Robert Whitaker’s website, Mad in America, is abuzz lately with articles challenging the medical model that underlies DSM and psychiatric “treatment” in general.
Recently there was an article by Alice Keys, MD, called “Do Diagnoses Injure People?” Of course I believe emphatically that they do, and I read the article.
Much of the content is valuable, and I encourage readers to take a look.
There was one aspect of the piece, however, that I found troubling. Dr. Keys made the point that psychiatric diagnoses can be dangerous, but then mitigated this considerably by making the same assertion about medical diagnoses in general. Whilst there may be a measure of truth to this assertion, it is misleading, in that it creates the impression that psychiatric “diagnoses” are just as valid as real medical diagnoses, which is simply not the case.
Dr. Keys points out that psychiatric diagnoses are based on lists of signs and symptoms. She then states: “Congestive heart failure, malignant melanoma stage four and rheumatoid arthritis are all defined by lists of signs and symptoms.”
But this latter statement is not true. Dr. Keys is confusing the concepts of definition and diagnosis. Congestive heart failure, for instance, is defined as “heart failure in which the heart is unable to maintain an adequate circulation of blood in the bodily tissues or to pump out the venous blood returned to it by the veins” [Merriam-Webster]. It is caused by specific heart disease(s) or by chronic high blood pressure. It is indeed diagnosed by signs and symptoms, but defined by actual pathology. Similarly for melanoma and arthritis. Psychiatric “diagnoses” on the other hand are actually defined by the DSM’s criteria sets (signs and symptoms). There is no reference to an established underlying pathology. Psychiatric “diagnoses” are simply shorthand labels for behaviors, and not very reliable labels at that.
It is a primary tenet of this website that psychiatric “diagnoses” are NOT valid explanations in the sense that general medical diagnoses are, and we need to resist any suggestion to the contrary.