The Future of Mental Health Diagnosis Goes Beyond the Manual

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From WIRED: “Do you have five or more symptoms of inattentiveness, including trouble staying organized, difficulty paying attention, and feeling easily distracted? What about five or more symptoms of hyperactivity or impulsivity? Have your symptoms been present for six or more months? Do they interfere with school, work, or your social life?

If you answered ‘yes’ to these questions, a mental health professional in the United States may diagnose you with ‘attention deficit/hyperactivity disorder,’ or ADHD, a ‘neurodevelopmental disorder’ that’s often treated with cognitive behavioral therapy and stimulants.

But what if the conversation went a different way—less Buzzfeed quiz, more detailed character study? Perhaps, instead of a specific label, you should be grouped with other people who struggle to prioritize long-term consequences over short-term gratification—a big tent that includes not only ‘ADHD’ but also those with substance use problems and even some ‘personality disorders.’ Or maybe you don’t need to be labeled at all. Instead of selecting a diagnosis from a big book, a therapist could help you see how what might feel like an internal struggle is really a response to your life circumstances and the power structures that surround you.

These are just two of the visions of psychiatry proposed by renegade psychologists and philosophers working to imagine a different future, free from the unscientific and often-stigmatizing diagnostic labels plaguing the field today.

. . . The question is no longer should we replace the DSM, but rather, what comes next? Depending on who you ask, the answer ranges from a new and improved psychiatric diagnostic system to no diagnostic systems at all.”

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12 COMMENTS

  2. I suppose the most interesting thing about this article is that it appeared in Wired. I found this information about the technology industry: “… the most recent Harvey Nash Tech Survey, conducted in 2019, included the stark finding that half of tech professionals said they were or had in the past been concerned about their mental health due to the pressures of work.”

    The article goes on to explain that a new survey conducted in 2020 found that about a third of this same group felt that their mental health had worsened.

    So this subject is a big deal among Techies. This same group at the same time tend to be fervent “science believers.” But that doesn’t mean that they are actually good at thinking scientifically. It just means that if you tell them that there might be a spiritual component to some human problem, they are likely to laugh nervously. Engineering school didn’t cover that.

    To be fair, I was taught about the importance of Spirit in the realm of mental health by a guy who likened the human mind to an electronic computer with “memory banks” and “circuits.” But as electronics was my field of study, I was amused by the analogy without being overwhelmed by it.

    In short, most of these people still don’t know what they are talking about. But they should at least be aware that there are two distinct and different aspects to the mental health problem.

    The first is: How do you treat (as in, handle administratively) someone who seeks help (or is forced to see a professional)? That is really what the DSM is all about. It is for the benefit of the doctor, the therapist and society at large. It is not for the benefit of the patient. Never was and never will be.

    The second aspect is, what do you do to make someone feel better? Or cure them? This involves the technology of treating mental illness. Psychiatry doesn’t like to talk about this because, as a profession they don’t really care or are apathetic about ever figuring this out. They are a bunch of posers who think that all their rules and manuals and drugs will convince people that they are doing something useful when they really aren’t.

    I wouldn’t be here writing this today if I didn’t think there ARE ways to make someone feel better. But you have to start by really wanting them to get better, and not just interested in making a buck off their suffering. So many “mental health” complaints could be handled by letting the person get enough sleep, or get properly fed, or in the extreme, remove them from an environment that is overtly abusive. If the patient doesn’t have any of those problems, the handling is a little more technical, but not necessarily rocket science. It all starts by wanting the person to feel better, to be happy. If you don’t start there, you’ll never get anywhere.

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  3. “A psychiatrist consulting the DSM would likely diagnose someone with checking behaviors …….with obsessive compulsive disorder………In the process, a psychiatrist might find that they also qualify for anxiety, depression, or any number of other comorbidities.“

    “In HiTOP, by contrast, checking behaviors would be treated as just one symptom reflecting a position on a larger internalizing spectrum—a general tendency to experience strong negative emotions that can encompass qualities of OCD, anxiety, and depression simultaneously.”

    This is the problem: Why wouldn’t a person who had OCD feel anxiety or depression or another comorbidity?

    This new way of thinking doesn’t seem any better than the old.

    Eliminating diagnostic categories altogether, as in PTMF, seems a little better, but what about all those who have similar symptoms, as in OCD? Shouldn’t there be a way to capture this?

    Anyway, as long as insurance companies demand diagnostic categories I don’t see the DSM going away.

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    • HiTop still doesn’t bother to look at the causal factors in whatever presentation is seen. Ten people could all exhibit “OCD” symptoms for 10 different reasons and need 10 different interventions. Until a “diagnostic” system is based on finding the actual CAUSE of something, it is worse than useless. And since the causes of so-called “mental disorders” primarily exist in a realm called the “mind” which psychiatry has not the vaguest understanding of (still confusing “mind” and “brain” and insisting they are the same), the odds that they will somehow sort this all out are about zero.

