UK Clinical Psychologists Call for the Abandonment of Psychiatric Diagnosis and the ‘Disease’ Model


In a bold and unprecedented move for any professional body, the UK Division of Clinical Psychology, a sub-division of the British Psychological Society, issued a Position Statement today calling for the end of the unevidenced biomedical model implied by psychiatric diagnosis. The key message of the statement is:

“The DCP is of the view that it is timely and appropriate to affirm publicly that the current classification system as outlined in DSM and ICD, in respect of the functional psychiatric diagnoses, has significant conceptual and empirical limitations. Consequently, there is a need for a paradigm shift in relation to the experiences that these diagnoses refer to, towards a conceptual system not based on a ‘disease’ model.”

In brief, the argument is that the so-called ‘functional’ diagnoses – schizophrenia, bipolar disorder, personality disorder, ADHD and so on – are not scientifically valid categories and are often damaging in practice. The statement argues that we already have alternatives, such as psychological formulation, and that there is a need to work in partnership with service users and professional groups, including psychiatrists, in order to develop these further.

The story made the front page of one of the UK’s best-known broadsheets, the Observer, sister paper to the Guardian, and there was a double-page spread inside (“Medicine’s big new battleground: does mental illness really exist?“, and “Psychiatrists under fire in mental health battle“). Within hours, over 500 comments (and counting) had been posted online, and the articles were being re-tweeted round the world. The articles quoted me, Professor Mary Boyle (author of ‘Schizophrenia: a Scientific Delusion?’) Eleanor Longden, researcher, campaigner and survivor, and Oliver James, psychologist and journalist, in support of the call for a non-medical approach to mental distress.

Needless to say, there has been as much backlash as appreciation. Perhaps most predictably, Allen Frances, outspoken opponent of DSM-5, described the document (without having read it) as ‘extremist posturing by British Psychological Society, just as silly as DSM-5 and NIMH – why not a balanced biopsychosocial model’ (@AllenFrancesMD 12.5.13.) Many took advantage of a somewhat unhelpful online headline to dismiss the debate as inter-professional ‘turf wars’, while others accused the DCP of ignoring the role of biology.

The actual statement makes it absolutely clear that these are misrepresentations. The DCP specifically states that ‘This position should not be read as a denial of the role of biology in mediating and enabling all forms of human experience, behaviour and distress.’ The statement also explicitly says that the argument is about ways of thinking, not about particular professions. The ‘turf wars’ accusation is particularly wide of the mark given that the DCP statement is simply a more measured reiteration of recent comments by some of the world’s most eminent psychiatrists: Allen Frances himself described DSM-5 as ‘deeply flawed and scientifically unsound’, while Dr Thomas Insel, NIMH director, said ‘Patients…deserve better’. Former NIMH director Dr Steven Hyman, was even blunter: he called DSM-5 ‘totally wrong, an absolute scientific nightmare’ and in response, the Chair of the DSM-5 committee, Dr David Kupfer, admitted “We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”

The main difference – and of course it is a crucial one – between the position of these eminent psychiatrists and the DCP is that the former are determined to pursue the biomedical model at all costs. Indeed, NIMH has (as discussed on this site) announced the intention of launching a 10-year programme to pin down, once and for all, the elusive biomarkers that have evaded researchers so far. The project starts from the remarkably unscientific position of assuming what needs to be proved: in their words that ‘mental disorders are biological disorders.’ Flawed as this enterprise is, it will allow traditionalists to continue to claim that ‘We’re getting there – honestly!’ In the meantime, the overwhelming amount of evidence for psychosocial causal factors is once again relegated to a back seat.

I was a member of the DCP working party which took 2 years to arrive, painstakingly and carefully, to this consensus statement. I believe there is nothing more important that a professional body can do than speak the truth about the evidence – and that is what this statement does. Nevertheless, given the nature of the issues, it is a brave move. I hope that other organisations will take heart – as they did from the original BPS response to the DSM-5 consultations in June 2011 – and join the DCP in calling for a more humane and evidence-based approach to mental distress.

