Pugilistic Discussion Syndrome

The Wired Alt-Text blog has an amusing list of made-up diagnoses for internet users, covering all the major pathologies of online interaction.

This is my favourite:

Pugilistic Discussion Syndrome

In this curious form of aphasia, the subject is unable to distinguish between a discussion and a contest. The subject approaches any online forum as a sort of playing field, and attempts to “win” the discussion by any means necessary. The rules of the imaginary contest are apparently clear to the individual as he or she will often point out when others break them, but when asked to outline these rules the individual is reluctant, perhaps not wishing to confer an “advantage” on any “opponents.” The conditions for winning are similarly difficult to pin down, although in some cases the individual will declare himself the winner of a discussion that, to all others, appears to be ongoing.

Of course, the next step is for an ambitious young researcher and a support group of affected families to champion the cause. Shortly after, a precise list of symptoms for each diagnosis will be created.

Some initial research will demonstrate that the behaviour in a particular category can be reduced by a particular psychiatric drug, at which point a drug company will fund a ‘public education campaign’ about the disorder.

Now flush with cash, the researchers and support groups will lobby for mainstream acceptance (inclusion in the DSM being the crowning glory), and as soon as that happens, the drug company will push for a licence for their treatment to be approved for the condition.

Voila. Another dreadful disease has been recognised, de-stigmatised and treated. The march of progress moves ever forward.

On a more serious note, what I’ve just described is a typical process by which new psychiatric conditions become mainstream.

Some people, and their families, may genuinely suffer from the effects jokingly described under ‘Pugilistic Discussion Syndrome’.

It is always worth helping people to suffer less, but the question you should ask yourself when you hear about a new mental illness is not whether people are suffering (which they almost certainly are), but whether the best way to alleviate that suffering is by deciding it should be diagnosed and treated by the medical profession.

Medicine uses science, but the decision over what is worth researching and treating is based on a mixture of political, personal, scientific and economic concerns.

Nowhere is this more apparent than in psychiatry. An essential question for critical thinking in this field is ‘who benefits from this approach?’.

The answer should always be the patients, but it isn’t always clear that this is the case. We need to keep asking ourselves this same question over-and-over to make sure psychiatry is serving those most in need.

So, if you want to get involved with medical progress, consider some of the conditions on Wired’s satirical list.

Link to ‘Narcissistic Blog Disorder and Other Conditions of Online Kookery’.

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