The biggest fallacy that I see in the DSM debate is not the proposal for a better diagnostic system but the fallacy that any diagnostic system is going to make things better. There is a difference in believing that a diagnosis might tell you something useful about someone and believing that it can tell you something fundamentally true about him. In the first instance the diagnosis is a map about a portion of someone’s experience which like all maps serves to guide you and inform you about how to make decisions about what to do. In the second the diagnosis is not a map to the truth, but the truth itself. It leads you to the ultimately destructive conclusion that a person is what you have decided to call him. The results in every form of human endeavor throughout history have proved time after time the tragedy of this. The history of the mental health system in this country has been too much a history of ultimately cruel and mean things being done to “mentally ill” people that we convince ourselves are being done for their own good. The lived experience of countless people is that labels, rather they be “scientific” or not, carry with them a great deal of prejudice and discrimination. Any professional who believes the act of labeling, regardless of the scientific language they cloak it in, is a morally neutral act is out of touch with the world of the people he labels.
The most important role of diagnosis that I can see is to insure that you receive payment for your services. Treatment seems to be relatively the same regardless of the diagnosis. Medications are not specific to diagnosis. The same meds are used for many varying diagnosis. We search energetically for the biological causes of things created by the consensus of a psychiatric committee without wondering whether or not social conventions have a biological basis.
This does not mean things dont have a biological basis. Everything does. But that is not the same as saying that bipolar disorder is the mental health version of diabetes. And it is not the same as saying that the biological component causes everything when much research tells us that the biological component is as fundamentally affected by the social component as the social component is by the biological component.
All this endless search for the correct diagnosis leaves us believing we have truly solved something when we figure out what is “wrong” with someone and losing the rather common sense notion that most people are a product of “what happened” to them. As the notion of trauma informed care gains more currency we are beginning to see more and more the shortcomings of the “what’s wrong” approach.
What I see in many recovery tools like WRAP is the recognition that people are helped most by giving them the resources to become stronger and more effective people. Recovery is based more on what people can do and growing the range of what they can do and less on what they cant do and teaching them to live with it. In fact the conclusion that I would make from something like WRAP is that the process of finding a new and better life is roughly the same for everyone regardless of the problems they have. If you do the things that make life better the things that make it worse find it much harder to make headway.
I hear many people quite rightfully saying that the emperors new clothes leave much to be desired. I agree. I just more people understood that maybe the emperor never had any clothes to begin with.
The biggest fallacy that I see in the DSM debate is not the proposal for a better diagnostic system but the fallacy that any diagnostic system is going to make things better. There is a difference in believing that a diagnosis might tell you something useful about someone and believing that it can tell you something fundamentally true about him. In the first instance the diagnosis is a map about a portion of someone’s experience which like all maps serves to guide you and inform you about how to make decisions about what to do. In the second the diagnosis is not a map to the truth, but the truth itself. It leads you to the ultimately destructive conclusion that a person is what you have decided to call him. The results in every form of human endeavor throughout history have proved time after time the tragedy of this. The history of the mental health system in this country has been too much a history of ultimately cruel and mean things being done to “mentally ill” people that we convince ourselves are being done for their own good. The lived experience of countless people is that labels, rather they be “scientific” or not, carry with them a great deal of prejudice and discrimination. Any professional who believes the act of labeling, regardless of the scientific language they cloak it in, is a morally neutral act is out of touch with the world of the people he labels.
The most important role of diagnosis that I can see is to insure that you receive payment for your services. Treatment seems to be relatively the same regardless of the diagnosis. Medications are not specific to diagnosis. The same meds are used for many varying diagnosis. We search energetically for the biological causes of things created by the consensus of a psychiatric committee without wondering whether or not social conventions have a biological basis.
This does not mean things dont have a biological basis. Everything does. But that is not the same as saying that bipolar disorder is the mental health version of diabetes. And it is not the same as saying that the biological component causes everything when much research tells us that the biological component is as fundamentally affected by the social component as the social component is by the biological component.
All this endless search for the correct diagnosis leaves us believing we have truly solved something when we figure out what is “wrong” with someone and losing the rather common sense notion that most people are a product of “what happened” to them. As the notion of trauma informed care gains more currency we are beginning to see more and more the shortcomings of the “what’s wrong” approach.
What I see in many recovery tools like WRAP is the recognition that people are helped most by giving them the resources to become stronger and more effective people. Recovery is based more on what people can do and growing the range of what they can do and less on what they cant do and teaching them to live with it. In fact the conclusion that I would make from something like WRAP is that the process of finding a new and better life is roughly the same for everyone regardless of the problems they have. If you do the things that make life better the things that make it worse find it much harder to make headway.
I hear many people quite rightfully saying that the emperors new clothes leave much to be desired. I agree. I just more people understood that maybe the emperor never had any clothes to begin with.