50 Things Wrong With A Psychiatric Diagnosis
Aug 1, 2017 17:40:46 GMT
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Post by Admin on Aug 1, 2017 17:40:46 GMT
50 Things Wrong With A Psychiatric Diagnosis.
1) The alleged concept of mental illness is itself in doubt. There is a vast literature about this, challenging the paradigm of the Medical Model. There are many altenatives including Developmental and Trauma models, psycho-spiritual crisis, relationship overwhelm, situational overwhelm, Labeling-Social Reaction Theory, and Social Constructionism.
2) The concepts of "Normal" and "Abnormal" are suspect. What are the criteria? Who defines "Normal"? Do we even have an ability to define, judge and apply?
3) When establishing the categories and classifications of alleged mental illnesses, i.e. the DSM-5, and ICD10, the drafters already assumed ideological positions, and are defining categories through vested interests. The results are neither scientific nor value free.
e.g. amongst many other IDEOLOGICAL POSITIONS:
4) There is a removal of the alleged "patient" from his communal, social, economic, political context. There is a bias as regards positions between collectivism and individualism.
5) Psychiatric diagnosis uses alleged illnesses to obscure and hide injustices and human conflicts. There is victim blaming. It needs to be clarified, to what extent so-called symptoms are actually realistic responses to external circumstances.
6) Psychiatric diagnosis disguises the vested interests of others e.g. Schools and universities, employers, communities, congregations, spouses and families to seek a diagnosis in order to justify dealing with the alleged "patient".
7) Psychiatric Diagnosis may serve the interests of social control. Any disliked or undesirable behaviour could be declared a mental illness and be set up for control.
8) Psychiatric diagnosticians are taking a physical, materialist postion, rather than an idealist or dualist position. They assume that the mind is the brain.
When a diagnosis sources thoughts, feelings and actions as caused by the brain, we have to ask, "What is "The Person"?
Biomedical explanations are chosen over psycho-social approaches. The choice of a genetic, biomedical model serves the interests of those who wish to avoid family and community activity and the possibilities of change.
By calling problems biological illnesses, it appears that they are fixed in nature, immune to socio-economic or personal change.
9) Psychiatric description tends to assume a causal-deterministic rather than a choice/free will/agency philosophy. "The Person" as agent tends to be lost.
The preference for a causal-deterministic approach (not only biological but also social and psychological causation) rather than a choice-agency approach serves the interests of those who do not want to feel responsible.
10) A biomedical model also serves the interests of the pharmaceutical industry, whose role in creating the categories of diagnosis cannot be ignored.
11) Psychiatrists, being doctors have a predominantly biomedical rather than psychotherapeutic training .To stay in the market and be able to practice a medical approach, a medical style diagnosis and treatment is needed.
12) Medical Aid insurance requires that something is defined as an illness before they'll pay for it. Here is a financial incentive for a diagnosis.
13) There may be a differences in orientation between psychiatrists and alleged patients regarding atheist, religious or mystical positions, and the use of diagnostic actions to implement these positions.
Missionary activity may be involved, to convert the client to the therapist's religion, or the reverse, to remove the patient's religion. Religious or atheist intentions are an ulterior motive in diagnosis and therapy i.e. religious abuse in therapy.
Someone from the background of a religious value system may talk about the "soul" while empiricism and materialism exclude the soul and attribute everything to the body-brain.
14) Gender, age, race, religion and social economic class affect psychiatric description and diagnosis. Diagnostic concepts and practitioners' judgments may have an ethnocentric bias.
15) The description and diagnosis will reflect the theoretical background of the practitioner. E.g. Psychodynamic tradition involving early childhood experiences may produce a developmental or trauma flavoured diagnosis, behaviourists will define people's problems in terms of learning and conditioning, a biological background could produce an organic disease diagnosis, a socialist background will suggest socio-economic conditions as causing distress.
16) While the diagnostic process may be largely descriptive, there is a strategic element involved, i.e. the doctor, community, family and client himself may be trying to achieve something. There is an agenda. E.g. removing a disliked person, escaping responsibility, facilitating a divorce, accessing care. The diagnostic process may involve scapegoating and 'Gaslighting'. Gaslighting is a dishonest, abusive technique causing a person to doubt his own perceptions, judgements and memories and may lead to a psychiatric diagnosis.
17)There are other philosphical positions involved in the concept of mental illness, the creation of categories, nosology-classification, and application which need explication.
18) The very limited nature of the diagnostic categories into which the rich and complex aspects of human behaviour are simplified, forced, pigeon holed, and named is out of touch with the nature of humanity. By accepting labels, someone accepts limitations to his nature and potential.
