The DSM and the Medical Model: New Video

Steve Spiegel

Since mainstream “mental health” care directly affects the public, the public deserves an overview of the issues raised by the critics of these practices. For this reason, I have created a short video lecture titled The DSM and the Medical Model (embedded below). This summary of criticism of the medical model of mental distress is intended to fill a void in public information, and offer a sharp rebuke of psychiatry and its narrative. The video is also intended to give voice to the disenfranchised faced with the injustices of their interaction with the mental health care system. It lays bare the counterproductive nature of the medical model and the pseudoscience and elitism that support it.

I am seeking feedback on my video from the Mad in America community, with an eye toward re-editing it to give the most impact possible. I am especially interested in feedback about the social welfare paradigm that is introduced as a better, alternative narrative of mental distress. I am also interested in ideas about how to promote the video, which will be presented free to the public after editing.

Here is a brief synopsis of the issues discussed in the video:

The first section introduces the medical model of mental distress (the disease model) and the DSM that describes it. The American Psychiatric Association publishes the DSM; their narrative dominates mental health care in the US. The medical model narrative is a “classical paradigm” as introduced by Thomas Kuhn in his landmark book, The Structure of Scientific Revolutions. A classical paradigm is a complete worldview — it is difficult to challenge because terms have interrelated connotations and contexts that support the existing narrative.

Consistently, most people in my country (the US) assume that mental health is a medical issue; few can imagine mental health referring to a social welfare narrative of emotional suffering. It is unfortunate for the disenfranchised that few people understand the World Health Organization definition of mental health as a social welfare issue of “well-being.” It is also unfortunate for the disenfranchised that few people can imagine emotional suffering greater than their own, or distressful experience more distressful than their own.

Section Two follows the introduction of the medical model with an alternative narrative — it introduces a social welfare model of natural emotional suffering (or “anti-social” reactions to the suffering). The social welfare narrative adds some humanity to our understanding of mental health with a discussion of emotions as direct reflections of human experience. It makes assertions about emotions that should be obvious: emotional suffering (mental distress) is a natural reaction to distressful experiences, rather than a disease. The social welfare narrative also advocates that physical health directly affects mental health: physical sickness, allergies, nutritional deficits, fatigue, and environmental toxins can all lead to mental distress.

Section Three is an overview of criticism of the medical model of mental distress. It begins with a brief history of the DSM, psychiatry’s attempt to explain its medical model. Chronicling the history of DSM revisions exposes its political rather than scientific foundation — it simply categorizes behaviors the American Psychiatric Association considers “anti-social” and tags them as medical problems by committee vote. The video criticizes the DSM for: 1) its lack of validity, 2) its lack of reliability, 3) discounting personal histories, 4) discounting the intensity of distress, 5) ambiguous category boundaries, 6) using common symptoms for categories, 7) stigmatizing clients, 8) promoting self-fulfilling prophecies, and 9) ignoring its cultural biases.

Criticisms should probably also include psychiatry tagging their “anti-social” behaviors with medical-sounding terms (Greek or Latin) to reify them — that is, to imply a medical (biological) problem and medical insight. For example, psychiatrists imply medical insight into bedwetting by describing causation as enuresis — a Greek word for urinating! The video also admonishes psychiatry for continuing to advocate the chemical imbalance theory (logical causation for “mental disorders”) after most eminent psychiatrists have rejected it.

Besides summarizing popular criticisms of the DSM, this section also addresses the scientific absurdity of the new DSM-5 changing its definition of a “mental disorder” without comment or explanation. Nothing screams pseudoscience louder than the DSM-5 changing its obfuscated definition of a “mental disorder” without psychiatrists defending or even noticing the change!

Section Four discusses vested interests — obstacles to changing a narrative. The reality of the strong vested interests of psychiatrists and pharmaceutical company executives is exposed to daylight. Moreover, this section describes several other groups that are also heavily vested in the medical model. There are many reasons people become vested in the medical model. Psychiatrists invest a medical school education and medical school debt believing that they can alleviate human suffering while reversing psychiatry’s embarrassing history of harmful “treatments.” The vast resources of Big Pharma create a wide swath of vested interests; parents and siblings defensive about abusive behaviors are vested; some sufferers of mental distress are vested, and cultural leaders seeking to maintain privileged injustice are vested.

