Psychiatric diagnosis has come under increased scrutiny in recent years following the release of the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5) in 2013.

Two organizations that played a prominent role in challenging the Bible of psychiatry prior to 2013, the British Psychological Society and the Society for Humanistic Psychology (American Psychological Association – Division 32), subsequently joined to form the Task Force for Diagnostic Alternatives (TFDA).

Today, February 12, 2020, the TFDA released a new Open Letter regarding the reform and revision of diagnostic systems. MIA spoke with two leaders of the Task Force, Sarah Kamens and Peter Kinderman, about this effort.

Sarah Kamens is an Assistant Professor of Psychology at the State University of New York (SUNY) College at Old Westbury and co-chair of the Task Force for Diagnostic Alternatives for the Society for Humanistic Psychology. Her research examines the intersections between extreme emotional distress and structural marginalization. More specifically, she studies the ways in which lived experiences of psychosis and trauma are entangled with social conditions in the world.

Peter Kinderman is past president of the British Psychological Society (BPS) and a Professor of Clinical Psychology at the University of Liverpool. He is also a past guest on the Mad in America podcast and the author of A Manifesto for Mental Health, Why We Need a Revolution in Mental Health Care (2019) and A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing (2013).

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Justin Karter: Sarah, can you give our listeners a little background on what the Task Force for Diagnostic Alternatives is and why it was formed?

Sarah Kamens: The Task Force for Diagnostic Alternatives is a task force of the Society for Humanistic Psychology, Division 32 of the American Psychological Association (APA). We originally came together back in 2011 when David Elkins was the president of the society.

This was around the time of the development of DSM-5. At the time, David Elkins had read a letter that was published by the British Psychological Society (BPS) written by Peter Kinderman critiquing the proposals for the upcoming DSM-5. Dave read this and contacted Brent Dean Robbins, who was then the Secretary of Division 32, and me, because I had written a master’s thesis on the DSM controversies and had some expertise in the area. We put a team together a team to produce a letter from professionals in the United States.

We felt that if our colleagues across the pond were critiquing a diagnostic system that’s developed in this country, we should be inspired by their efforts, follow suit, and publish something from our own perspective as well. We developed an open letter, put the letter online on a petition website, and we thought, “We’ll send this out to our colleagues and we may get a few dozen endorsements from like-minded professionals.”

Then within the span of a few days, we received support from over a thousand individuals and, at the same time, institutional endorsements started coming in and we were absolutely overwhelmed by the response. It seemed that we had tapped into something: a kind of concern or discontent with the developing DSM system.

By the end of our campaign, we had endorsements from over 50 professional organizations, including 16 divisions of the APA and over 15,000 individuals, many of them mental health professionals.

After this, we really wanted to understand the kind of collective concern that we had tapped into so we started to expand our efforts.  We decided we would continue to critique the basis of the DSM systems, but also look and explore the possibility of whether or not there are alternative systems out there.

 

Justin Karter:  Peter, Sarah mentioned past letters, published prior to 2013, which contested the validity of DSM-5. How is this new open letter different?

Peter Kinderman:  First, this approach is different because of the timing and the professional context that we live in. Back in 2011, we wrote both the BPS and the Humanistic Psychology letters specifically as a response to the proposed revision to DSM-5. Both letters questioned whether the experiences that fall under the remit of mental health symptoms can accurately be considered illnesses at all. They asked, “Is this the best way to think about our mental well being?” There was a particular challenge.

Since then, obviously, the DSM-5 has been published. It hasn’t been boycotted. It hasn’t been ignored and it’s evolved into the new crazy Bible of psychiatry.

We’ve also had the proposed revision of the World Health Organization (WHO) classificatory system, ICD 10 to become ICD 11, which is in draft form. We’ve also had the development of RDoc. We’ve also had a number of people proposing alternatives to the DSM.

In talking about these issues, we realized that we were talking about the inadequacies of the crazy medical pathologizing diagnostic system and that, instead of critiquing a particular proposal, we had views on the whole nature of what it means to go about proposing diagnostic systems.

Rather than trying to write a response to each proposal, we thought we would group the whole issue of diagnostic approaches in psychiatry together and write to the leaders of the main groups involved in those efforts.

It is intriguing that you’ve got different diagnostic systems that purport to be better than each other, which, by definition, critique the validity and utility of the other systems.  Yet, at the same time, they purport to have read-across (similarity) between the systems. So you can go to websites that tell you how an ICD 10 diagnosis reads across to DSM-4 or DSM-5 or ICD 11. It is like they’re saying, “Their diagnosis is invalid, ours is better, and yet they’re the same thing,” which is kind of is nonsensical.

