From Psychiatric Times/Conversations in Critical Psychiatry: “If you have a reasonably complete hypothesis, based on someone’s life experiences and the sense they have made of them, about why they are having mood swings or feeling suicidal or self-injuring, then you don’t need another, competing hypothesis that says, ‘And it is also because you have bipolar disorder/clinical depression/borderline personality disorder.’ Even if we think these are valid categories, the diagnosis is now redundant . . . Moreover, these hypotheses are based on contradictory core messages: ‘You are experiencing an understandable reaction to your life circumstances’ and ‘Your problems are the symptoms of a medical illness.’ This is not just theoretically confused—in practice, it gives mixed messages to the client about causality, responsibility, and so on . . .
Diagnosis—however we choose to understand it—has no place in this field, and nor does the diagnostic thinking that it supports and perpetuates. All human experience has biological aspects, but not all forms of suffering are medical illnesses. We are dealing with people with problems, not patients with illnesses, and the whole paradigm—the ‘DSM mindset’ as clinical psychologist Mary Boyle puts it—needs to change.”
