New York Times: Invitation to a Dialogue on Diagnosis and the DSM-5


The New York Times invites readers to respond by this Thursday for a dialogue about psychiatric diagnoses and the forthcoming DSM-5. The dialogue is initiated by a letter from Ronald Pies, which concludes ““Diagnosis” means knowing the difference between one condition and another. For many patients, learning the name of their disorder may relieve years of anxious uncertainty. So long as diagnosis is carried out carefully and respectfully, it may be eminently humanizing. Indeed, diagnosis remains the gateway to psychiatry’s pre-eminent goal of relieving the patient’s suffering.”

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. It is long time that psychiatrists be held criminally liable for the devastation they leave in the wake of their unites ting, and inherently dangerous and lethal drugs. As the DSM V is nothing but a bunch of unqualified opinions, it needs to go the way of last years phone books. Immediately and safely recycled.

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    • Indeed, who knows anyone with more than one diagnosis?

      Who knows anyone with more than one diagnosis who got the same treatment for each diagnosis (drugs and neglect)?

      Who knows a bunch of people who got different treatments for the same diagnosis (a mix and match combination of different drugs depending on the practitioners favourite drugs plus, if you are lucky, a partonising chat from a worker once a fortnight who suggests doing the washing up do add structure to your life)

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  2. Ronald Pies believes that “there is nothing inherently dehumanizing or “stigmatizing” about a psychiatric diagnosis”. Really? Tell that to someone who has been shunned by friends and employers because of a schizophrenia diagnoses, years after the person has recovered from a psychotic episode and learned how to recognize the causes of, and prevent, a recurrance. Most psychiatrists just don’t want to “get” that when they pretend that their opinions are science, and that some people have defective brains, that IS stigma. It diverts attention from the real roots of distress – sensitive people trying to maintain their humanity in the face of external difficulties and traumas, and a system that insists their problems are not systemic in origin, but lie within them. It looks to me that there are problems with this “dialogue” right from the outset – the issue is framed with false premises.

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  3. And there is research showing that psychiatric labels and the concept of “chemical imbalances” actually encourages people to indulge in their biases to a greater degree.

    This is a typical “I’m a psychiatrist and I say it’s so” argument, without any scientific or evidentiary basis. I hope someone else will write in a rebuttal using the research. I would do it, but I got mine published the last time they brought up the subject, and I doubt they’d publish me again so soon.

    Someone want to take this on?

    —- Steve

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  4. Oh, and “diagnosis” doesn’t really mean just distinguishing one condition from another. It should be a means of accomplishing a plan of treatment. But in truth, psych diagnosis doesn’t even accomplish his stated goal, as people with wildly different situations are lumped together with the same “disorder”. It would be like diagnosing someone with “a rash” without determining the cause and possible treatments for the rash. Could be they have poison ivy, in which case, Calomine lotion is appropriate. Could be they have syphilis, in which case, they’d better get antibiotics.

    I’m looking forward to hearing the discussion.

    — Steve

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  5. Another “futile” exercise. Expect the NY Times to published a long list of letters by “experts” claiming that a psychiatric diagnosis is as real as diabetes, that people should be put on “treatment” immediately and that because of “anosognosia” many “sick” people do not get the “help” that they need. Nothing new here, really.

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  6. Yet another reason psychiatry is a big bunch of cow dung. I have diabetes(type 1). I would never have been disabled by. Diabetes. I was/am disabled by psychiatry. Insulin has basically two potential effects: low blood sugar, and maybe low potassium. Psychiatry has millions of negative effects. They all belong in prison.

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