Bringing this all together, we decided to write a critique of how we should go about the business of searching for appropriate psychiatric diagnosis, or more properly, alternatives to diagnosis. We ask questions like:  What’s the purpose of this? Is this a diagnostics system to identify the pathologies in the population and sell drugs, or are you aiming to improve the wellbeing of the population?

Who should be leading this? Is this an exercise by psychiatrists and mental health professionals for psychiatrists and mental health professionals or is this a democratic exercise?

Are you starting by assuming that there are such things as mental illnesses and trying to examine the entrails of the slaughtered goat in order to find out which diagnostic system is best? Are you critiquing the system at all from first principles? Are you considering alternatives?

Are you considering different perspectives? Are you including sociologists, philosophers, critical psychologists into the mix? Are practitioners open to alternatives? Are you exploring psychological classifications, which, personally, I don’t think are that much better than pathological classifications, or are you considering the sorts of approaches used by social workers or social pedagogues? Are you considering phenomenological approaches? Are you considering a public health perspective rather than a pathologizing perspective?

Our open letter sets out all of these possible alternative perspectives and presents some of the principles that we think should apply to the business of looking at diagnoses.

Sarah Kamens: To add to what Peter was saying, we have all of these different alternative systems being proposed. It is a really unique time and, in some ways, it’s an exciting time because there was a period after DSM-3, where researchers and practitioners were really laboring under the DSM-3 system and very invested in its success and had strong beliefs in its success.

It was a period of what Thomas Kuhn would’ve called “normal science,” where people are doing a lot of studies trying to support that paradigm. Then this anomalous evidence started to emerge that the system wasn’t really holding up empirically by its own standards. There was all of this overlap or comorbidity between the diagnoses, fuzzy boundaries, and other types of empirical problems.

Now we’ve got of these different systems being proposed and, as Peter said, they critique each other. Then, at the same time that you have these critiques out there, there is this continuation of using the DSM system that has been widely identified as problematic for not having the types of validity and reliability that you would hope for.

We also have a situation where, paradoxically, the DSM is used in clinical and counseling settings, and we ask those accessing services to have belief in this same system that we as researchers and professionals are permitted to identify as faltering and problematic. Yet, if those with whom we work do not hold a belief in that system and their own place in it, we say that “they lack insight into their diagnosis or their ‘mental illness.’” This, to me, seems to be the great hypocrisy of the present time.

As our open letter identifies, a lot of the systems that have been proposed would not be a true paradigm shift if they’re successful. A true paradigm shift would occur if, as we propose in the letter, we somehow tie in this overwhelming evidence for social and structural factors to mental distress.

Peter Kinderman: To build on that, one of the things that happened when we came together and criticized DSM-5,  was that people responded by saying, “well, we’ve got HiTop and we’ve got RDoc and we’ve got ICD 10 and 11.” But our point in this letter is that all of them have assumptions and failings built into them.

They make assumptions of pathology, assumptions that we can make subjective judgments and define what normal is and define what abnormal is.

We wanted to take a step back and challenge all of those underlying assumptions. So if the leadership is by psychiatrists for psychiatrists, because after all the job of psychiatry is to define illnesses and then treat them, then you’re not doing your job properly.

We need to challenge that. Are you including alternative and diverse voices? Are you including the voices of people who think that those assumptions need to be challenged? I think we did a good job in 2011, but we need to do a broader job now and a more conceptual job. That’s what this letter is about.

Justin Karter: I want to pick up on these assumptions that are built into the current diagnostic systems. One of the points made early on in the letter is that current diagnostic systems, “identify and locate problems within individuals.” Sarah, how are our relationships, communities, cultures involved in the symptoms that then get diagnosed by psychiatry and psychology?

Sarah Kamens: When we think about the quantitative research evidence, it is really clear that social factors play an enormous role in the generation of mental distress.

We can take the example of psychosis, which is an area of interest of mine. The research evidence has clearly laid out that the experience of psychosis is very much tied to social and structural experiences such as homelessness, not having a place to live, housing insecurity, economic inequality, racial and ethnic segregation, multiple deprivations, and childhood trauma. From the side of human experience, we might say that these “symptoms” are also results of exposure to our particular world.

Peter Kinderman: I was just thinking that maybe we should also point out some things have happened in the world of psychology and critical psychiatry since the DSM-5 was published.

After 2011, I think that we were surprised by the level of positive response that people had to our letter. There were a lot of people who are hungry for alternatives.