After describing obstacles to shifting from an erroneous disease narrative to a social welfare narrative, Section Five discusses the harm of treating a social welfare problem as a medical problem. It describes the current crisis in mental health care. The medical model is not just wrong; mental health is actually harmed by treating natural emotional suffering (or “anti-social” reactions to the suffering) as a disease — as a medical problem.

Robert Whitaker’s classic book, Anatomy of an Epidemic, documents how treating emotional suffering as a disease worsens outcomes. First, the medical model harms mental health by gaslighting emotional sufferers — by advocating that natural emotions related to real, distressful experiences are instead imaginary “mental disorders.” Secondly, the medical model harms mental health by stigmatizing emotional sufferers with a medical label that falsely implies a neurological dysfunction. Thirdly, the medical model harms mental health by promoting drug abuse; it is harmful to falsely describe psychiatric drugs as “medicines” treating a medical (biological) problem.

Lastly, the medical model harms mental health by promoting “coercive therapies.” The term “coercive therapy” is an oxymoron. Denying basic human rights to people suffering emotionally from unusually distressful experiences is absurdly cruel — it worsens outcomes, which include suicide.

The video should be edited to include how the medical model of mental distress harms the general population as well as the disenfranchised. There is a substantial economic as well as social cost for causing increased disabilities in a community. The epidemic of “mental disorders” caused by “drug therapy” for natural emotional suffering is promoting an epidemic of people needing public assistance (see Anatomy of an Epidemic); this is a staggering waste of public resources. The video should also include criticism of the medical model for promoting flagrant violations of The Convention on the Rights of Persons with Disabilities (the new, international UN human rights treaty).

The conclusion is an appeal to challenge the medical model narrative — to comfort the afflicted rather than add to their plight by ostracizing them and violating their human rights. It tries to voice the tragedy of the tremendous harm caused by erroneously considering natural emotional suffering to be a disease. Fortunately, psychiatry and its medical model narrative are now faltering under the increasing weight of their pseudoscience, elitism and harm to community mental health.

Perhaps the video should conclude with a more upbeat note? Replacing the false, disease model narrative of mental distress with the humanity of the social welfare narrative will promote a revolutionary improvement in the human social condition!

I welcome and value any comments from the MIA community before I re-edit The DSM and the Medical Model. (Please note: the annual profit from sales of psychotropic drugs was misstated, and will be edited to reflect the correct figure of 18 billion dollars.)

* * * * *

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  1. I’m glad you point out today’s psychiatric system as a gas lighting system, since that is exactly what today’s psychiatric system is, and gas lighting a person is mental abuse, not “mental health care.” “First and foremost, do no harm” is the promise all doctors made to the public, and this includes the psychiatrists. Today’s psychiatrists have hypocritically betrayed our society on a massive scale, for profit.

    I absolutely agree that the DSM and medical model harm community mental health. As Whitaker points out in “Anatomy,” the ADRs of the ADHD drugs and antidepressants were misdiagnosed as “bipolar” in epidemic proportions, especially amongst children. And today’s “bipolar” drug cocktail recommendations, especially combining the antidepressants and antipsychotics, can create the positive symptoms of “schizophrenia” via anticholinergic toxidrome poisoning. And the antipsychotics (neuroleptics), all by themselves, can create the negative symptoms of “schizophrenia” via neuroleptic induced deficit disorder. But since these psychiatric drug induced toxidrome/syndrome are not listed in the DSM as possible causes of any of the DSM disorders, these psychiatric drug induced toxidrome/syndrome are almost always misdiagnosed as one of the billable DSM disorders, since this is the only way the “mental health care professionals” can get paid. Out of sight, out of mind, right? But this is medical proof that the DSM harms the mental health of our communities, with its omission in the DSM of the medically known adverse effects of the psychiatric drugs. This means the DSM actually encourages misdiagnoses and malpractice on a grand scale.

    I agree the mainstream medical community should be distancing themselves from the psychiatric industry’s fraud. Although it was confessed to me that “the dirty little secret of the two original educated professions” is that the psychiatrists have been covering up the easily recognized iatrogenesis of the incompetent mainstream doctors and the “zipper troubles” of the religions for decades, while the psychiatrists, mainstream medical community, and religious hospitals all profiteer in the tune of billions by supporting the fraud that is psychiatry.

    And it does appear from the medical evidence that the actual primary function of today’s DSM deluded psychiatric industry is defaming, torturing, and silencing child abuse victims given that, “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012).”

