‘We’re Not Buying It!” — Survey on Emotional Distress and Diagnosis Reveals Mistrust of Psychiatric Labeling

Lois Holzman, PhD

It’s been a little over one year since the Survey on Emotional Distress and Mental Health Diagnosis was launched online.

The survey was designed by the East Side Institute, an organization with a long-standing opposition to the individualized model of human development and the medicalized understanding of emotionality.

Very few public opinion polls on mental health issues have been conducted, and those that do exist are “forced choice” and presuppose an illness model. We at the East Side Institute wanted people to get the opportunity to reflect on and socialize their thoughts about the medical-mental illness-diagnostic model and its impact on their lives. And that is what they did! We have results from over 1000 surveys — mostly from across the US, but 33 other countries are also represented — and they’re quite revealing. Despite being bombarded with medical-mental illness-diagnostic propaganda, people are skeptical of the model. Their concerns ranged from pragmatic to ethical, from philosophical to political.

I recently completed a draft paper summarizing and discussing the survey results for a special issue of a journal dedicated to the growing movement to develop alternatives to the current diagnostic system in psychiatry and clinical psychology. Here’s a sneak preview of what a thousand people told us. (Lesson: if you ask people to tell you what they think — without telling them how they should think — they’ll tell you!).

  • Despite the fact that emotional distress is presented as diagnosable illness by nearly every institution and professional people have contact with, most of them are not buying it. At best, diagnosis is a necessary evil, required under the current system in order to have the possibility of getting some help. At worst, it is stigmatizing, limiting of possibilities, isolating and potentially physically harmful.
  • There was significant awareness of the corruption of mental health services by pharmaceutical companies and, more broadly, the politics of a medicalized mental health system.
  • The idea that emotional distress is caused by chemical imbalance or brain disorder was soundly rejected. The popularization of neuroscience research seems bogus to some and to others a denial of mind-body holism and human relationality. Neither view dampers the interest people have in the notion that the brain plays a role in our emotionality.
  • Sociality and mind-body unity were also apparent in the responses to how to help people in emotional distress. Talking to people, being listened to, and therapy were most frequent. Social activities of many kinds, as well as yoga and meditation, were also common responses.
  • There was an understanding of and appreciation for the impact of diagnosis on mental health professionals. Some people were critical and some were sympathetic of the predicament professionals face—having to work with a model that distorts the people in front of you and is impossible to “get right” but, nevertheless, being influenced to see and relate to people in terms of that model.
  • People encouraged more surveys and conversations like these. 48% of survey takers asked to be contacted for further conversation.
  • People were appreciative of being included in the ongoing debate over diagnosis and alternatives to it. They wanted their voices heard — with 87% of survey takers having something to tell the professionals directly.

For more information or to get a copy of earlier reports on this survey, visit loisholzman.org, or email me at [email protected].


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


  1. Thank you for reporting this, Lois. It feels good to see this perspective put in such concrete and clear terms. I think that’s a powerful collective voice.

    This struck me in particular, been sitting with this to see what occurred to me–

    “There was an understanding of and appreciation for the impact of diagnosis on mental health professionals. Some people were critical and some were sympathetic of the predicament professionals face—having to work with a model that distorts the people in front of you and is impossible to “get right” but, nevertheless, being influenced to see and relate to people in terms of that model.”

    Feels like a loud call for a shift, with this ‘model’ creating such personal inner conflict and struggle. That seems flagrantly paradoxical to me, to have a personally traumatic and double-binding system which is supposed to help people heal from trauma and inner conflict!

    While empathizing with those caught in this double-bind, still, the fact that we know that the currently *required* perspective distorts people (and how does that help people find balance, truth, and their sense of self? How ironic and self-defeating is that??), certainly is a loud wake up call for something radically new–at least, to protest this impossible task which leads to harm to others through distorted (stigmatizing) perspectives.

    I’ve been there, in a professional sense, and I found it unacceptable, so I called it out, faced the consequences which was the process which led to my clarity and vindication of justice, and moved on wholly intact, with more life education under my belt. And in the process, many changes occurred within me, and also in the environments which I challenged.

    So I can, indeed, have empathy and feel compassion for professionals caught in the middle. But my respect goes up tremendously when someone casts their fate to the wind in the name of truth and justice and takes a bold stand with courage and trust in the process.