We’ve seen more research into the networks of associations and mediating processes between life events and mental health outcomes for people. We’ve seen the development of cogent, coherent alternative approaches such as the Power Threat Meaning Framework.

For me personally, one of the things that’s happened since the letter in 2011 is that I started to realize some of the potential for systems to not only capture information about individual psychological phenomena but also to capture those social determinants that Sarah talked about.

We’ve been so focused on identifying disorders, we’ve taken our eye off the fact that it’s perfectly possible to measure, to identify, to categorize, to respond to and take seriously both clinically and politically the phenomena that people experience (like low mood or hearing voices ) and the events in people’s lives (like domestic violence, racism, losing your job, or failing exams).

Sarah Kamens: I want to emphasize that there are serious consequences to ignoring the evidence we have for the role of social structures. When we locate symptoms within an individual, it can be detrimental on a number of levels.

One is to that particular person who is then not encouraged to or supported in examining the way in which their unique life historical circumstances might play into their distress. The person is not encouraged to explore the ways in which their social environment contributes to how they’re feeling.

On the broader societal level, exposure to this sort of mental health discourse that identifies problems within individuals gives us an excuse not to look at these social structures that make us suffer and that make us “sick.”

Peter Kinderman:  I’m somebody who believes that my thought processes emerge from the physical processes of an organic brain. I know that I think with my brain and I am genuinely interested in neuroscience. I’m interested in what happens biologically when people lose their jobs. I’m interested in whether there are consequences that you can see in not only in the psychological functioning of people (changes to your self-esteem, the way that you relate to others, a sense of optimism or agency for the future) but in measurable and identifiable changes to brain processes.

I’m really interested in that. But it’s more likely that we’ll be able to see changes in brain functioning and psychological phenomena following major life events than we will by studying the etiology of major depressive disorder. It is actually a foolish way to study neuroscience, let alone a foolish way to study sociology and psychology.

I absolutely agree with you that if we want to understand how toxic society’s impact is on us as human beings, we’ve got to move away from a disease model. But you know what? I think that if we want to understand how life events impact on a child’s developing brain, we’d be better off ditching the disease model there as well.

Sarah Kamens: Absolutely. I think that it’s important to say that of course all of these experiences have biological correlates and biological determinants as well. I think one of the questions is, “what does it mean to focus primarily (or sometimes even solely) on those biological determinants?

What happens when I identify someone as having anxiety or depression and provide them with medical treatment or maybe a psychological treatment for that and don’t focus on the fact that they have just lost their job? I think that those are the types of questions that we’re asking.

So absolutely, I think it’s really important to say there’s no denying that we are biological beings and that all of the phenomena that we’re talking about have biological correlates and often biological determinants as well.

I think a really good example of a bio-psychosocial model that really takes all of this into account is the social defeat theory of psychosis. The idea of the social defeat theory of psychosis is that all of these social risk factors that I had mentioned (homelessness, childhood trauma, migration, etc.) share the common experience of social defeat, or being excluded from a dominant social group. That experience of marginalization has an effect on the dopaminergic system.

Social defeat theory draws on animal models and some imaging research to show that, in situations of social defeat, indeed, there are alterations in the mesolimbic dopamine system.

We can, of course, model things like that. The question is what does mean to talk about someone’s dopamine system when they are sitting in front of you and they have just lost their job.  So, there’s a question of context as well.

 

Justin Karter: This discussion leads to another important question about how the current diagnostic systems impact service users and people who are accessing services. There are also people who find the current psychiatric diagnoses helpful. Can you address this point? What might it look like if this open letter is successful in challenging the current diagnostic paradigm and opening up more frameworks? How might it impact service users if there were multiple systems to choose from?

Sarah Kamens: It’s a wonderful question. First of all, if people have a number of systems that are in play and in the general public discourse, there’s more of a freedom of choice and, I think, more of an understanding of the relativity of these systems.

One of the issues that with DSM-5 is that once these diagnoses are put into play, they’re reified within public discourse. They’re made concrete and seen as these definitive biological aberrations. I think that having options that are different from the DSM would allow people to explore the meanings of what their particular stress distress is to them.

Now I think it’s really important that you’re asking about people who do find the current system helpful. I think that there are certainly psychological benefits to understanding, for example, that one is not alone, that other people have had similar experiences, that those experiences can be named and described, that people have gotten better or have felt better, and that there’s hope there.