    If it is true, “…the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped,” then our current pro-psychiatry government fails this moral test.

    Thank you for speaking out against the fraud of today’s DSM deluded “mental health” industry.

  2. I like the video, and I see much good in it, with reservations.

    First, “emotional suffering” is a very presumptive supposition that can cause, given coercive “relief” and intervention, much “emotional suffering”. I can tell you for a fact that it isn’t always “emotional suffering” that is being “treated”. You mention people being “anti-social” at one point. Sometimes, on the other hand, you’ve actually got “societies” that are “anti-people” in one sense or another. My point, “right behavior” isn’t always “right”.

    Then, let us lay out the cast of characters in the scenario you would oppose. When we are dealing with the medical (disease) model, the maiden in distress is the patient, the knight in shining armor is the physician (the man with a medical degree), and the villain is disease. Those mental ill health germs have been very astute in the art of keeping their colonies beyond our detection.

    The social welfare model is a little more tricky. The maiden in distress is the patient. The knight in shining armor might be said to be the state (Did I say a little more tricky? I must have been jesting.) coming to the patient’s rescue, but specifically who the villain might be is reduced to the vague term “social conditions” or “social injustice”. I sure wish we could be a little more specific, as in giving your Scrooges and Heaps names and faces.

    My problem with this scenario is that really, in both cases, a disability check or a welfare check, the government is expected to be, in some sense, an assistant in the rescue of the “distressed” patient. Out of this expectation, we get the kind of bureaucracy we’ve got going today. The question I’ve got is how do we find creative ways to engage people without adding to the problem. For example, today the mental health system is getting patients/ex-patients work within the mental health system. One could call it the mental illness system. (I do anyway.) This is the way the mental illness system grows. How do we get more people working outside of this “disability” system instead?

    You are sort of setting a psycho-dynamic approach to treatment versus a biological medical model approach. Biological psychiatry can, and does, accuse psycho-dynamic psychiatry of pseudo-science (lack of validity) and causing more harm than benefit as well. If the proof’s in the pudding, so to speak, you’re going to have people question just who actually has the pudding. Commercial interests also present a problem. There isn’t a lot of proof out there when most all of the money is going to research financed by the drug industry. I’d say, in a sense, that bureaucracy and corruption ‘go together like a horse and carriage’ in this instance.

    • Q:”How do we get more people working outside”
      Answer : a general basic income.

      Regarding ” a disability check or a welfare check” If I and others could launch a successful lawsuit against psychiatry and prove damages, we would get a check for the rest of our lives for the damage done/imprisonment without reasonable proof etc. The Government hired and licensed the quacks, they have to pay damages.

      Besides, what skills does a 20 year long mental patient have to offer an employer? What is the mental patients motivation to work when everything has been stolen, raped and beaten from them?

      • Will check this out in more depth. As with others, I don’t know why people’s suffering is some kind of mystery that needs specialized “expertise” to understand. As to the above, why is just “working” a goal — is that in the interest of the individual or the capitalist system?

        Also I TOTALLY agree that a guaranteed minimum income for EVERYBODY would resolve many of these issues, and people’s material impoverishment would not be an issue to be addressed as something involving “health.”

        • Well. “working” as a goal has got to be an improvement over “not working”, just as “broke” as a goal can’t be any sort of improvement over “loaded”. I can’t really imagine even a communist system without workers of some sort or another, and as far as robotics are concerned, don’t even let me go there.

          I’m not against a minimum guaranteed income, I’m just not necessarily for a civil suit lottery either. The workers collective, without workers though, that gives me a real conception and sustainability problem. I’d say it’s way up there with mutual support that lacks mutuality and support.

          • If people get a basic income, either they will become drug fiends with the money or work on a project they enjoy like the arts or music. Not harming anyone, because there is no reason to. I myself do volunteer work when/if I have energy.

      • Yeah, really sick of his rant/obsession about this.

        The ‘taxpayers’ are paying for a lot of evil shit, but if even a crumb drops down to those whose lives have been ruined by psychiatry, he just can’t stand it.

        If I wasn’t *disabled* before I met the shrink, I sure am now.

        And yeah. I lost *EVERYTHING*.

