In Daniel Carlat’s book “Unhinged” he talks a lot about psychiatric diagnosis. He talks about the controversy regarding the DSM and the seeming proliferation of diagnosis for every problem in life and makes a point I have not heard enough people talk about.
He says that in his experience the real problem is not, as many critics have said, that everyone is being given a diagnosis for issues that are basically part of normal life. He says that the real problem is not that people are being told they need help when they dont, but that people who do need help are too often being shortchanged by the way diagnostic labels are being used.
Psychiatrists are too often, under the illusion, that diagnosing someone is the same as understanding them. They believe that people are the labels they attach to them, the names they call them. Psychiatry basically becomes a mechanical process. It becomes about what niche you fit into and what is done to people in that niche, instead of about understanding who you are.
Meaning matters. The meaning of what I do may have something to do with how the pattern of my behaviors compare to the pattern of other peoples behavior, but it is more dependent on the context of my experience. My social, cultural, historical, emotional, spiritual, and cognitive context give meaning to what I do and who I am.
No matter how much someone knows about me it doesnt mean they know me.
Treatment is, or at least should be, about what is done with me- not simply to me. It is, I think, why so many people feel disregarded by their experience in the mental health system and why so many people fall to seek the help they may really need.