The Harm Suffered by Many because of a Psychiatric Diagnosis is a Well-Kept Secret
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This website is not supported by any funding, and it is totally independent of all groups and organizations.
Copyright © 2011-2017 by Paula J. Caplan. All rights reserved.
Caplan not connected with Scientology, as explained in this Letter to the Editor.
People — even many psychotherapists — often assume that psychiatric diagnosis is a science. The fact is, however, that very little solid science goes into the creation of categories of psychiatric diagnosis or the application of them to patients. (For more about this, click on Further Reading button below) And when science is absent, every conceivable kind of bias can enter in to decisions about who is diagnosed as mentally ill and which label they are given.
The impetus for this website is the project of issuing a public call for Congressional hearings about psychiatric diagnosis. Since psychiatric diagnosis is unregulated, since many people are harmed because of getting a diagnosis, and since the extent of harm needs to be documented and ways to minimize such harm need to be found and implemented, Congressional hearings are one of six important steps that can be taken to reduce the harm. Hearings would put psychiatric diagnosis in the public eye and on the national agenda.
The concerns about psychiatric diagnosis apply not only to those diagnostic labels found in any official diagnostic manual but also to other diagnoses, since the latter are constantly being invented and used.
Copyright © 2011-2017 by Paula J. Caplan. All rights reserved.
Caplan not connected with Scientology, as explained in this Letter to the Editor.
People — even many psychotherapists — often assume that psychiatric diagnosis is a science. The fact is, however, that very little solid science goes into the creation of categories of psychiatric diagnosis or the application of them to patients. (For more about this, click on Further Reading button below) And when science is absent, every conceivable kind of bias can enter in to decisions about who is diagnosed as mentally ill and which label they are given.
The impetus for this website is the project of issuing a public call for Congressional hearings about psychiatric diagnosis. Since psychiatric diagnosis is unregulated, since many people are harmed because of getting a diagnosis, and since the extent of harm needs to be documented and ways to minimize such harm need to be found and implemented, Congressional hearings are one of six important steps that can be taken to reduce the harm. Hearings would put psychiatric diagnosis in the public eye and on the national agenda.
The concerns about psychiatric diagnosis apply not only to those diagnostic labels found in any official diagnostic manual but also to other diagnoses, since the latter are constantly being invented and used.
VIDEO -- Psychiatric Diagnosis: The First Cause of Everything Bad in the Mental Health System -- Harvard lecture with performance https://youtu.be/-qIQqRl94_YTo Warn or Not to Warn: essay about why it's harmful, even dangerous to name any psychiatric diagnosis without at least putting it in quotation marks and ideally warning that psychiatric categories are unscientific, are rarely helpful (except for getting insurance to pay for therapy), and expose people given the labels to a vast array of risks of harm. https://www.madinamerica.com/2019/06/critique-diagnostic-terminology/?fbclid=IwAR0Gkb7pQi6semc7ys7eRRh16ltCRAe5ATK7nrAzxdxLzhkaAnxa4U6ERYo |
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Major summary of psychiatric diagnosis matters
This video is a lecture by Paula J. Caplan, and the text following the link here was compiled by Dr. Leslie Anderson and lists references mentioned in the lecture. https://youtu.be/73xZl20MpSg
Webpage: psychdiagnosis.weebly.com
(1) Caplan, Paula J. (1996 paperback). They Say You’re Crazy: How the World’s Most Powerful Psychiatrists Decide Who’s Normal. https://www.amazon.com/They-Youre-Crazy-Paula-Caplan/dp/0201488329/ref=sr_1_1?ie=UTF8&qid=1539957289&sr=8-1&keywords=they+say+you%27re+crazy
(2) Caplan, Paula J. (2015). Diagnosisgate: Conflict of interest at the top of the psychiatric apparatus. APORIA:The Nursing Journal 7(1), 30-41
http://www.oa.uottawa.ca/journals/aporia/articles/2015_01/commentary.pdf
(3) Caplan, Paula J., & Patterson, Kade. (2015). Recent case raises hopes for reducing harm from psychiatric labeling: A blow against “weaponized diagnosis.” APORIA: The Nursing
Journal 7(3), 29-36. http://www.oa.uottawa.ca/journals/aporia/articles/2015_07/commentary.pdf
(4) Caplan, Paula J. (2013). Call me Crazy. Online play. https://www.youtube.com/watch?v=6myXKiXGuUA
Is anybody normal? And who gets to decide? And how do they decide? A young therapy trainee on the last day of her internship starts to question the supervisor she has respected and trusted all year.