          • I don’t see it as my task to encourage more and more people to live on “disability” payments for as long as they may happen to live. If by not doing so, I’m making a target of myself, so be it. I think there are more sensible ways to do things than by developing an artificial invalid industry. Sooner or later, it doesn’t matter what kind of system you may be working under, with this kind of artificial invalid manufacture, sustainability is going to become an issue. If we aren’t there yet, okay. We will be there eventually.

          • Agreed, wholeheartedly, Frank. I have had a change of thinking over the past month or so. For maybe two years I felt that in my own life the absolute worst thing psych did to me was to personally abuse me. I am specifically speaking of the later events that occurred to me after age 50. This after 30 years, suddenly I had a PTSD-type reaction and I realized I had to get out.

            However, now, my thinking is that really, the bigger crime, even than that, was that all those years I was clearly not disabled, there wasn’t anything about me that definitely kept me from being unable to do the tasks necessary to do a job. My mind worked fine. I was still intelligent. I could think logically. I could walk, talk, follow directions, read, write, do math, etc. Lift things, carry stuff, all the necessary things for a job. And during that time I attended college and was a stellar student without using accommodations. Only bigotry kept me unemployed.

            And one other thing. I was kind of a klutz, one of those brainy kids who tripped over her own two feet but could do figures in her head and loved to compose music, so I was only good for some types of jobs. I needed someone to guide me to those few positions open to girl nerds, and no one was around. Bad luck.

            But that’s my change of thinking, the greater harm being the determination of “disabled” and putting thousands out of work who by all means, should not be called that, should not be seen as that, and most of all, should not experience having to see themselves as that.


          • I didn’t say that, uprising. I said thousands, not all of us. I do not think I should have been working the entire time. I believe I would have benefited from a short break, not being permanently takenn from the workforce, nor do I believe society benefited from being protected from me.

            I found it harmful to be called “dangerous,” too.

          • A lot of this conflict could be averted by discussing who defines “work,” and what activities contribute to the common good. Packaging and distributing napalm for Dow is probably remunerative work, maybe even with a pension plan, who knows? Meanwhile people working just as hard on oh, say, posting information of great import on MIA for the benefit of the world-at-large, or any other form of urgently-needed activism, would be considered by the vast so-called mainstream as doing nothing, or even presenting a public danger.

            What constitutes work cannot be measured by capitalist standards or in capitalist dollars.

            I still look forward to watching this video when I can pay close attention. In the interim I remain a partisan of the fucked-over-by-capitalism model.

    • Yeah, about “anti-social”, it isn’t at all clear what that even is. Wasn’t Whitaker called a “menace to society” by one of the chief headshrinkers? He didn’t exactly “diagnose” him but he was basically calling him anti-social. What else does “menace to society” mean? So basically we have here a talented, hard-working, well-meaning person exposing the truth for the public to see, in its own interest…and gets called anti-social by a person whose very job is supposed to be to make people’s lives better. What gives?

      Love the video in general though. Good stuff.

  3. Hi, I have read this summary and am about to view the video. So far, I am in support of what I see. I am especially in support of the “whole picture” view rather than the drug-focused view. In other words, this is a societal problem, since it is an entire society that now has this “mental illness is a sickness” viewpoint. Believe it or not, back in 1981 when I first started therapy and I first heard other patients refer to themselves as “ill” or “sick” I honestly had never heard that term used for that type of experience before. I had not had a word for it nor used one in my ordinary speech, except “going crazy,” or “ending up in a mental hospital” or something similar. Imagine my surprise! Okay, on to viewing the video! Julie Greene

  4. Okay, I watched it. I have a few things to add. First of all, I’d add your credentials into the film, so that way, viewers will know 1. Who you are and what gives you the authority to make these statements and 2. this should lead to a suggestion as to why you are concerned about the DSM. You speak well and with an authoritative tone, succinctly, clearly, authentically, and certainly with confidence. This of course will win the confidence of viewers as well.

    To ensure you retain their confidence, be sure to spell-check all the slides. I saw spelling errors, including psychiatrist, focusing (spelled focussing), ambiguous (spelled ambiguos) and I think another time psychiatrist spelled wrong, and I also took my eyes off the slides at times (plus I miss many of my own errors due to not seeing well).

    Toward the end you made the statement regarding “everyone” disliking seeing a person forced into ECT, or forced into a hospital, etc, but this isn’t actually true. Be careful with these “everyone” statements because I am guilty of such statements myself and I get knocked down whenever I make them!!!! Badly knocked down!!!! You don’t want that!! (I know someone who is dying to get her “sicko” relative forced into “treatment.” Oh, “for her own good.” Such “caring” types we wish understood that it’s not care…….)