One of the questions is, first of all, what are those benefits, and are those benefits unique to the DSM? There are other descriptions of mental distress, like formulation, like the power threat meaning framework, for instance. How can those types of alternatives also help people connect with communities, understand that they’re not alone, understand that there is hope out there?

With alternatives, we will have this greater freedom of choice, but we also have to respect people’s choices either way.

Peter Kinderman: The goal is not to tell anybody how they should think and certainly not to tell people how they should think about their own difficulties, but we are suggesting that there are alternatives.

I’m very taken by a blog that I read a few years ago by a junior psychiatrist. He seems a very pleasant and caring chap who slipped into his blog that he had a genuine belief that if he took somebody who was profoundly depressed and couldn’t tell them that they were ill, he had to respond by telling them they were being weak.

It’s really interesting that we are so constrained into this disease model way of thinking that many people, whether they’re people seeking help from the psychiatric system or people working in the psychiatry system, seem to default to the notion that if they can’t use language of pathology and illness, there is simply no other way of describing people’s problems other than to use pejorative language. It seems that if you can’t say, “I am ill with depression,” you have to say, “I am being weak and stupid,” and I personally want to move away from that way of thinking.

To return to your question Justin, what do we envisage? I would love to see a situation where I could go to my family doctor, tell them that I’m feeling depressed, and my family doctor could say, “okay, well let’s explore why.” They could say, “what’s happened to you?”

Personally, I think that that immediately turning to medication to help would be an unwise choice. I want people to listen to what I’m experiencing, understand what I’m experiencing, but not to assume that by understanding and listening and naming my experience that they’re therefore diagnosing an illness and should treat it.

I think they should listen to my experiences, understand it, name it, report it if necessary. If I turn up at my family doctor and say that I’m feeling anxious and depressed and then reveal that I’m being abused by my partner, then one of the questions is, do I need a safe house? Do I need the police involved? Giving the opportunity to name and describe what has happened and not defaulting into an illness model, and offering a drug to alter the functioning of my brain, allows us to start to think about alternatives that can address those problems.

 

Justin Karter: I want to dig into the different considerations that the letter recommends that should be addressed by any diagnostic system in order to push forward toward a new paradigm that works better for clinicians, researchers, and service users. What are some of the values and principles that the letter lays out?

Sarah Kamens: The recommendations that we make in the letter, in part, draw upon a document that was recently produced by one of the workgroups that came out of our global summit on diagnostic alternatives. We ended up

producing and eventually publishing the “Standards and guidelines for the development of diagnostic nomenclatures and alternatives in mental health research and practice.

[These principles include]:

  • The guiding values of developing or improving any diagnostic system or alternative should be the general promotion of public health and human wellbeing.
  • The purpose of developing or improving diagnostic systems should not be a professional or commercial benefit.
  • Diagnostic systems and alternatives should be developed free from industry influence and based on scientific evidence that is unbiased.
  • In terms of the leadership, those who are charged with developing or revising diagnostic systems or alternatives should include members of the general public, current or former users of mental health services, experts by experience, and family members, in addition, of course, to professional representatives who are free from conflicts of interest. There needs to be a democratic representation of relevant stakeholders and multidisciplinary professionals.

 

Justin Karter: The new open letter also lays out some very specific and practical recommendations for immediately improving diagnostic practice that do not require a complete transformation of the existing system. Can you tell us of some of these specific recommendations and how you see them improving practice in the short term?

Peter Kinderman: In the ICD system, because it was set up across the whole of medicine and healthcare, rather than a specific project of psychiatry, there is a system that allows health care professionals to respond to the needs of their patients. So the system includes methods for accounting for issues like pregnancy or taking preventative medicine or even doing things like resetting broken bones.

These aren’t diseases, but they are reasons why people go for healthcare. So, especially within ICD, what we have is a system for saying why has this person presented for help at this time?  These are perfectly legitimate reasons for accessing healthcare, but they aren’t diseases.

What my colleagues and I realized is that, within the healthcare system, there are ways of doing things differently.  We have things like phenomenological codes where you can say this person came in for self-harm or disrupted eating patterns or for low mood or guilt or anger, things that are reasons why you would go to see a healthcare professional, but aren’t diagnoses.

One of the things that we recommended is to look at existing codes for specific experiences of phenomena. The other thing is that, of course, people go to their healthcare provider because things have happened to them. This happens in physical medicine as well. There are codes for these things and we ignore them. There were codes for things like adverse experiences, childhood poverty, experiencing abuse, homelessness. These are all codes within ICD.

So, yes, we would like a total transformation of the diagnostic system, but one of the ways that we get there is to start recording specific experiences that already exist as codes, which will point to those social determinants.