19) The selection and groupings of patterns of human behaviour into labels is capricious. There are myriads of possible ways of classifying and labeling ,and these are arbitrary, and man made not divine nor fixed in nature.
20) The subjectivity, and sometimes poor competence of some psychiatrists who establish a diagnosis based purely on the slander of others and a verbal interview, in the absence of any objective physical examination or laboratory tests does not inspire confidence. There are no objective tests like blood tests or X-rays.
The incompetence, moral failings, unethical behaviour or perhaps even the malicious intent of some diagnosing psychiatrists do not inspire confidence in their ability to accurately apply the already invalid diagnostic categories.
21) Projection:- The diagnosing practitioner, or community may be projecting their own imperfections and character flaws onto the patient/client.
22) A great leap is required by the psychiatric diagnostician over the gap between theoretical textbook DSM-5, descriptions and real life, applying a theoretical concept to a unique individual with a name, a face, a mind, heart, soul, and life. The categories are abstractions and do not correspond to real concrete life.
So we need to ask, Is the illness itself real? Is the diagnostic category valid? and is the diagnostic process reliable?
23) The uneven power balance between the psychiatrist and the alleged "patient"/client is of concern. A psychiatrist or psychologist may have a desire for power, and wish to control and "Fix" other people. The superior position of the diagnostician, accompanied by feelings of importance has it's counterpart in the shame and humiliation of the patient-client's inferior position.
24) The involuntary, coercive context of the diagnosis, where the alleged patient/client may not want to be diagnosed and may be unable to disagree and defend himself is a problematic aspect of psychiatric description and diagnosis.
Often the diagnosis is unilateral and the client may be able to only minimally contribute.
25) The confusion of behaviours with lesions. E.g. Psychiatric diagnoses frequently involve behaviours which are violations of social norms. Real Medical diagnoses involve Lesions. Lesions - tissue damage, deviations in anatomy, histology, physiology and biochemistry, and the presence of microorganisms. There is a conceptual leap from behaviour to so-called "illness"
26) Psychiatrists may be missing out on the presence of a real physical illness when making their psychiatric diagnosis. E.g. depression may be a symptom of hypothyroidism, influenza or a side effect of tranquilizers.
27) Psychiatrists may be missing out alternative explanations to the medical e.g. a narrative life history, involving bereavement, abuse, bad religious mystical experiences, turbulent romantic relationships and break-ups, financial loss or other trauma.
Bereavement and heartbreak are lost and forgotten in the term 'Disorder'.
Humanity and Empathy towards heartbreak, are lost in a scientific, technological approach.
Tragically, when one loses a loved one, the grief experienced is part of being human. Calling grief an illness is dehumanising.
'Diagnosis' implies 'Illness'. However a person's complex life narrative is NOT an illness.
28) The occurrence of False positives. I.e. The diagnosing of healthy people as sick.
29) Inconsistency. A person diagnosed with one mental disorder can see another psychiatrist and get a totally different diagnosis. This doesn't only take place between countries and cultures, but between individual psychiatrists.
30) A Psychiatric Diagnosis may be very vague and ill-defined. That is why the layman is fooled, because it appears as if only the expert can make the diagnosis.
31) Describing the person's behahaviour as given, instead of acknowledging that the person could behave differently.
32) The diagnosis imposes a static picture upon a dynamic person.
The diagnosis fixes in time what may be only a transient experience. What should only be an episode may be turned into a life long career. Something a child usually just "grows out of" is made into an issue.
Emotional distress and intellectual confusion should be transient, episodic.
What turns an Episode into a life long career?
Chronic medication? Societal labeling? Self labeling?
Prejudiced community members blocking return? Unemployment? Social isolation? and financial dependance?
33) The definers of diagnoses, are allowing treatment considerations to precede "illness" and classification. This may be influenced by pharmaceutical companies first having the drug, and needing to market, and secondarily defining the "illness".
34) There may be cultural, historical and geographical bias in a diagnostic category, and diagnosis application i.e. Relativism! Historicism means historical relativism. Clearly psychiatric diagnoses have changed through time. Recognised illnesses change with each new edition of the DSM.
35) Mental illness concepts may be socially constructed. In a capitalist system health may be defined in terms of being ready to work and produce.
36+ Psychiatric Diagnosis ignores the destructive consequences of the proceedings. The physical, psychological and social harm of a psychiatric diagnosis.
36) The language of psychiatric diagnosis is frequently slanderous, dehumanising, demeaning, degrading, infantilising and disempowering.
PSYCHIATRIC DESCRIPTION AND DIAGNOSIS, INFLUENCING PERCEPTION.