    Other than those minor things I think this is an excellent instructive video. The slides move at a comfortable pace, not too fast, not too slow, and also, they are readable, even for me! The text is a readable font with readable colors and good contrast, too. This is so often a problem with videos for us old fogies who cannot see well anymore. I like the approach, I like the way you sum up, the way you return to the summary, the way you stick with the outline, and the way you also use the “review” format within the lesson. You never stray from the topic, and the entire piece is compact and accessible. Keep it up.

  5. All this talk of psychiatry reminds me of this quote:

    “An ideology is reluctant to believe that it was ever born, since to do so is to acknowledge that it can die . . . It would prefer to think of itself as without parentage, sprung parthenongenetically from its own seed. It is equally embarrassed by the presence of sibling ideologies, since these mark out its own finite frontiers and so delimit its sway. To view an ideology is to recognize its limits.” – Terry Eagleton (1991:58)

  6. Hi Steve,

    Here are my “live-blogged” notes made in a Word file as I was watching your excellent video:

    provide clickable links during the relevant section for references to the NIMH leaders’ statements and the British Psychological Society’s critique. Or provide brief on-screen references to books / articles / talks. I was thinking where is the backup for this claim? Many people may not wait to see references if they are coming at end of video.

    “cultural acceptance of medical model?” – questionable that most of the public accept this unquestioningly. John Read’s research shows it is not widely accepted by the public. In most countries the public favors the social welfare model, not the medical model, already. See his Youtube videos.

    May want to give more references / links on screen showing how biological / medical model framings lead to more pessimism, fear, and distancing. See my article, “Rejecting the Medications for Schizophrenia Narrative.”

    Not sure if it’s accurate to say that Freud considered psychoses a medical problem. I thought he didn’t know how to effectively treat psychoses and didn’t spend much time writing about this area. Could be mistaken. But no references for your statement given.

    You could expand on the notion “Validity is about truth of DSM” by clarifying that the question is whether DSM labels refer to discrete, “carved at the joints” entities which exist in the external world.

    “two different diagnoses from two different clinicians” – references for this? True but would be good to see data, if only brief links to articles / books. See Noel Hunter’s articles for good examples of how this can be done.

    “Manual with terrible reliability” – true but where is reference for this? Can you show the charts of how reliability has even decreased over time? See 1BoringOldMan blog for these pics.
    “Increase criticism of DSM” – can you give a few quotes from prominent critics? Both recently and in 80s/90s.

    I like Brian Koehler’s (of ISPS) quote, “The human genome did not evolve to reify DSM diagnoses.”
    – Where does it say that only clinicians can understand DSM diagnoses? I didn’t know this was in the DSM. On the other hand I haven’t read it nor would I waste my time doing so.
    “The DSM 5 totally lacks validity” – gives the quotes from Insel, Hyman, Kupfer, Frances right here. Best attacks come from the other side’s own words.

    “erroneously implies discrete boundaries” – yes, crucial criticism, and it is a deal breaker. Cannot have reliable valid categories given relativistic continua of distress which actually don’t break up into discrete concrete entities.

    Ignores harmful effect of stigmatizing – again where is reference or source for this? What studies suggest this is the case? True but give people link to read or research…
    EuroAmerican focus? Yes. Maybe mention Ethan Watters here.

    Strong vested interests – yes. I wrote about this provocatively in my article, noting how the disease model underlies psychiatrists’ supposed superiority and greater knowledge to other mental health professionals.
    18 billion in neuroleptic sales? Yes, but would be good to provide a link here in my opinion evidencing this stat.
    Perhaps give examples of how much some psychiatrists and researchers were paid to promote drugs and diagnoses. Perhaps link to website DocsforDollars etc.

    Parents being defensive about abuse. Yes, but provide support for this contention as it is contentious. Perhaps reference ACE study or John Read’s research on trauma and psychosis.

    Harmful to treat emotional suffering as a medical problem. Yes!!! But where is link to this evidence.
    Worsens outcomes? Yes, at least you mentioned Whitaker here. Also mention many references given by Sami Timimi and John Read in their online talks on Youtube.

    Agree with you not to criticize or try to write off psychiatric drugs but to promote informed consent and respect people’s right to choose to use these drugs if they think they help.