    I’ve experienced this on both sides, as client and professional, and the client is at way more of a disadvantage when the professional is double-bound by the system. The client ends up suffering from this–via scapegoating and being subject to the whim of that socially imposed power differential–so my greater empathy is with the client.

    Although, sure, everyone has their challenges in the system, which is why this entire things need to change into something without that particular dilemma. Then, we might see some actual healing and social change happening.

    Thank you again, the information you reported here has been very helpful to my own process and personal clarity.

    • In other words, you can’t please everyone. It’s either the system or the client. In reality, the two are quite incompatible, to my mind. There should be no more riding the fence, as this is what causes the clinician to be split, and that trickles down to the client, it’s inevitable.

      This is why I say this field has become all cognitive dissonance, exactly what you say here. Why should there be a conflict here? The clinician is not an arbiter, that does not work. They will always side with the system, unless they have the courage to face the consequences of dissidence. Then, they will be good example of personal freedom, rather than shackled to the system from oppressive fear. Isn’t that what we all want, personal freedom? If that is not universal, then I’m in the wrong universe!

  2. Someone who has survived the middle-class family and who does not accept its abuses, will never be able to have anything like a normative identity. So of course they will feel emotional distress because they lack social legitimacy and we are persecuted in every corner.

    So they we at great risk of falling prey to the additional abuses of psychiatry and psychotherapy.

    So the remedy for this is for we survivors to stand up, organize, and start fighting for some concrete goals.

    We must reject all psychiatry, psychotherapy, and the premises which underlie evangelical region and recovery.


  3. This is the truth for me: No one is going to be there to help you! A lot of people don’t understand that but their circumstances are different from me. I have a great supporters. That being said even my supporters can’t help me when I’m sick.

    Some are usually afraid and probably with good reason. A lot of people can’t understand that either. I can’t stay home and I can’t go to family or to be with friends. The only thing I can do is go to a hospital. I would go to a peer respite, but there is not one near me. Thankfully I don’t get sick that often these days.

    An organization that is recovery oriented with staff trained in this philosophy is with certainty the better option. It can make a world of difference. Organizations like the Recovery Innovations comes to mind.

    ~ Pat

  4. So lots of people are actually opposed to the medical/disease/diagnosis models? You want an alternative to the current diagnostic system (the DSM) in psychiatry and psychology? Then we need a new model. Simple as that. And there already exists the exact model that should be used. It’s called the psyche model.

    Psychology and psychiatry both (supposedly) study the psyche, the Greek word for mind, soul, and spirit. That’s where the names of the professions come from. However neither profession currently knows how the psyche (the mind) itself functions. This has resulted in completely wrong theories being promoted and accepted, namely the biological/medical/disease models promoted by psychiatry. As most people on MiA are aware, the biological, medical, and disease models used by psychiatry to explain ‘mental illness’ are wrong, because ‘mental illness’ is not a real biological illness or brain disease.

    We need to drop the flawed biological, medical, and disease models currently used by the psychiatric/pharmaceutical/mental health industry. Start using the psyche model. A copy of The Map of the Psyche: The Truth of Mental Illness, which explains how the psyche model functions and what ‘mental illness’ really is as it relates to the psyche, is available here (http://s000.tinyupload.com/?file_id=15608219692732934858)

    In the interest of disclosure and transparency, I’m the author of The Map of the Psyche and creator of the psyche model. I give permission to freely download a copy of my book/theory. The psyche model, the alternative to biological psychiatry and the medical/disease model, is available. Use it.

      • What are you trying to figure out about the “psyche” that hasn’t yet been recognized?

        Ummm the whole thing? I tried to figure out how the psyche itself functions because there is no current model of how the psyche/mind functions. So what part of the psyche has not yet been recognized? The whole part? Sure they have a number of different theories to explain how certain aspects of the psyche functions (emotions, personality, etc), but currently there is no single model that unifies all the other theories. So currently psychology is just a bunch of separate theories to explain separate psychological concepts, but there is no theory/model to combine them all into a single design. If you think there already is a theory/model to explain how the psyche/mind functions as a whole, please post it.

        So to answer your question again, I’ve figured out how the psyche as a whole functions because currently the psyche as a singular theory/model has not yet been recognized.

        For what purpose or in pursuit of what ends?