37) The language used in a description or diagnosis affects how we see people, and our way of seeing people affects how we treat them.
Picturing someone as less than human, makes it easier to treat him inhumanely.
Once a psychiatric description or diagnosis is applied, others, may look at the recipient differently as well as treat him differently.
38) The recipient of a psychiatric diagnosis may look at his own self in a different way to how he saw himself before.
39) A psychiatric description and diagnosis may produce self-stigmatisation with loss of feelings of self worth.
40) A description and diagnosis should only be an alleged attribute of a person not his entire identity. "You are not your diagnosis!"
41) A psychiatric description and diagnosis may tend to make the recipient perceive himself as helpless, dependant, powerless, and lacking control.
42) Hope Versus Despair.
Psychiatric Description and Diagnosis takes away hope:
Descriptions and diagnoses such as schizophrenia and personality disorder, seen as a life-long condition, can unnecessarily take away people’s hope for a future life.
43) Painting someone with a psychiatric diagnosis may be setting him up for social stigmatisation with damage and losses in the worlds of employment, friendships, relationships and marriage. The recipent of a psychiatric label becomes subject to discrimination, rejection and exclusion, a diagnosis may result in isolation and loneliness.
44) Psychiatric diagnoses have a "stickiness", once applied they are hard to get rid of.
45) A psychiatric diagnosis may act as a self-fulfilling prophecy, and the client may behave according to its expectations and stereotypes. The self-identity of those labeled may be determined or influenced by the terms used to describe or classify them.
46) The concept of 'diagnosis' implies illness, resulting in the recipient of a psychiatric diagnosis perceiving his task as getting cured instead of seeing his task as living his life. Also, living of one's life, should be authentic, personal, creative and free and not being "fixed" by someone else.
47) The psychiatric diagnosing, induction, orientation, and hospitalisation procedures are degrading and demoralising. This is an aspect of dehumanization.
48) Psychiatric Diagnosing may lead to radical and undesirable treatments such as incarceration, drugging, electric shocks and lobotomies. Therapy itself may be filled with pitfalls, abuses and negative consequences.
49) A psychiatric diagnosis and treatment are themselves traumatizing and produce distress in a vicious circle!
50) Is a psychiatric diagnosis necessary, when it does not benefit, when it does more harm than good?
For thousands of years people have comforted and counselled each other without resorting to the illness concept. We can listen to a person's life story and description of distress, and offer help without making a diagnosis.
- Jonathan Fishman
1) The alleged concept of mental illness is itself in doubt. There is a vast literature about this, challenging the paradigm of the Medical Model. There are many altenatives including Developmental and Trauma models, psycho-spiritual crisis, relationship overwhelm, situational overwhelm, Labeling-Social Reaction Theory, and Social Constructionism.
2) The concepts of "Normal" and "Abnormal" are suspect. What are the criteria? Who defines "Normal"? Do we even have an ability to define, judge and apply?
3) When establishing the categories and classifications of alleged mental illnesses, i.e. the DSM-5, and ICD10, the drafters already assumed ideological positions, and are defining categories through vested interests. The results are neither scientific nor value free.
e.g. amongst many other IDEOLOGICAL POSITIONS:
4) There is a removal of the alleged "patient" from his communal, social, economic, political context. There is a bias as regards positions between collectivism and individualism.
5) Psychiatric diagnosis uses alleged illnesses to obscure and hide injustices and human conflicts. There is victim blaming. It needs to be clarified, to what extent so-called symptoms are actually realistic responses to external circumstances.
6) Psychiatric diagnosis disguises the vested interests of others e.g. Schools and universities, employers, communities, congregations, spouses and families to seek a diagnosis in order to justify dealing with the alleged "patient".
7) Psychiatric Diagnosis may serve the interests of social control. Any disliked or undesirable behaviour could be declared a mental illness and be set up for control.
8) Psychiatric diagnosticians are taking a physical, materialist postion, rather than an idealist or dualist position. They assume that the mind is the brain.
When a diagnosis sources thoughts, feelings and actions as caused by the brain, we have to ask, "What is "The Person"?
Biomedical explanations are chosen over psycho-social approaches. The choice of a genetic, biomedical model serves the interests of those who wish to avoid family and community activity and the possibilities of change.
By calling problems biological illnesses, it appears that they are fixed in nature, immune to socio-economic or personal change.
9) Psychiatric description tends to assume a causal-deterministic rather than a choice/free will/agency philosophy. "The Person" as agent tends to be lost.
The preference for a causal-deterministic approach (not only biological but also social and psychological causation) rather than a choice-agency approach serves the interests of those who do not want to feel responsible.