    Allen Frances was a major taker of money from drug companies, then turned around to criticize the newer DSM editors once he’d made millions of dollars from the older DSM and from drug companies. Maybe note this?

    – “flagrant coercive practices” banned by Human Rights – can you give a quote from the UN writing about this?

    Question – what type of cameria / recording software did you use?
    what type of editing program did you use to do the on-screen text and images?
    Wondering because I’m interested in producing videos myself about other mental health issues.

    Hope this is useful Steve. Take what you like and leave the rest.

    I really liked your video and think it’s a great first step. Basically I recommend to give more references, links, and further reading to defend the talk against assertions that it’s unevidenced, unsupported or nonspecific.

    Steve if you didn’t yet please join this group –

    I posted a link to your article there.

  7. Perhaps it would be good to add a bit about the notion of neuroplasticity and how brain changes are a common result of life events, including our own thoughts.

    “Purely mental activity can change the brain in physiologically significant ways. And to back up this fact we look again to the work of Dr Jeffrey Schwartz[3], who has taught OCD patients techniques to think their way out of obsessive thoughts. After exercising these thought practices, research showed that the brains of OCD patients looked no different than the brains of those who’d never had OCD. If you change your thoughts, you change your brain physically – and this is voluntary.” – Steven Slate

  8. OK. I was sailing along with this going yeah, right, ok, right, yeah, whatever…but had to make my first full stop when you started to posit that the medical model began with the DSMIII. This is erroneous. The medical model began as soon as they started referring to states of mind as “diseases.” What you are referring to is the biomedical model, i.e. the further mystification of the already linguistically absurd reification of metaphor represented by the concepts of “mental illness” AND “mental health.”

  9. “Bottom line — do you agree that capitalism is the problem, and must be replaced forthwith before any of these problems can be eliminated, or are you proposing some sort of “reforms” within the current state of rot? If the latter, what concrete form would these take, and what would be the strategy to get them implemented?”
    To quote Bob Marley, (cue Reggae beat): “I’m sick and tired of your ism schisms!”
    oldhead, if you think so-called “capitalism” will EVER be “replaced”, much less “forthwith”, then you’re medically delusional. And, isn’t there a word for folks who *pretend* to be true believers, but who actually work from within to undermine whatever it is?…. If we have to wait for capitalism to be eliminated, before we can address the very real harms psychiatry & it’s poison pills inflicts on folks, then we’ll be waiting forever. I think your comments on the video are largely irrelevant, and detract from Spiegal’s efforts here…..

    • If we have to wait for capitalism to be eliminated, before we can address the very real harms psychiatry & it’s poison pills inflicts on folks, then we’ll be waiting forever.

      Exactly. If we wait around hoping for capitalism to end we’ll be waiting forever. We need to be actively engaged in overturning it, which is the ONLY way it (or psychiatry) will end.

  10. Steve Spiegel,
    I haven’t watched the video yet, BUT I did read your description, above, and ALL the comments here. I think “oldhead” got way too political, as I noted in a comment just above. I agree more with the other comments. After I actually watch your video, I’ll come back with more better comments. I’m VERY impressed, so far! The DSM is a catalog of billing codes, but that’s ALL it is. Psychiatry is a pseudoscience, a drug racket, and a means of social control, but that’s ALL it is. Psychiatry has done, and continues to do, far more harm than good. So-called “mental illnesses” are exactly as “real” as presents from Santa Claus, but not more real.

  11. The idea that there is such a thing as mental illness is bogus. But it is also bogus to believe that problems are solved via therapy, recovery, or healing. Rather, we need to redress wrongs, to obtain justice. In the vast majority of situations it comes down to the abuses characteristic of the middle-class family. And this is redressed in court, not the therapist’s office.


  12. Love the video, and I love your social welfare model of mental distress and emotional suffering. It all rings true to me and it speaks to my experience. I especially appreciated this slate in the video, and I am shortening it here, to extract the core meaning–

    “The DSM worsens outcomes by gaslighting… stigmatizing…promoting long-term drug abuse and…coercive ‘treatments.'”

    Unfortunately, people have taken this example and are paying it forward, big time. I believe once we understand exactly how gaslighting and stigma are expressed and projected, in so many ways subtle and overt, and the devastating effects these have on individuals and communities, we will be a step closer to resolving some of these socially distressing dynamics, the polarizing issues they create for all of us, as a collective, and the always eventual catastrophic effects thereof. Problem is, it can be quite challenging to change habits of thought, belief, and social programming/brainwashing.

