcoholic.
Expert witnesses usually have qualifications within the field of their testomony. The reason they are allowed to give opinion is because few proffessionals would state much as fact.
I still feel I should not and would not give a diagnosis or prognosis ove the internet refering to someone I'd never even seen.
Expert witnesses usually have qualifications within the field of their testomony. The reason they are allowed to give opinion is because few proffessionals would state much as fact.
I still feel I should not and would not give a diagnosis or prognosis ove the internet refering to someone I'd never even seen.
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Originally Posted by escape artist
i found this board when searching for al-anon. i presumed it was based on the al-anon forum. to be a member of al-anon all you need is to be someone who is having a problem with someone else's Use of alcohol. for all i know they are not drunks, i am just overreacting to their drunkenness.
I think that is VERY fair. I don't think it's in opposition to anything in my OP.
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Join Date: Dec 2004
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All good points, equus!
I've heard for years that the only person qualified to declare someone an alcoholic is the alcoholic in question. Of course, professionals can diagnose alcohol abuse, alcohol dependence, substance dependence, and so on.
Personally, the only time I share that someone I know is an alcoholic is if they have given me permission to do so.
I like it when I see people stick their necks out! It reminds me that it's ok to risk, and that growth inevitably follows!
I've heard for years that the only person qualified to declare someone an alcoholic is the alcoholic in question. Of course, professionals can diagnose alcohol abuse, alcohol dependence, substance dependence, and so on.
Personally, the only time I share that someone I know is an alcoholic is if they have given me permission to do so.
I like it when I see people stick their necks out! It reminds me that it's ok to risk, and that growth inevitably follows!
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Join Date: Nov 2004
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Like someone said on another message board, "Relax Equus, if someone takes medical advice from the internet, they're probably dead anyway." This is a forum to share experiences and if someone bases their personal health decisions on advice from a person on a message board, then they have their own issues besides alcoholism in a relative or friend. Take what works for you and leave the rest behind. I think it is more irresponsible to believe that folks cannot decide for themselves what is appropriate for them or their loved ones, then to post your experiences. Get the information out there...if you want to post about studies, new diagnostic criteria etc....I would be very willing to read your information and then I would read the studies myself and make a decision from that....the more information and advice the better. I agree in many respects that if it "walks like a duck"...it is most likely a duck, but I would draw my own conclusion and what it takes for me to draw this conclusion is different than anyone else. Does it quack, what color is it, does it fly, does it waddle? Even after all the "right" answers, I could still be wrong (I have seen some ducks that I wouldn't have thought were ducks and vice versa). Whether or not a loved one is "classified" as an alcoholic, or "diagnosed" with alcoholism doesn't make a whole heap of a difference to the person residing with or loving this person. If alcohol is a "problem" for one or the other or both...it is a "problem" and the person needs help and advice regardless of whether or not the other person ever comes to the same conclusion. That is what this board is about and I rather like it.
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Like someone said on another message board, "Relax Equus, if someone takes medical advice from the internet, they're probably dead anyway."
If we were uneffected by what we read here we wouldn't bother coming - no effect = pointless time spent without reward. I'm presuming that as many of us return we are effected. Personally I know I am effected.
Realistically me and many others living with alcoholism understand full well how frightening it can be and it would appear to me to be very careless not to take that into account - ESPECIALLY when people arrive here with a bucket of fear and asking whether their .... is alcoholic.
I have no problem being upfront that I can reason by fear rather than logic sometimes, I don't think I've ever met a person who doesn't. I also see no reason for the internet to be immune from normal standards of caution when we interact. Face to face I wouldn't tell someone concerned about their BF/Son/GF the worst I've seen of my husbands addiction, I wouldn't have the confidence to answer 'Is my... an A?'. I would tell them where to get information and support. I would tell them I could understand how they felt, I would help them to not feel alone, I would do all the things you suggest here:
If alcohol is a "problem" for one or the other or both...it is a "problem" and the person needs help and advice regardless of whether or not the other person ever comes to the same conclusion. That is what this board is about and I rather like it.