Links to BPS consultation responses on DSM-5

Society Statement on DSM-5 (12/12/2011)

The British Psychological Society Still has Concerns Over DSM-5 (6/20/2012)


  1. Hi.

    I think it’s great that this position is being taken, it rings true with a lot of my experience.

    I wonder if the way the story has come out could of been better. It’s not the most pleasant experience to have headlines that can cause confusion for us that have been given diagnosis, and in some cases accepted them. I think this is made more problematic when we can’t read what the statement is until tomorrow, thus leading to speculation and confusion.

    I say all of this with a deep respect for the message, i just think how it plays in the media is important to those diagnosed, it’s already a confusing experience.


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  2. The even bigger challenge will be how diagnosis is separated from administrative, financial, and social support systems all of which require it.
    I really look forward to the DSM/ICD bonfires but I equally don’t want to see social Darwinism.
    I don’t want to see any model dominate [including recovery], I’d like to be free to chose from anything.

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      • I’d like to answer the question you pose here. Who cares how “insurers code”? Because your question both answers, and asks, further questions. First, the DSM itself, is in fact, nothing more than a catalog of billing codes. And now, within “Obamacare”, we see, literally *70,000* “codes”. Also, those 300+ “diagnoses” in the DSM, are in fact designed to be used as excuses to $ELL DRUG$….
        So-called “psychiatry” is in fact a pseudo-science, and a drug racket, and a means of social control. It should long ago have been thrown on the scrap-heap of history, along with Phrenology. Psychiatry has done, and continues to do, far more harm than good. It causes untold and undeserved death and distress. It manufactures the very “stigma” which it then purports to “treat”. I’m not saying that there aren’t a very few, small number of truly “crazy people”, or that sometimes, some people DO “go crazy”. But, none of that justifies the massive forced incarceration and forced drugging, to say nothing of the physical restraints and Electro-Cution Torture(“ect”), which the evil lies of psychiatry promote. RSVP?_____________________
        (c)2016, Tom Clancy, Jr., *NON-fiction

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  3. @cannot

    You might have been joking with that remark…it certainly made me smile..

    More seriously rejecting the twin technologies of psychiatry and psychology for me is more about saying that their are other legitimate forms of knowledge based on what I have experienced as a human.

    Our knowledge as survivours has always been denied, ridiculed and painted as being in the same box as astrology and tea leaf reading rather than just as legitimate if not more so, than anything the professions have to say about us….

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    • Poet,

      We might have had our differences in the past, but I think that we have reason to celebrate our commonalities and everything of what has happened during the last 2 weeks. It has been exhilarating and I have to admit that I was wrong when I said that engaging the Europeans was not a good idea.

      Apparently, a lot has happened over there that is not reflected in the books/online (which is how I learn about European stuff today).

      “More seriously rejecting the twin technologies of psychiatry and psychology for me is more about saying that their are other legitimate forms of knowledge based on what I have experienced as a human.”

      Indeed. The problem is that the shrinks/psychologists had been exploiting a very cheap semantic fallacy to justify themselves, namely, that by using the language and vocabulary of “science” (even medicine with terms such as “mental illness”) they were “sciences” when it comes to science’s ability to predict outcomes (and medicine’s ability to treat diseases successfully). Now that fallacy has been destroyed (why is that the fallacy lived for so long is a different matter) and there is no way back.

      I have no problem with people engaging in the soul searching endeavors of their choice, be it those two, astrology or religion, as long as it is done voluntarily. As I have said many times, my only beef with psychiatry was and is its status as a coercive force, out of which all of its ability to inflict damage derives. It derived said status from its “perceived” status as science. Now that it has been admitted by everybody that it is not a science, I would expect it to lose it (although I am under no illusions as to how hard is going to be to deprive psychiatry from its coercive powers even with the new regime).

      “Our knowledge as survivours has always been denied, ridiculed and painted as being in the same box as astrology and tea leaf reading rather than just as legitimate if not more so, than anything the professions have to say about us”

      It is not that this is “about to change”, is that with the cataclysmic events of the last two weeks, this has already changed :D.