        Do you really need to ask that oldhead? After all your comments on MiA surely you would be one of the people open to such a theory. Why and for what purpose? Look at the current mental health system, based on biological psychiatry, the medical/disease models, the DSM, forced drugging, chemical imbalance theories and other nonsense. Surely you know how harmful the current system is and how flawed the current models are. To get rid of the current system we need another one to replace it. To discard the medical/disease models we need another model to replace it. Psychology and psychiatry, by definition of their own professional names, both (supposedly) study the psyche, but since there is no model (other than my own) to explain how the psyche functions other theories have been used, mostly biological/brain based theories, which as we know, are flawed and in many cases flat out wrong. So the purpose of my theory is to replace the current harmful system with a model that is more accurate, easier to use and understand, and respects individual difference.

        But you know oldhead, continue to dismiss something that you’ve not read and know nothing about.

        • Any comments on the work of Dr Berezin who publishes on this site Ragnarok? Just interested coz I personally get a lot of what he is saying about ‘mind’ (though I think more in terms of a three ringed circus rather than a single stage where psyche is played out)

        • To get rid of the current system we need another one to replace it.

          Aha, the crux of the issue. To get rid of the system we need to expose it in the public eye, abolish forced “treatment,” and watch it wither away. You don’t need a “replacement” for something with no valid reason for existence in the first place.

          • why do you want to “know how the psyche functions”? Seriously oldhead? That’s like asking a mechanic “why do you want to know how an engine functions?” or asking a neuroscientist “why do you want to know how the brain functions?”. Ummm cause it’s kind of their job? That’s what they do! The professions of psych-ology and psych-iatry even have the word psyche (minus the e) in their names.

            oldhead, your argument that we need only expose the current system but do not need anything to replace it is like saying we need to discard the flat earth theory because that’s a lie but refusing to accept a replacement model. You’re basically saying we know what it’s not, but we don’t want to know what it is. That’s crazy.

            Also, I dunno if you noticed, but you’re posting regularly on a website almost completely dedicated to the mind. The site is called Mad in America, and madness affects the mind. The majority of posters (not commenters) are licensed psychologists or psychiatrists. That’s psych-ologists and psych-iatrists. We are talking about things such as legislation (Murphy Bill) that dictates what rights or freedoms a person may have based on the subjective labels regarding a persons mental state (state of mind), or what is called ‘mental illness’. We are talking about trying to expose and remove a profession that has immense power over others which is derived from them being able to subjectively label people as ‘mentally ill’ while claiming it is a real illness/disease that is biologically based (which there is no evidence to support) and needs a medical treatment (which the drugs cause far more harm than good).

            oldhead, you go back to your “we know what it’s not, but we don’t want to know what it is” mentality, and I’ll stick with my curious nature of wanting to know how things work.

          • And I still don’t know what you’re trying to figure out that isn’t already known, and why. A car has a useful function, so it makes sense to know how to maintain it. Not so for psychiatry; it’s primary function is repression. Do we need an “sound alternative” to fascism before we undertake to eliminate it?

          • And I still don’t know what you’re trying to figure out that isn’t already known

            The point I’m trying to make, which you seem unable to grasp, is that currently it is NOT known how the mind works, so I’m trying to figure out something that is not already known. And that argument of yours could be applied to anything, so should we stop all psychological studies (of which there are many on MiA) because its ‘already known’? Should we stop learning new things in medicine because its ‘already known’? How would we ever learn anything new? That’s a really idiotic argument. We, as humans, are constantly learning. You on the other hand sound like the old saying of “you can’t teach an oldhead new tricks”.

            A car has a useful function, so it makes sense to know how to maintain it.

            Are you saying the mind doesn’t have a useful function?

            Not so for psychiatry; it’s primary function is repression. Do we need an “sound alternative” to fascism before we undertake to eliminate it?

            My theory is based on psychology, not psychiatry. There’s a difference. You’re arguing against a theory you have not read and know nothing about. That’s just showing your arrogance and ignorance. My theory can be used to expose and help bring down psychiatry and you’re arguing against it? Psychiatry says mental illness is a real illness, my theory says its not an illness and proves it. How is that a bad thing? Trying to tear down a flawed system is a noble venture, but almost impossible when it is so deeply entrenched in so many areas (psychiatry itself, Big-Pharma, laws and legislation, government groups such as CPS etc). Good luck trying to remove such a system without something to replace it. And what do you propose for all the people caught up in the current system? You don’t want to give all those people needing help an alternative to the current toxic system? Tear down psychiatry and just leave them hanging huh?

            oldhead, with your callous disregard for other humans, your blockheadedness, your arrogance and ignorance, and opposing any theory that might help bring down psychiatry, you’d make a fantastic psychiatrist yourself.