Like it or not we're all human - we do listen to each other, and sometimes it's more resonable to be open when we CAN'T answer a question, than to be so eager to help that we answer it wrongly.
Get the information out there...if you want to post about studies, new diagnostic criteria etc....I would be very willing to read your information and then I would read the studies myself and make a decision from that....the more information and advice the better.
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National Institute on Alcohol Abuse and Alcoholism
Sorry I got the name wrong!! Anyway if you are interested and come back this will link to PLENTY of research - but starts at the FAQ page.
Sorry I got the name wrong!! Anyway if you are interested and come back this will link to PLENTY of research - but starts at the FAQ page.
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Another one - who likes learning?
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I honestly don't see a lot of "telling" on this board. I find that the majority of the people that give advice or suggestions or commiseration, generally premise with "In my experience" in some form or another. I don't know which posts you are referring to exactly. If I hadn't attended an al-anon meeting where people were willing to share their "secrets" or perused this board, I would have been hiding behind the mask of shame. I would have continued to believe that I was a shameful, pathetic mess married to a person who drank. It is due to this board that I have been able to cast away that shame and tell my story to people here and people in my meetings, and even people in my everyday life....because frankly, I am not the first and I will not be the last. I was deeply amazed by how many people could tell stories that were very much like my own and I was given hope that there is a light at the end of the tunnel. The tunnel is different lengths for all of us, but I really needed the hope that only comes from those that have gone before. I also have gained in so many ways by reading the stories of people who have not succeeded or from those who struggle every day...it is a reminder that it isn't easy for anyone and the journey to self-actualization can be tough. I have a genuine faith in people and the ability for good people to rub off on good people. The advice from this board (I would rather call it information), comes from people that have struggled in their own way and they may have suggestions for how I can avoid the same mistakes or misjudgements that they have made.
I agree with you that nobody can diagnose an alcoholic from the information that is relayed here, but I see many more attempts to help the person focus on their "selves" rather than on anothers behavior. Al-anon is not about wallowing in self pity, but much more about what I am going to do to change my situation. Whether they are a true alcoholic, sound like an alcoholic, or don't even drink....the ability to change yourself has wonderful consequences. When a poster asks the question, "Is my H an A?" there is always an overwhelming response of..."we can't tell you that, but here is my experience and how it may relate to your situation". This is invaluable.
Since there is no blood test, CT scan, or MRI to diagnose this disease and the only way to have a "true" diagnosis is for the alcoholic to admit it to themselves.....we must rely on the school of hard knocks. I guess I assume most people wouldn't be looking into message boards about chemical addiction unless they thought there was a problem of chemical addiction/dependency and if they thought there is a problem, then there is a problem. Someone suggested to me that I read "co-dependent no more" because I would most likely see myself in every page....were they diagnosing me as co-dependent? No, merely suggesting that I seek out some information that may make things clearer. Did I see my self in every page.....no....maybe every other page, but it doesn't mean I am either co-dependent or not co-dependent...it means I need to figure it out. There is a wonderful thing that I have figured out through reading posts, that this is a disease and it is manifested in a whole myriad of different symptoms and signs. I had been told that alcoholism is a disease by health professionals, but it took seeing the experiences of others to drum it into my head. Just as one thread is focusing on now...."Do all A's cheat?" the answers can be very diverse, but there is a commonality to it all.....a group of symtoms when brought together form some sort of diagnosis for some sort of disease. Lying, cheating, abusive behavior are all symptoms of a soul-disease whereas drinking is a symtom of alcoholism. I would never say..."Your A is lying or your A is cheating"....most wouldn't...they would simply say, "In my experience, A's have a propensity to lie and a propensity to cheat because they have a soul-disease." I don't think on these message boards that people can answer a question "wrongly" as it is in their experience and that makes it "right". I wouldn't assume that all A's are genuinely good people or good husbands because my AH is a good person and a good husband. I wouldn't tell someone that their spouse is a good person, but rather that it sounds like he is a good person or I would ask, "what is it that you see in him that makes him a good person?"