      If I were not so concerned with my privacy, I would have thrown today a party for my friends and neighbors to celebrate this :D.

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      • I think it’s going to be sometime before we can truly celebrate. Diagnosis being junked is not around the corner, neither is the loss of coercion, we’ve only moved a step forward and governments will not let go of social control that easily even if the battle is won elsewhere. Governments could also easily turn around and say fine, no mental illness, no problem we need not have any services then. Do you imagine they will hand over that money to survivors?! They would happily adopt a sink or swim position because here they are already dismantling the welfare state.
        The real challenge is ensuring distress is recognised and support is there, on our own terms, but all systems are enmeshed with diagnosis, separating them is not an easy task.

        Just as Thatcher’s death didn’t rid our country of right wing bastards

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        • “Just as Thatcher’s death didn’t rid our country of right wing bastards”

          Watch your language. There are many proud conservatives here for whom Thatcher and Reagan represent the best politicians can be.

          As I have said previously, I think that denigrating those of us who can be described as “conservative” is not the way to go for MIA.

          It will take time, but there is no way back. And as I said, I am under now illusions about how hard it is going to be. That said, for the very first time in a long time I have reasons to be hopeful. A lawsuit challenging one of the many unfair decisions made over the years based on the “scientific validity” of psychiatry would be my next move if I had the economic resources to pull it off (we are talking probably millions of dollars here).

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          • I think that denigrating those of us who can be described as “conservative” is not the way to go for MIA.

            I didn’t denigrate you, I didn’t denigrated our former PM and current government, as a British citizen I’m allowed to do that

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          • Correct me if I am wrong, but with “bastards” in “Just as Thatcher’s death didn’t rid our country of right wing bastards”, you were referring to those British citizens who vote Tory, I am wrong? It is one thing to express some political opinions, quite another to call “bastard” all those who disagree with you. Thatcher won all her elections cleanly, so there must be many “bastards” in the UK.

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          • ….ah, the wounded ego of a self-identified “conservative”….
            ….at least now you know how WE feel, when we’re labelled with some imaginary “mental illness” “diagnosis”, pulled from that catalog of billing codes known as the DSM….
            Both “conservative”, and “liberal”, are arbitrary, imaginary delusions, obsolete, and archaic, and perpetuated by a system of mass, induced delusion by the money-and-political power elites.
            Feel free to call whatever you will. But don’t call me “wrong”, or else you will be wrong, too. Right?
            (c)2016, Tom Clancy, Jr., *NON-fiction

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    • All I am saying is that the fight against psychiatry is a common cause. You might not want to hear this, but Thatcher saved the UK from becoming Greece. All the economic indicators in the UK when she arrived to power support that contention.

      Capitalism has raised more people from poverty than any other political system in the world even if along the way there are some difficult economic situations that arise. This is not even a theoretical question anymore. Germany an Korea provided the rare opportunity of testing the hypothesis controlling for everything else (culture, ethnicity, language, etc). While West Germany and South Korea flourished, communism brought East Germany and North Korea to the ground. Had it not been for Thatcher, the UK would be making “Greece type” of news.

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      • No she did not, she privatised everything and paved the path for banks and corporations to be bailed out and subsidised by the poor. She decimated communities, cosied up to dictators such as Pinochet and supported Aparthied calling Mandela a “terrorist” because of her sons “interest” there.She sold off social housing so that NOW we have a housing crisis, I could go on and on and on but I’m not going to debate my countries political history with you.You can be conservative in your country, that’s your business and I won’t attack you for it but it’s shocking you fail to see how capitalism is a cause of mental distress and poverty. So you don’t see the political causations of distress at all?
        I’m guessing you have full health insurance..

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      • I don’t want to debate Thatcher, Capitalism and it’s benefits and downsides at this moment. I will say I have very different views and when I want to debate them can give different interpretaions from you and quote other evidence.

        I do however want to point out that on the one hand you’re saying stick to the cause – ie critiques of psychiatry – on the other you’re giving biased political opinion on Thatcher and Capitalism.

        It think you’re contradicting yourself.