    I will share this video when opportunities arise. Thanks for providing such good clarity so articulately and accessibly. We needed something like this. I look forward to subsequent videos.

  13. Hi Steve, I thought the video was great! I think it’s a good length and is succinct. The visuals were good except for one beautiful abstract image which I couldn’t figure out how it fit with the narration (minor point). On first viewing I have 2 bits of feedback. 1. Would your main argument be weakened if you omitted the part at the beginning about Freud and psychodynamics? The reason I ask is that I am trying to engage a friend of mine in conversation about the ideas you present and he is a big fan of Freud. If I showed him the video it might put him off. He is very critical of mainstream medicine, though, so this predisposes him to be more open to your arguments. 2. The narrator (you?) has an even, calm tone of voice through most of the video. However, there are parts where the narrator sounds angry. I can identify! Its justified. I’m angry, too! However, it might scare some people off. It might sound a bit fanatical to some people. I wonder if these 2 bits were edited would it reach a wider audience?

  14. I’ve been using the term “medical model” and “disease model” in conversation a lot lately assuming my meaning was clear. But maybe I should not make that assumption. In their article “Fifty psychological and psychiatric terms to avoid” ( the authors argue that the term “medical model” can have many different meanings. They say:

    “Although many authors who invoke the term “medical model” presume that it refers to a single conceptualization (e.g., Mann and Himelein, 2008), it does not. Some authors insist that the term is so vague and unhelpful that we are better off without it (Meehl, 1995). Among other things, it has been wielded by various authors to mean (a) the assumption of a categorical rather than dimensional model of psychopathology; (b) an emphasis on underlying “disease” processes rather than on presenting signs and symptoms; (c) an emphasis on the biological etiology of psychopathology; (d) an emphasis on pathology rather than on health; (e) the assumption that mental disorders are better treated by medications and other somatic therapies than by psychotherapy; (f) the assumption that mental disorders are better treated by physicians than by psychologists; or (g) the belief that mentally ill individuals who engage in irresponsible behavior are not fully responsible for such behavior (see Blaney, 1975, 2015, for discussions). Similar semantic and conceptual ambiguities bedevil the term “disease model” when applied to addictions and most other psychological conditions (e.g., Graham, 2013).”

    I don’t want to take away from your excellent video, Steve. However, I’m not sure, now, what term to use when trying to explain my concerns about the DSM, psychiatry and Big Pharma. Maybe it’s still ok to use the term “medical model” and have it mean all those things from (a) to (g). Maybe the arguments by Meehl (1995) are not strong. Maybe someone can clarify this for me.

    • THANK-YOU, MIA5, for posting the link to that article! Until I followed the link, I’d forgotten I’d read that article a couple years ago! So, I want to strongly encourage ALL our MiA friends here, to read that article. It’s kinda’ longish, but well worth the time! And, MIA5, my answer to your Q? would be that we can always use “so-called”, or “supposed/ly”, or some other such modifier, in either speaking, or writing. The 2 points I’d be clear on:
      1.> As long as we know our audience, we can be a little relaxed about exact words. Some of these concepts / ideas / words can be tricky to use, and are used to fool & deceive, so we need to be as clear as we can be, but not worry too much, and instead end up being confusing, when we’re trying to be clear!
      2.>*SOME* of these words/phrases are best described as “psychobabble”, and “gobbledygook”. They are serious-sounding words, which are really just word games, and head games. They’re NOT clear communication.
      I’d like to see MiA re-print this article, here!
      Thanks again, MIA5!
      (As if I could forget the fraudulent, bogus, and deceptive language of the pseudoscience drug racket and means of social control known as “psychiatry”!….)….

    • MIAS — Your questions are illustrative of my original criticism here. The cavalier usage of the term “medical medical” takes the essay from being fairly enlightening to being outright confusing and disinformative. It is not “scientific” to consider basic terms as subjective, to be defined according to the whims of the scientist.

      The medical model has been discussed and deconstructed since Szasz wrote the Myth of Mental Illness in 1961. It refers to the portrayal of problems in living, of thought, behavior and emotion, as medical diseases. It is intellectually disingenuous to write an article in 2017 and use the term to refer to something completely different.