10) A biomedical model also serves the interests of the pharmaceutical industry, whose role in creating the categories of diagnosis cannot be ignored.
11) Psychiatrists, being doctors have a predominantly biomedical rather than psychotherapeutic training .To stay in the market and be able to practice a medical approach, a medical style diagnosis and treatment is needed.
12) Medical Aid insurance requires that something is defined as an illness before they'll pay for it. Here is a financial incentive for a diagnosis.
13) There may be a differences in orientation between psychiatrists and alleged patients regarding atheist, religious or mystical positions, and the use of diagnostic actions to implement these positions.
Missionary activity may be involved, to convert the client to the therapist's religion, or the reverse, to remove the patient's religion. Religious or atheist intentions are an ulterior motive in diagnosis and therapy i.e. religious abuse in therapy.
Someone from the background of a religious value system may talk about the "soul" while empiricism and materialism exclude the soul and attribute everything to the body-brain.
14) Gender, age, race, religion and social economic class affect psychiatric description and diagnosis. Diagnostic concepts and practitioners' judgments may have an ethnocentric bias.
15) The description and diagnosis will reflect the theoretical background of the practitioner. E.g. Psychodynamic tradition involving early childhood experiences may produce a developmental or trauma flavoured diagnosis, behaviourists will define people's problems in terms of learning and conditioning, a biological background could produce an organic disease diagnosis, a socialist background will suggest socio-economic conditions as causing distress.
16) While the diagnostic process may be largely descriptive, there is a strategic element involved, i.e. the doctor, community, family and client himself may be trying to achieve something. There is an agenda. E.g. removing a disliked person, escaping responsibility, facilitating a divorce, accessing care. The diagnostic process may involve scapegoating and 'Gaslighting'. Gaslighting is a dishonest, abusive technique causing a person to doubt his own perceptions, judgements and memories and may lead to a psychiatric diagnosis.
17)There are other philosphical positions involved in the concept of mental illness, the creation of categories, nosology-classification, and application which need explication.
18) The very limited nature of the diagnostic categories into which the rich and complex aspects of human behaviour are simplified, forced, pigeon holed, and named is out of touch with the nature of humanity. By accepting labels, someone accepts limitations to his nature and potential.
19) The selection and groupings of patterns of human behaviour into labels is capricious. There are myriads of possible ways of classifying and labeling ,and these are arbitrary, and man made not divine nor fixed in nature.
20) The subjectivity, and sometimes poor competence of some psychiatrists who establish a diagnosis based purely on the slander of others and a verbal interview, in the absence of any objective physical examination or laboratory tests does not inspire confidence. There are no objective tests like blood tests or X-rays.
The incompetence, moral failings, unethical behaviour or perhaps even the malicious intent of some diagnosing psychiatrists do not inspire confidence in their ability to accurately apply the already invalid diagnostic categories.
21) Projection:- The diagnosing practitioner, or community may be projecting their own imperfections and character flaws onto the patient/client.
22) A great leap is required by the psychiatric diagnostician over the gap between theoretical textbook DSM-5, descriptions and real life, applying a theoretical concept to a unique individual with a name, a face, a mind, heart, soul, and life. The categories are abstractions and do not correspond to real concrete life.
So we need to ask, Is the illness itself real? Is the diagnostic category valid? and is the diagnostic process reliable?
23) The uneven power balance between the psychiatrist and the alleged "patient"/client is of concern. A psychiatrist or psychologist may have a desire for power, and wish to control and "Fix" other people. The superior position of the diagnostician, accompanied by feelings of importance has it's counterpart in the shame and humiliation of the patient-client's inferior position.
24) The involuntary, coercive context of the diagnosis, where the alleged patient/client may not want to be diagnosed and may be unable to disagree and defend himself is a problematic aspect of psychiatric description and diagnosis.
Often the diagnosis is unilateral and the client may be able to only minimally contribute.
25) The confusion of behaviours with lesions. E.g. Psychiatric diagnoses frequently involve behaviours which are violations of social norms. Real Medical diagnoses involve Lesions. Lesions - tissue damage, deviations in anatomy, histology, physiology and biochemistry, and the presence of microorganisms. There is a conceptual leap from behaviour to so-called "illness"
26) Psychiatrists may be missing out on the presence of a real physical illness when making their psychiatric diagnosis. E.g. depression may be a symptom of hypothyroidism, influenza or a side effect of tranquilizers.
27) Psychiatrists may be missing out alternative explanations to the medical e.g. a narrative life history, involving bereavement, abuse, bad religious mystical experiences, turbulent romantic relationships and break-ups, financial loss or other trauma.