        I think that really effective coalition builders allow differences of opinion and viewpoint, including political opinions, in those they wish to find common ground with.

        I’ve worked with UK conservatives and Anarcho-Socialists on this issue. That can be very hard work, to explain my point of view, listen to the others very different point of view and then see if there is enough common ground to work together on the issue at hand.

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  4. Our current political masters are making her dream a reality right now. There were things she couldn’t do then which they are doing now such as destroying our NHS and welfare state and you don’t know what these things mean to British people and how UK survivors are suffering because of it

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  5. These two men have done more for our movement than any others:

    1) Dr. Thomas Szasz
    2) Dr. Peter Breggin

    Both conservative.
    Dr Szasz, with libertarian views; Dr. Breggin, a patriotic soul.

    Toss conservatives under the bus, and this movement will fail.
    I may not know much, but this much I do know:

    We need a big tent.
    We need to practice what we preach, namely becoming a more diverse group – including politically.


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    • Szasz isn’t worshipped here because of his social Darwinism and Scientology links.

      So you need right wing politics for your movement to survive?
      So you all have good health insurance, jobs and homes then because from programmes I’ve seen here your poor do not do well

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      • Joanna,

        I understand where you are coming from but what has happened during the last two weeks is that the NIMH, the APA (in its response to the NIMH) and the DCP have all adopted the talking points that were pioneered by Thomas Szasz.

        As Szasz explained several times, he was not a Scientologist (in fact he was an atheist). The only reason he founded CCHR with Scientology is because he understood very well that unless psychiatry was confronted with the type of power Scientology has, the fight against it would not have been successful. It would have been great if other Churches/institutions would have joined, but the all rebuffed Szasz. CCHR won some battles and lost some others, but there is no question that the type of PR battles they engaged in, against Prozac for instance, served our movement well.

        If there is an afterlife he must be having a great smile in his face now :D.

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      • Joanna,

        *All* I’m saying is that for our movement to thrive, we will need to be *diverse* – in many ways. This is a comment I’ve made more than once on this site.

        We will need people from many walks of life; many different spiritual/religious beliefs. We claim to want to celebrate *diversity*. So, let’s practice some.


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    • I agree, particularly when it comes to Thomas Szasz, who was Peter Breggin’s mentor and who put his reputation and livelihood in the line and never gave up.

      Individual freedom is a core conservative value. What boggles my mind though is how easily right wing politicians have fallen to the psychiatric scam as the “easy answer” to problems such as gun violence. Are these people aware that under the DSM-5 regime, psychiatry could be used as a proxy to take away guns from people deemed “too mad” to own them?

      Not everybody has fallen to the scam though. Although in very subtle ways, Bill O’Reilly has repeatedly (enough as to make valid inferences) rejected calls by several of his guests including somebody I used to respect a lot until I learned of his past life as psychiatrist, Charles Krauthammer, to lower the standard for civil commitment.

      He has said repeatedly things such as “in a free society you cannot do that”. I don’t know what is the reason of him having those views, but it is clear that he has not been fooled by psychiatry. Given that O’Reilly is the highest rated TV personality in cable news, it’s a good ally to have :D.

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        • “really?! I find it really easy to understand”

          Why? And this is not a joke. I am looking for a serious answer. At least in the US, the right is associated with “individual freedom” opposed to the tyranny of “big government”. I don’t want to get into an angry dispute, but what I always found odd is those opposing psychiatry from the “left” since “big government” intrusion into people’s privacy is a core “left” value, at least in the US.

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          • No, big government isn’t at the core of “left” thinking, actually we have no left now, all parties are right leaning. Survivors don’t do well under capitalism, only being valued by their economic productivity doesn’t suit many mad people well.
            I didn’t appreciate how conservative politics are a part of American activism, and how revered Szasz is. It’s a bit different here, he’s definately referred to by recovery activists who don’t support people using services/taking meds/being in receipt of welfare, but in other areas of activism he is not as highly regarded. I’ll be mindful of those differences.

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          • I see. Here in the US, left = “big government”, which is why I always found odd that people who defend “big government” then go and oppose psychiatry, which is the poster example of “big government” interfering in individual’s lives “for their own good”.