(5) Caplan, Paula J., organizer, Harvard Ash Center (2011). A Better Welcome Home for Veterans. 28 brief videos of nonpathologizing, effective ways to help veterans and their loved ones: https://www.youtube.com/playlist?list=PL51E99E866B9D735E
(6) Caplan, Paula J., producer. (2014). “Is Anybody Listening?” documentary film includes depathologizing of reactions to war trauma and rape trauma https://www.isanybodylisteningmovie.org
(7) Caplan, Paula & L. Cosgrove (Eds.). Bias in Psychiatric Diagnosis. https://www.amazon.com/Bias-Psychiatric-Diagnosis-Paula-Caplan/dp/0765700018
(8) Caplan, Paula J. Website: Ending Harm From Psychiatric Diagnosis. https://psychdiagnosis.weebly.com
(9) Cohen, D. (2004). Broken Brains or Flawed Research? The Journal of Mind and Behavior, 25(2). http://www.mentalhealthexcellence.org/wp-content/uploads/2013/10/neruoimagingupdate.pdf
(10) Cohen, D., & Jacobs, D. (2007). Randomized controlled trials of antidepressants: clinically and scientifically irrelevant. Debates in Neuroscience, 1, pp. 44-54. https://link.springer.com/article/10.1007/s11559-007-9002-x
(11) Hearing Voices Network. https://www.hearing-voices.org
(12) NARPA (National Association for Rights Protection and Advocacy.) http://www.narpa.org
(13) Oaks, David. MindFreedom http://www.mindfreedom.org/who-we-are/david-w-oaks/david-w-oaks-mindfreedom/view
(14) Seeman, Philip. (2006). Probing the Biology of Psychosis, Schizophrenia, and Antipsychotics: An Expert Interview With Dr. Philip Seeman, MD, PhDhttps://www.medscape.com/viewarticle/547112
(15) Spaulding, W., Sullivan , M., & Poland, J. (2003). Treatment and Rehabilitation of Severe Mental Illness. Guilford Press. https://www.amazon.com/Treatment-Rehabilitation-Severe-Mental-Illness/dp/1572308419/ref=sr_1_1?ie=UTF8&qid=1539957615&sr=8-1&keywords=Treatment+and+rehabilitation+of+severe+mental+illness&dpID=41PionnXsCL&preST=_SY291_BO1,204,203,200_QL40_&dpSrc=srch
(16) Stefan, Susan. (2016). Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law (American Psychology-Law Society Series) 1st Edition https://www.amazon.com/Rational-Suicide-Irrational-Laws-Psychology-Law/dp/0199981191
(17) Watters, Ethan. (2009). Crazy like us: The globalization of the American psyche. http://novselect.ebscohost.com/Display/TreeNodeContent?format=html&profile=s4872903.main.novsel3&password=dGJyMOPY8Ui2qLIA&ui=436152&schema=http:&source=154378&version=2.1&print=true
(18) Watters, Ethan. (2010). The Americanization of mental illness. New York Times Magazine. http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html
(19) Whitaker, Robert. (2011). Anatomy of an Epidemic:Magic Bullets, Psychiatric Drugs,and the Astonishing Rise of Mental Illness in America. Broadway Books.
RECOMMENDATIONS based on students’ questions and discussion:
What can we do?- Never reify any diagnostic label. Instead, at least say, “This person has been diagnosed with or given the label of” X, instead of “This person HAS X.”
- Brochures in waiting rooms: What you should know about psychiatric diagnosis – that it is not scientific, is rarely helpful, and exposes labeled people to a wide array of risks of harm.
- If for whatever reason you are going to assign a diagnostic label, tell the client you are labeling them, and tell them why. Tell them even when you give an innocuous label that it can have harmful consequences. Tell them there is no science behind the label. Tell them what you think may be going on with them rather than that they “have” a psychiatric “illness.” Tell them what you will write on their chart, i.e., “The fact that this person has been given this diagnostic label should NOT be taken to indicate anything about their ability to be a good parent, employee, friend, caregiver, etc. And if anyone has any questions about this at any time, I will be happy to talk with them.” Tell the client they don’t have a flawed brain. Tell them to know in their heart they are not crazy. Explain that sometimes psychiatric labels are required to get benefits or services that they want and that you wish that were not necessary. Tell parents. . . (speak the truth). Instead of saying what’s wrong with you, ask “what happened to you?”
- Fight publicly if you can.
- Don’t spend time worrying about what’s in the DSM or not. Focus on the individual and their difficulties, strengths and resources.
- Radical honesty. The system should be changed so that insurance companies stop requiring a psychiatric diagnosis. Instead, anyone who is licensed to give labels should be told the following: describe the problem or the symptoms. . .not the label. Ask the client if the problem is subsiding. Tell the insurance company you expect you will need x number of sessions in order to help. If the client is not better after that number of sessions, don’t change the narrative, just tell what has been tried and ask for y (number of) more sessions.
- Join an organization called NARPA, narpa.org and attend its conferences.
- Form your own lobby groups. Educate school boards, parents etc.
- Consult psych diagnosis weebly site. (see reference above), and join Facebook pages “Stop Psychiatric Diagnosis Harm” and “Drop the Disorder.”
Further Reading
To read about the profoundly troubling implications of psychiatric diagnoses being overwhelmingly applied to people suffering from the effects of war, see this website for the book, where Paula J. Caplan writes a blog about matters related to this. She also writes about topics including but not limited to psychiatric diagnosis on her Psychology Today blog and her blog at paulajcaplan.net.
Two books contain extensive lists of descriptions of problems with psychiatric diagnosis.
In Paula J. Caplan's They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal, in the bibliography, books and articles that include at least some element of critical, questioning perspective are marked with asterisks (*).
The various chapters in the book Bias in Psychiatric Diagnosis include a wide variety of descriptions of specific forms of bias.