 

Justin Karter: This letter is addressed specifically to several international leaders in the field of psychiatry. Why address these leaders in particular? How do you hope that they’re going to respond to this open letter?

Peter Kinderman: We’re particularly addressing people who have leadership roles in the most dominant diagnostic frameworks, DSM, ICD, and RDoC. We are also speaking to the wider public, to the media, to healthcare providers generally. In making it public, we’re inviting the leaders of those frameworks to respond.

I would like them to consider very seriously whether they are brave enough to suggest that the leadership issues, the conflict of interest issues, and the guiding values and principles issues are significant enough that they would be able to put their efforts under a slightly more democratic perspective. Instead of this being an exercise by doctors for doctors that is then imposed on patients, we are asking for this to be something that is for the public, by the public.

 

Justin Karter: Sarah, as you are co-chair of the task force on diagnostic alternatives, I’m wondering what you imagine comes next? What are the next steps for the task force and how will this open letter evolve from here?

Sarah Kamens: The truth is that I’m not really sure. The reason for that is that I think that we want to see what the response is to this open letter. With our original open letter, the response was unexpected. It was overwhelming, but it also allowed us to understand more about the perspectives and opinions and concerns of other mental health professionals as well as the general public.

I think that we’re going to wait and see what the response is and then see where people’s concerns and interests lie and then take things from there.

Peter Kinderman: In a sense, it is a statement of what we are up to and what we are thinking we are inviting comments to further the discussion.

In terms of next steps, we need to be open-eared to people’s responses. There are many people who worry that, because the system is based on so heavily on diagnosis at the moment, changing the system will make services harder to access. For instance, how are people likely to get services? How will people get help, get therapy?

Extending it further to institutions like the civil benefits system, the way in which people get benefits and financial support from the state is often heavily dependent on diagnoses. The way in which the criminal justice system responds to mental health issues is heavily dependent on diagnosis.

As we propose reforms to the way in which we go about making diagnoses, we have to listen carefully to people pointing out the flaws in the proposed alternatives that we come up with and to take those seriously and amend and change.

Sarah Kamens: One hope that we have is that the response to this letter will help us to refine our goals and narrow or expand as needed.

I think that is the general direction we’re headed in. We’re trying to remain open-minded so that we can gather people’s responses to the letter. We would love to hear input from Mad in America listeners today and if people have ideas for our task force or thoughts or suggestions, you can always reach out to us.

 

Justin Karter: I understand that professional organizations and individuals are both invited to sign on and add their support to this new open letter at the following link (here).

Sarah Kamens: The last line of our letter says as the next step, what we want to do is discuss these issues. That’s the point.

*******

You can sign the letter here: https://forms.gle/yHWjrTxHCv5tXx5t6

MIA Reports are supported, in part, by a grant from the Open Society Foundations

19 COMMENTS

  1. The problem isn’t just with ‘DSM diagnostics’and harmful labeling.. that is the first stage of the abuse ; it’s also with the whole abusive psychiatry system. Why do you think this legal challenge is happening :

    https://www.equalityhumanrights.com/en/our-work/news/health-secretary-faces-legal-challenge-failing-patients-learning-disabilities-and

    It’s happening because psychiatry is treating people worse than animals for profit… and at the same time.. being a eugenics movement.

    If anyone thinks psychology is any better… I’ve heard tell of many horror stories of abuse. Also it’s used in psych hospitals to gain confessions to some suspected crime. As Bonnie said: ‘it’s the hand maiden of psychiatry’. It’s all got to go.

  2. Justin Karter:

    Yes. There are serious problems with diagnosis, DSM included. Horrific problems! Yet, it seems to NOT be amendable at this time.

    On top of the lists of concerns just may be the social problems of our day. Societies are sick, some are not. Science has been explaining this well. We don’t hear, don’t know. The subconscious soots us well, so we think. (Not really).

    Another thing to consider is how big, gigantic, is the system trying to be changed. The DSM is about money concerns to a larger degree. Be honest. Two words to begin explain this is “insurance companies.” Ultimately, changing the method of diagnosis (the DSM) would involve an enormous collaboration from a much wider viewpoint than imagined.

    One last thought is that decisions for others, by others, is not going to hold strong all that well, ever. Ask the patient/client. Include them in on decisions.

    Change is inevitable. The DSM is not the right road. Hard science will change that. Look ‘that’ direction. Keep trying.