            In any case, I think that it is better to leave politics aside, this cause is something that unites left and right since psychiatry has been, for the most part, an “equal opportunity basher” :D.

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          • I’ve said this numerious times and will state it again. Neither the Left nor the Right in American government is a friend to psychiatric survivors. Both groups are trying to throw us under the bus at this very moment. I do not trust any politician at this point in time since most of them are in the business to feather their own next in some way, rather than to see that their constituents are taken care of properly.

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    • Thank you Duane. Agree about the big tent. The conservative issue just came up at Peter Breggin’s conference last month. He made the point that there had been many times, including recently, when more liberal-leaning press were not as supportive as conservative press. People are concerned across the spectrum, and not concerned across the spectrum too. And harm is done on both sides of the political aisle.

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  6. @Cannot

    Our differences are informed by our differing political starting points but I agree, we agree about a lot. I change my mind about things all the time as well….

    I agree it’s all about power and the legitimacy of the power that “psychiatry” wields. I’ve no interest in out Doctoring Doctors. Psychiatrists know full well the gap between what they do and other doctors. The extent to which they deny the size of that gap varies from psychiatrist to psychiatrist.

    Psychologists and psychiatrists can fight each other to a standstill and do wage semantic battles to capture our hearts and souls…in my case they needn’t bother….of course these debates are important on one level, and we know that, which is why we take an interest.

    I’m not so confident that any of this will have much of an impact on the way people experience the mental health system in anything like the immediate future…

    The everyday reality for people is far removed from these debates….

    A press release and an article in the Gaurdian isn’t going to get anyone a decent place to live and enough money to live on…

    I’d certainly come to your party but I’d be the grumpy person in the corner putting a damper on things…. 🙂

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        • I think in the political climate in the UK (and large parts of the world) where benefits and services are being eroded, rents are rising, wages stagnating and unemployment rising and where services patch people up, put them on drugs and send them back to thier grotty bedsits it will make little difference.

          But I also think that over a longer term the fact that such a large professinal body as the UK Clincal Psychologists are prepared to loudly say that diagnosis is pants is a significant step. It opens the door to a wider range of people looking at how people with extreme mental distress are treated.

          What the Clinical Psychologists are saying is that the alternative to diagnosis is to see people as having thoughts, feelings, life stories, attitudes and social contexts.

          It’s got a lot of coverage, it will probably get a lot more. They’ve been working on it for a long time and are likley to continue to do so. Other professional groups are more likely to take this on.

          I take on board the point that survivors points of view should be validated. Uncritically cow-towing to any profession would be a silly idea. However I think this can be used by survivor activists to challange pschiatric institutions and to break down predjudice against those who are diagnosed.

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  7. @ The(not-so inarticulate)poet

    I always enjoy your comments, because you force me to come out of my comfort zone, and learn something new. Thank you.

    @ Joanna

    I appreciate your passion. Sometimes, I wish people were more honest and expressed how they really feel like you do. The world would be a better place for it.

    @ Cannot

    I often feel part of a (political and religious) minority on this site, but not all-alone thanks to many of your comments.

    And hey, I’m celebrating what’s taken place these past couple of weeks!


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    • Thanks Duane, not everyone appreciates my raw honesty and passion, but I really appreciate anyone who will hear me out and not run a mile or throw me in the bin!

      May I share some memories of difference with you?