I apply the al-anon principles, traditions and steps in what I am trying to accomplish...this board has some of this, but it is not al-anon so it has some other stuff too. That's okay...none of us are perfect, but we are all trying to gain the same thing....serenity, peace of mind, a life unto our own and freedom from alcoholism in our lives.
Thanks for the links....I work in a research field so I really enjoy looking into stuff and I have been to both sites. Just so you know Equus, I feel your pain, but internet stuff is not kept at the same standards as in-life stuff, but there is good with the bad. I was just remarking yesterday to a colleague that we used to have to go to the library to learn new stuff and that was very time-consuming and arduous at times...now we can just click a mouse (even though you can't always trust the information). I am glad that you can reach out to those in need, how you do the reaching is not important, the reaching is. People are reaching out here every day and it matters, it works for some and it is important. When someone asks me about a problem they or a loved one may be having with alcohol, I explain what worked for me and then I offer to go with them to a meeting. If they are not interested, I give them the information that I have and let them decide. We all do things differently.
I agree with you that nobody can diagnose an alcoholic from the information that is relayed here, but I see many more attempts to help the person focus on their "selves" rather than on anothers behavior. Al-anon is not about wallowing in self pity, but much more about what I am going to do to change my situation. Whether they are a true alcoholic, sound like an alcoholic, or don't even drink....the ability to change yourself has wonderful consequences. When a poster asks the question, "Is my H an A?" there is always an overwhelming response of..."we can't tell you that, but here is my experience and how it may relate to your situation". This is invaluable.
Since there is no blood test, CT scan, or MRI to diagnose this disease and the only way to have a "true" diagnosis is for the alcoholic to admit it to themselves.....we must rely on the school of hard knocks. I guess I assume most people wouldn't be looking into message boards about chemical addiction unless they thought there was a problem of chemical addiction/dependency and if they thought there is a problem, then there is a problem. Someone suggested to me that I read "co-dependent no more" because I would most likely see myself in every page....were they diagnosing me as co-dependent? No, merely suggesting that I seek out some information that may make things clearer. Did I see my self in every page.....no....maybe every other page, but it doesn't mean I am either co-dependent or not co-dependent...it means I need to figure it out. There is a wonderful thing that I have figured out through reading posts, that this is a disease and it is manifested in a whole myriad of different symptoms and signs. I had been told that alcoholism is a disease by health professionals, but it took seeing the experiences of others to drum it into my head. Just as one thread is focusing on now...."Do all A's cheat?" the answers can be very diverse, but there is a commonality to it all.....a group of symtoms when brought together form some sort of diagnosis for some sort of disease. Lying, cheating, abusive behavior are all symptoms of a soul-disease whereas drinking is a symtom of alcoholism. I would never say..."Your A is lying or your A is cheating"....most wouldn't...they would simply say, "In my experience, A's have a propensity to lie and a propensity to cheat because they have a soul-disease." I don't think on these message boards that people can answer a question "wrongly" as it is in their experience and that makes it "right". I wouldn't assume that all A's are genuinely good people or good husbands because my AH is a good person and a good husband. I wouldn't tell someone that their spouse is a good person, but rather that it sounds like he is a good person or I would ask, "what is it that you see in him that makes him a good person?"
I apply the al-anon principles, traditions and steps in what I am trying to accomplish...this board has some of this, but it is not al-anon so it has some other stuff too. That's okay...none of us are perfect, but we are all trying to gain the same thing....serenity, peace of mind, a life unto our own and freedom from alcoholism in our lives.
Thanks for the links....I work in a research field so I really enjoy looking into stuff and I have been to both sites. Just so you know Equus, I feel your pain, but internet stuff is not kept at the same standards as in-life stuff, but there is good with the bad. I was just remarking yesterday to a colleague that we used to have to go to the library to learn new stuff and that was very time-consuming and arduous at times...now we can just click a mouse (even though you can't always trust the information). I am glad that you can reach out to those in need, how you do the reaching is not important, the reaching is. People are reaching out here every day and it matters, it works for some and it is important. When someone asks me about a problem they or a loved one may be having with alcohol, I explain what worked for me and then I offer to go with them to a meeting. If they are not interested, I give them the information that I have and let them decide. We all do things differently.
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