  3. The DSM is best seen for what it TRULY is: A Catalog of Billing Codes. Everything in the DSM was either invented, or created. NOTHING in the DSM was discovered. Think about that a while….
    Psychiatry is a pseudoscience, a drug racket, and a means of social control. It’s 21st Century Phrenology, with potent neuro-toxins. Psychiatry has done, and continues to do, FAR MORE HARM than good….
    And the DSM is STILL noting more than a catalog of billing codes. Nothing in it was “discovered”, – everything in it was either invented or created. So-called “mental illnesses” are exactly as “real” as presents from Santa Claus, but not more real…. And I bet nobody will challenge my statements here….because they are TRUTH.

  4. I just spent an hour or 2, clicking links on the article above….I even went to the Homepage of the American Psychiatric Association. Clicked on the link to “buy” a copy of the DSM-5. And got an “error” page! So I couldn’t buy a DSM-5 from the quack shrinks, even when I tried to! LOL…..
    But seriously, folks, much of what I read on those linked pages can be easily condensed to 2 words:
    PSYCHOBABBLE, and GOBBLEDYGOOK….. What a bunch of over-educated IDIOTS!….
    But that’s not just an idle insult…. I’ve been reading their tripe for enough decades that I sometimes almost find myself seduced by the sheer intellectual masturbation of it all…. It’s so high falutin’ and edu-ma-cated sounding! Must be REAL, huh?…. Hey, they got Ph.D’s and shit!….They must know what they’re talking about! No, really, actually, most of them are grossly over-educated, and so full of their own self-referential bullshit, that they can’t even see it. They have an especially virulent form of professional anosognosia….
    They literally can’t see the beautiful forest of life, for their own bullshit DSM trees….
    Psychiatry can’t see the GENOCIDE it daily inflicts on people…. Too busy working on the DSM-6, maybe….

  5. There is something here in this article that exposes a large problem.
    If the systems themselves cannot develop a system to get RID of the harms of psychiatry,
    then how can those systems be claiming to have an ability to help people with problems?

    If you really want to ‘change’ something, you have to dismantle it’s wrongs, by presenting it to the powers that be, the powers that are there to make sure all humans get equal rights.
    So this has to be dealt with.
    DSM labels cause discrimination in ALL constructs. They cause doubts, suspicions, paranoia, abuse, minimizing and outright taking away of human rights. Telling a judge to stop looking at the person as mentally ill, all the while a shrink testifies that the person IS mentally ill, will not result in the judge giving clout to the person said to be mentally ill.
    So the pretense by psychiatry of speaking out against stigma is a joke and diversion. The problem is not stigma. The REALITY IS THAT IT IS DISCRIMINATION.

    If Psychiatry cannot get rid of it’s DSM, then there is no fixing it. So if your organization can come up with a plan that exposes the harms of psychiatry, but more so that psychiatry is NOT actually helping anyone.
    That it’s treatments and diagnosing are based on falsities and not anywhere close to understanding of the human mind.
    Psychiatry is involved in blatant lies, but so is every system that pretends to know the mind.

    Psychiatry IS the system that discriminates between normal and abnormal and so it should read. It should read exactly what it is, and if that passes in an ‘ethical’ or ‘moral’ society, so be it.

    I see no alternative except to educate our kids. Educate them away from thinking they are abnormal, and present them with schools and education where they can be seen as normal.

    The whole problem is the word “normal” and it seems we cannot communicate regarding that, because we are forever trying to define it, which is impossible. Which is the very reason we are not getting anywhere.

    There is no way that shrinks sit in the DSM room with any sincere belief in it’s making. We all understand what it feels like when we are part of a system where we kind of have to keep pretending to believe in it.
    We try to gaze at one another with eyes not downcast, we try to talk with assertiveness, with interest, with seeming contemplation. It actually takes great effort to psych oneself up to keep being interested and invested in lies.
    What keeps it going is that there are a few truths in psychiatry. The truth part being that humans need direction. We run into problems of self doubt and need direction, encouragement, change of environment. People need to hear the possibility that it is NOT themselves….These very human problems have been turned into abnormals.
    The idea that humans need to work on THEIR psyche, that THEIR psyche is one that exists by itself and is thus afflicted with a disorder is nothing but discrimination.

  6. “Is this a diagnostics system to identify the pathologies in the population and sell drugs, or are you aiming to improve the wellbeing of the population?” The former.

    “Is this an exercise by psychiatrists and mental health professionals for psychiatrists and mental health professionals or is this a democratic exercise?” The former. Let’s be real, since you are systemically force neurotoxic poisoning people, that’s 100% the opposite of what would happen in a free society.