          • Wow. All that emotionalism based solely on a few questions? I would check that out if I were you.

            You know that the mind is not a “thing” but a description of an abstract process, correct?

          • Psychiatry says mental illness is a real illness, my theory says its not an illness and proves it.

            I’m sure things can always be restated in new ways, but Szasz and many others long ago disproved the possibility of “mental illness,” it’s not rocket surgery. Not to say that every fresh twist of insight doesn’t help.

      • Hi Nancy. If the Buddha mapped the mind 2600 years ago why are we not using such a mind map when it comes to psychology and psychiatry? Why is it not taught at a university level with all other psychological theories based on it? Why do we currently live in a world were the mental health system is based on medical/disease models of mental illness, where the brain or biology is blamed? Why isn’t the mental health system based on Buddha’s mind map?

        I understand your fear of potential viruses, but there is no reason why I would. It’s a pdf of a book with my name on the cover, so it wouldn’t be very smart to include a virus. Tinyurl is a standard upload site and the page itself has a link to download the pdf and a link to download the file after virus scanning it.

        I’d try to explain it but it’s far to complex with many interlocking parts. About the best I can explain it is it’s a map of the mind, and being a map of the mind it can explain what mental illness is, which isn’t an illness, but it is mental. It incorporates numerous psychological concepts such as emotions, personality traits, morals, ego, Self, persona, consciousness, and unconscious (personal and collective). The primary language used is Jungian. It references such people as Whitaker, Breggin, Ekman, Healy, Moncrieff, Rosenhan, Szasz, and lots more. I don’t remember exactly how many but I think it’s over a hundred references.

        • Regarding your question (why are we not using the mind map from 2600 years ago): I think the major reason is that these ancient understandings are cast aside as “religion” and are often ignored and assumed to be not the territory of psychology and psychiatry. It is only now (because mindfulness practice has become popular, and as a result of better access to many resources via the internet) that this information is coming out. If you take a look at the article (link I provided), you will understand how the model explains the “stream of consciousness” – the moment-by-moment manifestation of the mind-stream. By the way, I managed to download the pdf of your book – I congratulate you for all the time you would have put into it (and I also think that it may interest some people). As for me, I realized that the analysis presented is done at a conventional (relative) level. When studying the psyche, there are two levels of analyses (relative and absolute) – the article link I posted earlier explains this.

  5. I’d say that we’re looking at a pseudo-medical model when we’re talking about the so-called psychiatric medical model. Simple distress is just a part of life and not subject to psychiatric treatments. Distress that arises from unusual physical circumstances merits closer examination that may discover treatable entities, but still don’t justify pseudo-medicine’s pseudo-treatments.

  6. So this article reinforces for me that when we see “ordinary” people quoted in the media as “spokespeople for the mentally ill” it is probable that they have an unspoken interest in promoting psychiatric/pharmaceutical interests. It’s very unlikely that they are random “person in the street” comments.

    We need to learn how to defeat these pro-psychiatry arguments by, for example, demanding to know the sources of people’s “information,” and demonstrating a greater knowledge of those so-called studies than the people citing them. Most of these “volunteer” types are just repeating what they have been told and would not be able to hold their own in a formal debate.

  7. Have you seen this report? Upcoming article: Antidepressant Nightmare. Ihttp://www.jimstonefreelance.com/antidepressants.htm l understand this may not be posted due to the included link. If so, it may be a good idea to look at it privately. I also don’t know the date it was posted. “This article will be approximately 50 pages long, and extensively documented, as well as have the classified internal documents linked in a zipped folder. Expect it to post sometime in July. (that is if I am still online!)” Although, I have read most of Dr. Breggin & Dr. Healy’s books I don’t know if they have already reported these GSK confidential documents in their books.

    Thank you…..

  8. The survey appears biased to fit the motives and goals of this institute.

    People are naturally empowered by their victim-hood, not “stigmatizing, limiting of possibilities, isolating and potentially physically harmful.”

    It is people like you who make them feel like that with your corrupt validations, and make them feel ashamed of their illness.

    When you are constantly unhappy, you are sick. Happiness is health, any study will tell you that constant worry or sadness leads to physical sickness which couldn’t make this any clearer.