Bereavement and heartbreak are lost and forgotten in the term 'Disorder'.
Humanity and Empathy towards heartbreak, are lost in a scientific, technological approach.
Tragically, when one loses a loved one, the grief experienced is part of being human. Calling grief an illness is dehumanising.
'Diagnosis' implies 'Illness'. However a person's complex life narrative is NOT an illness.
28) The occurrence of False positives. I.e. The diagnosing of healthy people as sick.
29) Inconsistency. A person diagnosed with one mental disorder can see another psychiatrist and get a totally different diagnosis. This doesn't only take place between countries and cultures, but between individual psychiatrists.
30) A Psychiatric Diagnosis may be very vague and ill-defined. That is why the layman is fooled, because it appears as if only the expert can make the diagnosis.
31) Describing the person's behahaviour as given, instead of acknowledging that the person could behave differently.
32) The diagnosis imposes a static picture upon a dynamic person.
The diagnosis fixes in time what may be only a transient experience. What should only be an episode may be turned into a life long career. Something a child usually just "grows out of" is made into an issue.
Emotional distress and intellectual confusion should be transient, episodic.
What turns an Episode into a life long career?
Chronic medication? Societal labeling? Self labeling?
Prejudiced community members blocking return? Unemployment? Social isolation? and financial dependance?
33) The definers of diagnoses, are allowing treatment considerations to precede "illness" and classification. This may be influenced by pharmaceutical companies first having the drug, and needing to market, and secondarily defining the "illness".
34) There may be cultural, historical and geographical bias in a diagnostic category, and diagnosis application i.e. Relativism! Historicism means historical relativism. Clearly psychiatric diagnoses have changed through time. Recognised illnesses change with each new edition of the DSM.
35) Mental illness concepts may be socially constructed. In a capitalist system health may be defined in terms of being ready to work and produce.
36+ Psychiatric Diagnosis ignores the destructive consequences of the proceedings. The physical, psychological and social harm of a psychiatric diagnosis.
36) The language of psychiatric diagnosis is frequently slanderous, dehumanising, demeaning, degrading, infantilising and disempowering.
PSYCHIATRIC DESCRIPTION AND DIAGNOSIS, INFLUENCING PERCEPTION.
37) The language used in a description or diagnosis affects how we see people, and our way of seeing people affects how we treat them.
Picturing someone as less than human, makes it easier to treat him inhumanely.
Once a psychiatric description or diagnosis is applied, others, may look at the recipient differently as well as treat him differently.
38) The recipient of a psychiatric diagnosis may look at his own self in a different way to how he saw himself before.
39) A psychiatric description and diagnosis may produce self-stigmatisation with loss of feelings of self worth.
40) A description and diagnosis should only be an alleged attribute of a person not his entire identity. "You are not your diagnosis!"
41) A psychiatric description and diagnosis may tend to make the recipient perceive himself as helpless, dependant, powerless, and lacking control.
42) Hope Versus Despair.
Psychiatric Description and Diagnosis takes away hope:
Descriptions and diagnoses such as schizophrenia and personality disorder, seen as a life-long condition, can unnecessarily take away people’s hope for a future life.
43) Painting someone with a psychiatric diagnosis may be setting him up for social stigmatisation with damage and losses in the worlds of employment, friendships, relationships and marriage. The recipent of a psychiatric label becomes subject to discrimination, rejection and exclusion, a diagnosis may result in isolation and loneliness.
44) Psychiatric diagnoses have a "stickiness", once applied they are hard to get rid of.
45) A psychiatric diagnosis may act as a self-fulfilling prophecy, and the client may behave according to its expectations and stereotypes. The self-identity of those labeled may be determined or influenced by the terms used to describe or classify them.
46) The concept of 'diagnosis' implies illness, resulting in the recipient of a psychiatric diagnosis perceiving his task as getting cured instead of seeing his task as living his life. Also, living of one's life, should be authentic, personal, creative and free and not being "fixed" by someone else.
47) The psychiatric diagnosing, induction, orientation, and hospitalisation procedures are degrading and demoralising. This is an aspect of dehumanization.
48) Psychiatric Diagnosing may lead to radical and undesirable treatments such as incarceration, drugging, electric shocks and lobotomies. Therapy itself may be filled with pitfalls, abuses and negative consequences.
49) A psychiatric diagnosis and treatment are themselves traumatizing and produce distress in a vicious circle!
50) Is a psychiatric diagnosis necessary, when it does not benefit, when it does more harm than good?
For thousands of years people have comforted and counselled each other without resorting to the illness concept. We can listen to a person's life story and description of distress, and offer help without making a diagnosis.
- Jonathan Fishman