    “We also have a situation where, paradoxically, the DSM is used in clinical and counseling settings, and we ask those accessing services to have belief in this same system that we as researchers and professionals are permitted to identify as faltering and problematic.” Concessions only made because your sins were exposed on the internet by your clients and independent scientific journalists, however. “Yet, if those with whom we work do not hold a belief in that system and their own place in it, we say that ‘they lack insight into their diagnosis or their ‘mental illness.’’ This, to me, seems to be the great hypocrisy of the present time.” The hypocrisy is staggering, I agree.

    “A true paradigm shift would occur if, as we propose in the letter, we somehow tie in this overwhelming evidence for social and structural factors to mental distress.” Yes, I had no idea in late 2001 that “mental health” workers believed distress caused by 9/11/2001 was distress caused by a “chemical imbalance” in my brain alone. How insane can our “mental health” workers be? By the way, that was ‘political abuse of psychiatry,’ by American psychologists and psychiatrists.

    “A true paradigm shift would occur if, as we propose in the letter, we somehow tie in this overwhelming evidence for social and structural factors to mental distress.” How the “mental health” industries could have collectively all gone off believing that distress, caused by distressing events, doesn’t exist, is mind boggling to me. By the way, your DSM is a description of the “mental illnesses” that you can create with your psych drugs, and a medicalization of the human experience. It’s a book of stigmatizations, not a “bible.”

    https://www.alternet.org/2010/04/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america/

    I’m quite certain public apologies and proper amends for all the recent psychiatric and psychological malpractice are in order, especially given the fact you all rape our entire economy for your malpractice insurance. Not to mention we need to end your ongoing mass murder of 8 million innocent people every year, via your “invalid” DSM “mental illnesses.”

    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2015/mortality-and-mental-disorders.shtml
    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

    “We wanted to take a step back and challenge all of those underlying assumptions.” Yes, since there are NO medical tests to prove ANY person has ANY so called “mental illness,” and since your drugs create the symptoms of your DSM disorders. I’m quite certain we need to question the idea of whether “mental illnesses” even exist whatsoever. And we were all taught as children that when you assume, you make an “ass” out of “u” and “me.” Maybe it’s time to stop making fools out of yourselves, and your clients, with your insane assumptions?

    “The research evidence has clearly laid out that the experience of psychosis is very much tied to social and structural experiences such as homelessness, not having a place to live, housing insecurity, economic inequality, racial and ethnic segregation, multiple deprivations, and childhood trauma.” Not to mention that both the antidepressants and antipsychotics can create psychosis, via anticholinergic toxidrome poisoning. And the ADHD drugs can also create psychosis.

    https://en.wikipedia.org/wiki/Toxidrome
    https://www.nbcnews.com/health/kids-health/common-adhd-medications-may-cause-psychosis-study-finds-n985616

    Why is it legal for psychologists, social workers, counselors, etc., who are not trained in medicine, to be able to diagnose and demand force treatment of people with the psychiatric drugs, of which they know nothing about the common adverse effects? That should be illegal. And shame on the medically trained psychiatrists, who were all taught about anticholinergic toxidrome in med school.

    Do we even need a scientific fraud based, iatrogenic illness creating, “mental health” industry at all? Especially given the reality that the primary, historical and continuing, societal function of the so called “mental health” workers, including the psychiatrists and psychologists, is profiteering off of covering up child abuse and rape.

    https://www.indybay.org/newsitems/2019/01/23/18820633.php?fbclid=IwAR2-cgZPcEvbz7yFqMuUwneIuaqGleGiOzackY4N2sPeVXolwmEga5iKxdo
    https://www.madinamerica.com/2016/04/heal-for-life/

    And all this misdiagnosis of child abuse survivors is by DSM design, one more reason to get rid of the DSM.

    https://www.psychologytoday.com/us/blog/your-child-does-not-have-bipolar-disorder/201402/dsm-5-and-child-neglect-and-abuse-1

    Does our society actually collectively benefit from having a bunch of child abuse covering up and profiteering “mental health” industries? No.

    https://www.amazon.com/Pedophilia-Empire-Chapter-Introduction-Disorder-ebook/dp/B0773QHGPT
    https://community.healthimpactnews.com/topic/4576/america-1-in-child-sex-trafficking-and-pedophilia-cps-and-foster-care-are-the-pipelines

    Oh, and how convenient for the globalist banksters, that their DSM deluded “mental health” minion just happen to be “in control” of our society, exactly when the globalist banksters have been stealing trillions in houses from the American people, unjustly making millions of American families homeless.

    https://boingboing.net/2013/08/12/unsealed-court-settlement-docu.html

    Not to mention the trillions more the globalist banksters stole from the entire American society with their bank bailouts.

