One list member suggested (quite rightly) that diagnosing is an
unsophisticated response to a complex issue. The reply they recieved was
that it sometimes depended upon how you employed it. Well, there is only one
way for a clinician to employ a diagnosis of mental illness/disorder -
fraudulently

I don't think it helps that in the argument we occasionally shift from using
the term 'diagnostic labelling' (i.e., giving someone a label based on a
diagnostic process) 'to labelling' (which is a catch-all type term that
could refer as much to pricing up a tin of baked beans as it could to
damning a person we don't understand or don't like as disease ridden). I
think we would be better to keep tightly focused on the issue and context
that generated the heat in the discussion. What we were talking about was
the diagnoses of children with mental disorders (ADD, ADHD etc). It is here
that this social practice is completely, unequivocally wrong and should be
utterly condemned whether or not it is state-sanctioned.

Diagnostic labels such as ADHD, OCD, ADD, depression, schizophrenia and so
on are diagnosed in ways that lack any scientific credibility because the
diagnostic categories are based on speculative rather than empirical
evidence (clinicians think the 'patient' is ill but can't actually prove
they are ill) and the diagnostic process is based on a social not a medical
judgement. 'Patients' are then treated with procedures that are experimental
and whose efficacy is unproven (the treatments can't be anything other given
they are designed to treat medical conditions that have yet to be proven to
exist and have been speciously diagnosed). If you are diagnosed as mentally
ill/disordered you can't be cured but you can be treated (you cannot cure
someone of something that has not been proven to exist but you can treat
them if you think that it does exist) which is very convenient because for
Big Pharma 'patients' are then placed on medication for life - lives which
are often shortened as a result - or on probation and under surveilance for
life (you will be forced to declare it when you travel to certain countries
[like the UsofAmerica], apply for certain [most] employment etc).

The clinician who diagnoses someone as having a mental illness does so
recklessly and irresponsibly by borrowing the language of medicine without
applying even a rudimentary understanding of medical science nor fully
recognising the social consequences of what they do. They then defend their
practice by claiming that those who don't believe in the practice of
diagnosing mental illnesses are politically motivated and that those critics
are using ideological rather than science based arguments. While all
knowledge becomes ideology once it affects how resources are distributed
(such that mainstream psychiatry and psychology are no less - perhaps more -
ideological than their critical counterparts), this defence/attack used by
the clinician is fallacious because the critiques of the practice of
diagnoses are more soundly science based than the diagnostic practice
itself. Why do clinicians continue to diagnose people as mentally ill and
mentally disordered? My experiences is that they do so because of
self-interest, carelessness or incompetence (but usually a mix of all
three).

The argument that diagnosing people helps people because it means you can
access more resources conflates the practice of diagnosis with the practice
of discriminatory/competitive resource distribution and perversely turns two
negatives into a positive. Conflating them in this way makes the issue seems
to some to be more complex than it is. How bad/dishonest does our practice
have to get before we decide that the fact the state sponsors/encourages
the practice does not make it legitimate nor make it any less of a crime.

The suggestion that we can defend the practice of diagnosing children (and
adults) with disorders like ADHD, ADD, etc, which results in many getting
prescribed amphetamine derivatives as 'treatments' would be risible if it
wasn't so dangerous. In fact, it upsets me. And, by the way, you can be
emotional and rational at the same time. Indeed, it surprises me that anyone
could not be in relation to these issues.

With the greatest respect to list members who believe that there is worth to
the 'patient' in diagnosing them as mentally ill/disordered, you get plenty
of opportunity to express your views unchallenged outside of this list while
those of us who challenge diagnostic practices in education and the mental
health field cannot go unchallenged at any point in our working lives given
we are proposing a view that is viewed as dangerous and irresponsible by Big
Pharma and their proxies (psychiatrists and psychologists in particular) and
we regularly get roughed up as a result (research funding, publishing
opportunities, professional registration and employment contracts threatened
or withheld or withdrawn). It is not that I want to close down debate about
this issue, I don't, but I would be dishonest if I didn't say how wearisome
I find such debates happening on this list when I thought we collectively
would have been critically minded enough to identify and resist the
fraudulent use of medicalised language when we talk about the education and
care of our children and to escape the disciplining gaze over us, for at
least a little while at least, of Big Pharma and Big Psy.

My test for any group of psychologists is to walk into their room and start
talking to them about how mental illnesses are real illnesses that need to
be diagnosed and treated as such by our profession. If they don't all start
either falling off their seats roaring uncontrollably with laughter to hear
such a funny man speaking or jump out of their seats weeping with
incredulity at such a stupid man speaking, I know that it's time to leave,
and that it would be best to lock the door on them behind me. But equally, I
have to make sure I laugh and cry if someone comes into my room when I am
there with my colleagues and says these things to us or else I might become
locked in a room with a group of psychologists that I would rather not be
around.

Paul Duckett
Division of Psychology and Social Change
Manchester Metropolitan University
England
Phone +44 161 247 2552
Fax +44 161 247 6364
email: [log in to unmask]

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