      I always remember many many years ago attending a notorious relatives group – let’s say they were at the mafia end of the spectrum. Also, a very medically minded survivor group. I went there because although I knew our views would be different I wanted to understand them. At the relatives group I was the antichrist. Literally, if anyone had possessed holy water I’m sure it would have been thrown at me. They had a member of their medico-legal committee visit and she made the mistake of attacking a respected survivor group [Survivors Speak Out] and so I did er take her to task shall we say. I found myself stalked for a few conferences and this person would jump up every time after I’d spoken and shriek that I was telling people to stop taking their meds! I never did that, so it was easy to counter but it became somewhat comical because the audience would answer for me, ‘oh no she didn’t’, it was like Punch & Judy.
      I attended one of their meetings where a prominent psychiatrist was talking about the latest “genetic find” [complete bollocks of course] and it was an extraordinary experience, they hissed as I entered the room. I sat down and listened to the presentation and noticed pamphlets given this psychiatrist ran a ‘genetic counselling clinic’ it made my hair stand on end. I said to her, ‘so were talking eugenics then? She coolly replied ‘well it has to be discussed’.
      One of the women associated with the relatives group made the effort to get to know me, and I her. We had very different views but respected of each other that they were deeply considered and no knee jerk. We became friends, and it amused us both as the relatives looked upon us shocked.

      Now the very medically biased survivor group looked frankly scared when I walked into one of their meetings and asked me whether I was there to ‘convert them’ to non-medical thinking. I assured them I wasn’t there to convert them but was a fellow survivor wanting to see their work. They relaxed and accepted me.

      The point is – I learnt a lot from the difference.

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      • @ Joanna,

        I really do appreciate raw honesty and passion. And like you, I too have learned from folks who did not share my views.

        I think it would be a boring world if we all shared the exact same philosophies, outlooks, etc. And we wouldn’t learn much either.

        Thanks for being part of MiA!


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    • “I often feel part of a (political and religious) minority on this site, but not all-alone thanks to many of your comments.”

      Yeah, but that’s because many of our fellow conservatives/Christians have forgotten about their values. It is different, in a complete different context, from RINO politicians dominating the GOP agenda.

      Take the issue of gun control for instance. I will never understand people like Ann Coulter viciously defending giving psychiatrists the ultimate decision as to who should be allowed to own guns when the fact is that under the DSM-5 regime, up to 50% of Americans will be eligible for a “label” and the majority of psychiatrists (if they follow the trends of the AMA) are left leaning. Certainly, Allen Frances is.

      With all this said, if lowering the standard of civil commitment, or making it easier to force psychiatry into its victims, ever became part of the GOP platform (it’s unlikely because of the libertarians/Koch brothers in the party), I am willing to betray the rest of my conservative values and vote Democratic. A party that is willing to adopt an “Inquisition” type of ideology is one that has renounced its belief in individual freedom. I’d have to find a different home.

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      • @ Cannotsay,

        I often read your comments and quietly smile, because we have so much in common politically and spiritually.

        The Constitution of the United States, particularly the 1st, 8th and 14th amendments are pretty easy to understand.

        *No person* is to be denied liberty or property without due process. *No person*. And that pertains to an individual charged with a crime. Surely, the same rights apply to someone who is having a reaction to an over-the-counter or prescription drug; or someone who has not slept in a few days, for whatever reason; or one who has been traumatized and is in emotional distress. Those things are not even crimes.

        When it comes to civil rights for people who have been diagnosed with “mental” illness, the left has it wrong; so does the right. I think it will take persuading both sides, with a coalition that is comprised of people from all political stripes.


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        • 😀

          Something tells me that you felt “alone” in the middle of an admittedly “left leaning” readership until I arrived here :D.

          I agree with your last point. And in fact, many conservatives would also agree with us if they only knew how evil psychiatry is.

          I don’t know if you watch The Factor, but if you do, you must have noticed that Bill O’Reilly has repeatedly rejected the notion of lowering the standard for civil commitment to some of his guests that suggested otherwise, especially in the aftermath of Newtown. When he first did it, I thought it was just some quick reaction to something he didn’t have strong feelings about. But he’s done it repeatedly, going as far as saying something like “in this country you cannot lock in somebody just because he is a weirdo” (the ugly reality is that abuses do happen but it has been refreshing watching him repeat the point so many times).

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          • As a fellow conservative, I agree.

            If other conservatives really understood what this masquerade called psychiatric treatment was all about, they would be outraged.

            In fairness, I think there would be those on the left as well. I have to believe that many care deeply about their fellow human beings, and have been duped.

            I think most good and decent people want to make this a better place to live. We just differ on *how* to do so.