    “We’ve been so focused on identifying disorders, we’ve taken our eye off the fact that it’s perfectly possible to measure, to identify, to categorize, to respond to and take seriously both clinically and politically the phenomena that people experience (like low mood or hearing voices ) and the events in people’s lives (like domestic violence, racism, losing your job, or failing exams).”

    Yes, you DSM deluded, “omnipotent moral busy bodies” have been “so focused” on irrelevant and “bullshit” DSM minutia, while aiding, abetting, and empowering globalist criminals in their destruction of America from within, for decades. Your industries’ systemic crimes boggle my mind. Wake up quickly, please.

    “I absolutely agree with you that if we want to understand how toxic society’s impact is on us as human beings, we’ve got to move away from a disease model.” Yes, wake up quickly please, flush your DSM. And stop working so hard to destroy the decent people, so you may maintain the satanic “elite” status quo, who have unjustly empowered your scientific fraud based “mental health” industries.

    “Instead of this being an exercise by doctors for doctors that is then imposed on patients, we are asking for this to be something that is for the public, by the public.” It’s shameful that doctors, long ago, promised to “first and foremost, do no harm,” and they’ve done the opposite, due to their greed. But since the doctors did do this, I agree, the concerns of the public should be taken seriously, and our concerns should have been taken seriously all along. I do believe public repentance by the DSM deluded, and proper amends to those they’ve harmed and murdered, are appropriate. Although I do not hold out hope for such real life repentance and justice.

    But I’m sure all will ultimately be judged fairly by God. Thus I do still recommend proper repentance and compensation, by all the DSM believers, to all the people they have harmed. If they actually are sorry for their staggering in scope scientific fraud based crimes against, and mass murders of, hundreds of millions of innocent humans over the past 50 years. Crimes which have also systemically aided, abetted, and empowered pedophiles, child sex traffickers, and the self proclaimed “elite.” Like the systemic, child abuse and rape covering up, leaders of my childhood religion.

    https://www.amazon.com/Jesus-Culture-Wars-Reclaiming-Prayer/dp/1598868330

    I’m sure the unrepentant hypocrites will be judged for who, and what, they actually are though.

    Eighteen years after 9/11/2001, do the “mental health” workers still believe that those of us who stand against never ending wars, that are bankrupting our country, and those of us who stand against child abuse, are the “mentally ill?” Or are those of you who stand in support of never ending wars, and systemically cover up child abuse for profit, are you insane criminals?

  7. Thank you Justin for this informative interview/report. This is outstanding work on the part of Professor Peter Kinderman and Dr. Sarah Kamens. Forming the Task Force for Diagnostic Alternatives (TFDA) and putting out another open letter gives hope to those labelled by the absurd, discriminatory labels of the DSM and hopefully can prevent others from suffering the same fate in the future.

    Even before my experience with a psychiatrist in cancer treatment I wondered how psychiatry possibly helps anyone facing traumatic or difficult life circumstances when the extent of their “help” consisted of a 15 minute appt once a month and prescriptions for toxic drugs that didn’t help. Instead these drugs caused harm to the brain in a multitude of ways, reduced the person’s ability to think and created a horrifying dependence on the drugs.

    What makes the practice of psychiatry SO bizarre and revolting is that context does not matter – at all, every societal problem or oppressive injustice in the world is deemed to be a “disorder” within the person. Psychiatry is a corrupted, ruthless system that somehow managed to place themselves above all other medical or mental health professionals and in doing so has been allowed to harm far too many. This needs to be stopped and I wholeheartedly thank you for your much needed integrity and perseverance in tackling this critical issue. I am wondering if professionals in Canada can also sign the open letter?

    • Yes, but remember the bait Katel.
      The BAIT of mental health is this: “It takes strength to ‘admit’ we have a problem, do not be ashamed to seek help. Everyone deserves to live a life full of ……..yadayada”

      So you see, they bait you in with “strength and “admitting”. Then they label the patients as weak.
      LOL.
      The system is weak and relies on bait. We have to suffer, then we read online, or we hear the DSM gospel and so there we go, we must go to where the healing is.
      OOPS, wrong door. It was the door to hell.
      It has consistently been a destructive force. They destroy and divide by it’s very practice.
      Don’t worry about name calling. Psychiatry honestly has no alternative. It is the basis of their religion.

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