What meaning do psychological constructs really hold, and how are they operationalized and statistically modeled within psychology research?
When psychiatrists conduct "diagnostic" assessments on public figures, they are drawing attention to the fact that psychiatry's "diagnostic" system is more like a children's matching test than a genuine medical nosology. They are drawing attention to the fact that the Emperor has no clothes. And we all know where that leads.
When I looked through my mountains of medical records, I saw that the providers who listed my race as black applied diagnoses like major depressive disorder and PTSD. The providers who saw me as white preferred diagnoses of panic disorder and borderline personality disorder. Of course, my experiences are just anecdotal. But if racial bias due to subjective experiences of practitioners can play such a large role in mental health diagnostics, how is this even considered a scientific discipline?
I imagine that everybody on this side of the issue knows by now that the eminent psychiatrist Jeffrey Lieberman, MD, Chief Psychiatrist at Columbia, and past President of the APA, called Robert Whitaker "a menace to society." The grounds for Dr. Lieberman's vituperation were that Robert had dared to challenge some of psychiatry's most sacred tenets! But in all the furor, it was largely ignored that in the same interview Dr. Lieberman had said something else that warrants additional discussion.
Regaining power over our own health was the goal of Ivan Illich’s 1976 book Medical Nemesis, which detailed an epidemic of physician-caused death and illness. This epidemic continues, and so does an epidemic of physician-caused anger, despair and crazy-appearing behaviors. In 2013, the Journal of Patient Safety reported that the “true number of premature deaths associated with preventable harm to patients is estimated at more than 400,000 per year,” making it the third leading cause of death in the United States It is especially drug use errors, communication failures and diagnostic errors that result in another medical nemesis: They can make us appear—and sometimes feel—like we’re “crazy.”
Based on my experience both as a therapist and client in the mental health field, I have learned that when therapists or psychiatrists give you the following diagnoses all too often here is what they really mean:
Mad Science is not 'just another critical mental health book' - the authors are not simply telling the same-old-story. Instead, it is innovative, creative, and thought-provoking. All of us hold fundamental assumptions about mental health diagnosis, coercion, and drugs. Mad Science guides the reader through identifying these assumptions, and then rigorously evaluates the underlying scientific evidence.
As co-chair of the Diagnostic Summit Committee of the Society for Humanistic Psychology, I am pleased to announce that today we officially launch the Global Summit on Diagnostic Alternatives (DxSummit.org), an online platform for rethinking mental health. Our goal is to provide a place for a collegial and rigorous discussion of alternative ways to conceptualize and practice diagnosis. Today's launch is marked by the appearance of our first eight posts. These posts come from a variety of prominent people in the field, each offering a unique perspective on the current state of diagnosis and where we might take things as we move forward.
Yes, a psychiatric diagnosis can be a dangerous thing to have. But, these days, so is having any medical diagnosis. The names and words of the diagnoses themselves are not so much to blame for the harm. Rather, the harm comes through the ways the diagnoses are created and how they are used.