      So, you can believe that this is an actual controversy, or you can take my word for it — if you talk about “mental health” or “mental illness,” you are implicitly using the medical model. If you believe that there can be literal diseases of the mind, then further imagine that these (at
      best) metaphorical diseases not only literally exist but are actual brain diseases, you are almost all the way down the slippery slope. But it started simply with the term “mental illness.”

      All this has prompted me to briefly explore the etiology of the term, particularly how it got distorted into people equating it with so-called “biological psychiatry.” Findings TBA.

    • It doesn’t matter what someone said in 1995; the term was well-established with a clear definition over 30 years prior (see my link & quotes further down). I can decide that I want the term “rooster” to mean something other than what it means, but my opinion would be considered irrelevant. I think part of the effort to confuse the term comes from a desire to subvert Szasz’s anti-psychiatry analysis (by my definition, not his). (Szasz wasn’t thrilled with the term “medical model” himself since, he said, medical doctors didn’t force treatment on people.)

  15. Those of us who have skills and do real work, we are always at risk for being turned into equipment by the financial sector parasites. So we have a common interest with all workers. And it goes beyond this, because with less labor being needed, our society also gets scape goats now from those directed into the mental health system, or getting labeled with learning disabilities. All of this stuff is bogus, just white coats helping parents to abuse their children. And it constitutes the re-emergence of the bogus sciences of Eugenics and Social Darwinism. So with all of these oppressed people we have a natural affinity.

    Pledges of non-violence only amount to appeals to pity, and they strengthen those who make the bogus eugenic arguments. So only when we are organized and when we demonstrate routinely that we use All Available Means to protect ourselves and each other, will there be a modicum of safety and stability.


    Stop collaborating with Psychiatry, Psychotherapy, and the Recovery Movement. Please Join:

  16. OK then, we could dispel any confusion about terms if you would simply affirm for those reading that the medical model has existed — using disease terms — since at least 1908 when Bleuler first used the term “schizophrenia,” and implicitly going back at least to the days of Benjamin Rush. Because the video clearly implies somewhere around 10:35 that DSMIII represented the dawn of the medical model. If this is NOT what you mean, suggesting you clarify it would be my “constructive criticism.”

    So-called “biological psychiatry” then reified the disease metaphor by actually purporting to identify mechanisms in the brain associated with these abstract and subjective categories of “disease.” That seems to be the “message” of DSMIII, though in reality the permutations of psychiatric newspeak is not something “mental patient” activists have been overly concerned with, historically speaking; if it’s not one thing it’s another.

  17. The DSM model is definitely a pathologically based approach of “mental illness” as a disease, describes dozens of perceived mental conditions, and does not take into account social or societal disruptions brought upon affected groups of peoples such as the Native tribes of the US and Canada whose cultural, familial, and clan social systems, beliefs, customs and laws were drastically impacted by the imposition of European forces of colonialism, mercantilism, capitalism, and the practice of individualism in contrast to ensuring the stability, cohesion, and endurance of the collective.

  18. So here’s a good article about the sociological/political implications of the medical model by a close associate of Szasz, which explains Szasz better than he explains himself sometimes. Some quotes:

    The medical model is a metaphor which portrays psychiatry, psychiatrists, and psychiatric patients in the language of medicine. Medicine does not need a medical model. It is the standard on which psychiatry models itself, like the real airplane is to the toy. The medical model projects the metaphors of illness on to the patient and the metaphors of medicine on to the psychiatrist.

    A second, parallel critique…maintains that the medical model of psychiatry is an ideology which justifies covert social control. “Diagnosing” persons as mentally ill who complain of or display certain forms of undesired and undesirable thought, mood, and behavior renders them vulnerable to being managed by a ubiquitous mental health system.

    A third approach involves the critical evaluation of psychiatric and psycho-pharmacological research… There is a strategic disingenuousness to this critique of psychiatric research. It assumes that proper research could demonstrate a causal connection between brain function and certain kinds of thought, speech, and behavior. This is questionable and debatable since the language of brain science and the language of mind and moral behavior belong to different logical categories.

  19. P.S.: If your thumb hurts and you paralyse your hand, your thumb will stop hurting.

    I assume that if there is ever a medical “cure” for any “mental illness”, this is the form it will take.

    Didn’t a guy once stop being depressed after he survived a gunshot to the head?