Linkblog: Can we stop diagnosing and start solving?

As anyone slightly familiar with psychiatry knows, psychiatrists reference a text called the Diagnostic and Statistical Manual of Mental Disorders both when diagnosing the source of their patients’  troubles and when determining how to treat them. Among the DSM’s many criticisms is that it enforces cultural stereotypes and its use is subject to the observer’s biases. In addition, the particular sets of symptoms have undergone alteration over the years (the next edition, DSM-5, is to be released next year), and even the names of disorders are cleaned up or rearranged, such that someone diagnosed with multiple personality disorder years ago would be described as having a “dissociative identity” now, and someone termed schizophrenic before may be bipolar, manic depressive, dissociative, or chronically depressed now.

The problems with defining mental problems have been dramatized endlessly in films, plays, and TV shows, and one in particular is the most compelling reason to change or eliminate the method. In anthropology, “labeling” is more than an action; it’s a set of symbolic actions, words, and sociopsychological connotations, in which labeling both produces the label and the associated activity that confirms the label. In adolescents this can both reinforce stereotypes about adolescents, contribute to “typical” adolescent behavior, and, for bullying victims, in particular, be potentially damaging.

Interestingly, the DSM is under attack:

Many [clinicians] will participate in “Boycott Normal,” a demonstration planned for May 5, when the American Psychiatric Association (APA) meets in Philadelphia and is likely to vote to go forward and publish the DSM-5.


Foremost among these advocates is feminist psychologist Paula J. Caplan, a fellow in the Women and Public Policy Program at Harvard’s Kennedy School, and the Joan-of-Arc of the new PLAN T Alliance (Psychiatric Labeling Action Network for Truth). The alliance is a coalition of individuals and organizations formed because of frustration with the unscientific nature of the DSM, the harm done to many people who receive arbitrary diagnostic labels, and the unwillingness of the APA to undertake serious reform.

Imagine being a troubled teenager, bullied, ostracised, and confused, and going to a counselor who recommends a psychiatrist who tells the student that they are A, so take B, and behave like C to “get better.” It frees the tormentors from responsibility because the victim was “just that way to begin with,” frees school counselors and administrators from responsibility to provide a safe, judgment-free school, and it slaps the “crazy” label on a vulnerable person in an overstimulating environment.

Am pressed for time so will continue this topic on my next bookblog, which is on the topic of adolescent culture.