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          • “In fairness, I think there would be those on the left as well. I have to believe that many care deeply about their fellow human beings, and have been duped.”

            Agree with that appreciation. In fact, I was as guilty as the next person of believing that there was “truth” behind the psychiatric propaganda. All that changed when I was forced into psychiatry.

            When the first polemics about DSM-5 began to gain traction, I always had the impression that it would be a cataclysmic event.

            As long as Big Pharma bribed psychiatrists attempted to target just a minority of people, there was a delicate balance that allowed psychiatrists and Big Pharma to make money and government to exercise control. DSM-5 committee members got greedy and thought they could get away with labeling up to 50% of the American people as “mentally ill”, with all the implication that such labeling has in day to day life. Their greed was their undoing.

            And now there is no way back. After what has happened during the last 2 weeks, I don’t see how they can recover from having the NIMH, the APA and now the British clinical psychologists all agreeing that the DSM is not scientifically valid. Time to celebrate :D.

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          • @ CannotSay,

            I think there would be *overwhelming* support from *all kinds* of groups if people rally knew what was taking place.

            IMO, church groups (including rabbis, ministers, priests, clerics; and military veterans and their families, would be delighted to support this movement if they only knew more about it.

            We have yet to *invite* more people to the cause – people from *all* political persuasions!


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  8. ps the pamphlet title I forgot to say said ‘aborting affected feotuses’.
    I managed to get thrown out of a Mind day centre a long time ago on the grounds that I was mad, no kidding.
    The users of the centre invited me to organise an event with them which I did, then they invited me back when the managers of the centre had organised a talk [they didn’t want] on ECT by a consultant psychiatrist. I’d just read Breggin’s book so used his thinking and evidence to counter the psychiatrists arguments, and if I say so myself, I was on form that day. The survivors were very pleased with the discussion but the psychiatrist was so incensed I’m told when he left the centre he was stomping and complained to the managers who decided that such a thorough critique of his presentation could only come from someone who was quite disturbed and mad, so they banned me from returning.

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  9. Made me smile;

    Diagnostic Criteria for DSM-IV½

    401.10 Bad Hair Day

    A pervasive pattern of distorted thinking, self-pity and sensitivity to stimuli lasting at least four hours after time for getting out of bed.
    BHD indicated by at least five (or more) of the following within a two-hour period:
    Wakes up with difficulty
    Does not recognize bedroom or other rooms or dwelling.
    Gets out of wrong side of bed due to mystery lump under the duvet.
    Finds is still wearing clothes worn yesterday.
    Can’t be bothered to shave / shower / shampoo / use deodorant.
    Cuts self when shaving face or legs.
    Wears clothing retrieved from laundry basket.
    Colour combinations appear vile to self or others …

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    • I like the Bad Hair Day diagnosis!! We need to keep our sense of humor here.

      Another good one Dr. Paula Caplan, Psychologist, made up for those VOTING in the bogus DSM disorders was “delusional dominating disorder!” Love it!

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  10. this is an interesting comment I’ve copied from the Guardian because it touches on the UK and the US on some of the issues I have raised:

    Look into the origins of the biopsychosocial model of illness & its use by Unum in the US to deny disability claims; how the UK government (Labour, at the time) bought in Unum to set up what are now called the Work Capability Assessments that are administered by ATOS. Unum’s behaviour and denial of illnesses & disabilities, with no goal other than to avoid paying out on health insurance claims, has led to it being declared “an outlaw company” in some US states & to being banned from operating in some countries (like New Zealand).

    DSM-5 has been, as I understand it, strongly influenced by such. In the same way that the Coalition is still influenced by what used to be called UnumProvident Centre for Psychosocial and Disability Research at Cardiff University but has since dropped the “UnumProvident” bit of the name. It determines that some disabilities that have been shown by tests & studies (for example, functional MRI scans of people with and without the various diabilities) to be neurological in origin or to be caused by a disruption of/in the Central Nervous System are a learned behaviour, a personal choice, or, to put it another way “all in the mind”.

    Do a websearch for “biopsychosocial model of illness unum”, or have a look at this sample of links:

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  11. Thanks John.