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          • I must say I think any “mental health professional” today who doesn’t understand there’s a difference between the mind and the brain; and doesn’t understand the ADHD drugs and antidepressants can create the “bipolar” symptoms; and doesn’t understand that the antipsychotics can create both the positive and negative symptoms of “schizophrenia;” and doesn’t understand that making people sick with forced or coerced psych drugging and lies is immoral.

            Those people are too stupid and unethical to be “mental health professionals,” since they’ve promised to “first and foremost do no harm,” yet done nothing but harm their clients, out of their own ignorance.

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      • I agree with you that psychiatry has little understanding of the mind and confuses it with the brain. But I still think some symptoms like OCD can be included in a diagnostic category even if there are several causes for the symptoms. And a good psychiatrist should be aware that treatments may have to be tailored to the individual. This is the case with some physical illnesses. For example, a stroke could be caused by a hemorrhage or a clot, but both types are called strokes.

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        • While what you say is sensible, what we are saying is that this whole medical approach to mental health is not only inappropriate but is also ineffective. It is not even that effective in the field of body health, as many doctors refuse to recognize the validity of using vitamins as treatments, even though much earlier work in medicine recognized some diseases as the result of vitamin deficiencies.

          The fact is that mental health practitioners do need a diagnostic system. But currently they don’t even have a workable theory of how to improve mental health. And this is partly due to the pressure exerted by vested interests, just as the drug companies would like to push supplement (vitamin) makers out of the field of body health.

          But in this case, the interest that the vested interests are vested in is the desire to prevent individuals from becoming aware of who and what they really are. Without this understanding, the route to any sort of workable mental therapy, or even a theory of one, is totally blocked. With this understanding, the whole world would change. And so the vested interests oppose it. If we cannot dislodge the current system, we could at least develop an appreciation for what a workable system would look like. Then, if we ever acquire the power to put one in place, we will be ready.

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  4. l. e. cox questioned, “you think the mind is product of the brain?” I wonder, if perhaps, the brain, in fact, the whole body is not actually a product of the mind. If you consider that the mind is Spirit or of God and if you consider yourself as a creation of God, then, in my manner of thinking that really might be the correct answer. I propose that is why psychiatry is its current state, especially as evidenced by the DSM, dismisses any concept of a “mind” and can only think of the brain as just one big biochemical computer. This is a dangerous shame, because not only does the good stay hidden, but also the true, real issues that need to be addressed are thus not addressed all hidden under the cloak of a psychiatric diagnosis. Then some pills are prescribed, some therapy attempted, and all is well. But it isn’t. First is the damage caused by the pills and second the augmenting damage from therapy which reinforces that damage. Eventually, the brain and body reach such a stress point that it either must die, become a vegetable or get better in some manner. And the only way the last one can be accomplished is though the Spirit or God. The other two, more tragic to our humanity, may also have the input of God or Spirit for God or Spirit’s reasons. The upshot of all this is that until we accept the fact that all that is comes from Mind (Spirit or God) and thus the brain and the body both originate from and in the Mind, nothing will be accomplished. And many will suffer, the least of which is that psychiatry, in its greedy desire to control, will continue to hide the real truth of their suffering (which may not be suffering at all if learning and adaptation to one’s specific situation occurs) from their “patients”. I think there is a future out there but not until we seriously consider regulating psychiatry, instead of giving free, unbridled reign over a very vulnerable population (which includes about everyone). Thank you.

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    • I was wondering if anyone else would eventually come to express this realization!

      I think, rebel, that you are basically correct in your assessment of the situation.

      Whether one believes in just one Creator, or that each individual is capable of being a creator, when we assume that such a creator exists, the problem begins to simplify. And the fact that the materialists have it backwards explains why they can never get it right. They have assigned Wrong Cause.

      I know from my experience in engineering that until you find the correct cause (or Root Cause or Right Why) a problem remains unsolvable. This is really just a basic of sane thinking.

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      • Thank you for your kind words. I was re-reading what I said, especially the part “just about everyone.” As I began to consider what I wrote, I now think that “just about everyone” should even include these psychiatrists that are causing so many so much suffering. Why do I say that? These psychiatrists do not realize that they are not only causing the suffering of others, but their very own suffering, too. At the very least, they, too, are victims of their own propaganda. At the very most, they are also victims of the same treatments (drugs, etc.) that they prescribe. In the world of the psychiatric, no one comes out unscathed. In short, psychiatrists are victims of their own psychiatry. And again, I remind all that due to the world of the psychiatric, all other worlds that do pertain to the “brain” become hidden and true understanding, learning, adaptation, and tolerance for self and others basically get crushed or cancelled. Thank you.

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