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by cluckindan 298 days ago
Relevant: https://ghaemi.substack.com/p/why-dsm-is-mostly-false

> All psychopathology was about unconscious emotional conflicts, mainly dating to childhood; if the conflicts were normal or mild, they produced “neuroses”; if they were severe, they produced “psychoses.”

> In addition to 14 validated diagnoses published in the RDC in 1978, a mere two years later DSM-III came out with 292 claimed diagnoses. There is no metaphysical possibility that 278 psychiatric diagnoses suddenly were discovered in two years. They were invented.
2 comments
bbor 298 days ago
That's just a blatant misunderstanding of what diagnostic criteria are. They don't Actually ("ontologically") exist, they're Virtual constructs made for a purpose.

   In particular, over half a century of personality research had supported the concept of personality “traits” or dimensions, rather than “disorders” or categories.
That is antithetical to the basic idea of a diagnosis. "You seem like an angry person" is not helpful for deciding which treatments to try.

  Where does this leave us?  We have to accept DSM-5 definitions from a legal and practical perspective. We have to use them for insurance forms, and to protect ourselves against lawsuits.  But we don't have to believe in them.
Yes, that's the whole point of the book. I'm confident that it's covered in the intro.
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XorNot 298 days ago
I mean the first and foremost principle of the DSM is that if the patient is not reporting or experiencing a debilitating ability to live a functional life, and is otherwise happy with their own lived experience, then whatever symptoms they have aren't a problem.

There's obviously a gulf of potential argument in that definition, but a unique form would be people who report hearing voices, but they're not hostile or angry..so actually it's not a problem.

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bbor 298 days ago
Well put, very true! I think (?) the technical term is “distress”. This is also their out for not getting rid of “transvestic disorder” yet, which they swear is totally unrelated to trans people, it’s just for men who feel compelled to wear dresses and are sad about it…
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nitwit005 298 days ago
All diagnoses are inherently made up. It's just humans lumping symptoms that appear similar into categories.

If you want to communicate about patients, you need an agreed set of categories.

What makes good categories is indeed what's most useful for the related profession(s). They're the ones who actually have to use them to communicate.

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