    At the same time as the BPS statement there are also psychologists wanting to take on the role of the AMHP and psychiatrists who would be more than happy for them to do so as that breaks down the ‘you don’t do the hard stuff’ line of argument. We need psychologists to resist the temptation to do that work.

    It’s interesting how survivors who were binned in the old style asylums and the modern brightly lit rabbit hutches in general hospitals will often say how much they preferred the old style. Put aside the horror of medication for one moment, what was appreciated was the space to be solitary and hide out in corners, and the grounds to walk in. Also the need at times to not be at home and in a different environment and to be relieved of every day pressures. Something the survivor movement in the UK really wanted was access to non-medical asylum but we remain a long way from that. The few alternatives to admission get hijacked by health and the few non-residential survivor-led services have seen their funding cut even though they work.

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      • I had a friend in one of those old style asylums in 1977. He was 18. The drugs were awful and he thought the charge nurse was a bit of a tyrant. But he made some friends, which is often what people say is the best bit about being in hospital.

        When me and my other freinds visited we walked the extensive grounds together. It seemed much easier to find rest and take time to get to know other patients in those extensive grounds than in the modern hospital.

        I’d hate it if psychologists start being able to section people. They are often too close to psychiatrists anyway. I hope this statement makes the ones who collaborate rethink thier position.

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  12. Lucy, thank you for speaking up and out to support alternative and humanizing perspectives on emotional distress and mental health challenges. I am encouraged by the DCP’s move. And the press it is garnering. We have professional groups in the US trying the challenge the medical model as well, but their voices seem to get lost in the din and the dazzle of new frontiers of brain research.

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  13. The paradigm shift is needed because so many companies have already been proving that influences subtler than medication can have a healthier effect on brain patterns. Technologies that transform harmonious brainwaves into sounds (e.g. from prove that reflecting back people’s inner harmony is extremely healthy. Conversely, social experiences that focus on and reflect back people’s presumed inner disharmony are thus unhealthy. So, focusing so much on diagnoses of mental disorder creates a mentally unhealthy social experience. This is why using the DSM as a cornerstone isn’t effective treatment!

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  14. I’m a trainee psychiatrist working in England. Having read the statement, I find little to disagree with, and I think that the action points are fairly uncontroversial. At the same time, I still think diagnoses are useful, despite their flaws and limitations (some more than others).

    I am quite explicit in discussions with my patients* that the diagnoses we use are based on collections of thoughts, feelings, behaviours, and biological symptoms (that for the sake of convenience we group together as symptoms) that it has been noticed sometimes are grouped together, and that they are mainly a way of looking at things which is useful in terms of making an educated guess at what treatment (which may be medication, psychological therapy or social interventions) may be most useful. From reading some of your previous notes I can see you would disagree with my view that they are useful, but you must acknowledge that there are arguments in favour of their utility and validity (which I’m sure you have heard before, sometimes from psychologists).

    I’m quite curious that you said the statement was “calling for the end of the unevidenced biomedical model”, as the phrase “paradigm shift” used in the document seems slightly more equivocal, and the action points seem far less dramatic. Are you of the opinion that the document shouuld have included a point saying something of the lines of “there should be a campaign by the DCP for psychiatrists to abandon diagnoses altogether”? And if so why was there not such a statement?

    *(I am aware that many readers may dislike the term patient, but I won’t dishonestly pretend not to use the word for the sake of an online forum- the arguments over terminology have been done to death!)

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  15. Thanks to everyone for your supportive comments. I am sorry to be late in replying. The debate has taken off in a big way and life has been very busy. In answer to the last commentator: you’re right, I don’t think diagnosis has a role (with obvious exceptions like dementia in which biological causes are established). As a psychologist I prefer formulation as a means of helping people to feel understood, deciding on the best way forward (I wouldn’t use the word ‘treatment’) etc. But there are many other ways of achieving the same ends – the general principles are about listening to people’s stories, constructing meaning, and finding paths to recovery. And it wasn’t up to us in the DCP to call for psychiatrists to abandon dx – we can only establish a position for our own profession.

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