Welcome to From Insults to Respect.
In a recent post, I shared some of my views about the pros and cons of the mental illness concept. I’m retired now, but derived my way of looking at these issues when I was employed in various settings as a PhD level psychologist.
During my career, I often interacted with people who, upon accessing mental health services, came away believing they were diagnosed as having a mental illness. I found that some of these people were just fine with this, while others felt the label, which went into their personal health record, was disrespectful and misleading. Although I believe my experiences provide a useful perspective, I also believe it’s important to hear directly from people who have been labelled in this way. Today’s post gives voice to one such person.
David William Oaks is a co-founder and former executive director of MindFreedom International which rejects the domination of the biomedical model of most current psychiatrists. He became interested in this issue because of being, himself, institutionalized and forcibly medicated in the 1970s while studying at Harvard University for what was “diagnosed” as schizophrenia. In his view, he recovered by rejecting the label, along with the psychiatric drugs, and by getting support from family and friends. To see what his take is on this labelling issue, below I provide with his permission an abbreviated version of his “Let’s Stop Saying ‘Mental Illness’” article which you can read in its entirety HERE.
An Abbreviated Version Of “Let’s Stop Saying ‘Mental Illness’”
The term “mentally ill” is very much a narrow medical model. If you want to use that term about yourself that is one thing. But when anyone uses the phrase “mentally ill” about others, including me and other psychiatric survivors, the implication is that since an “illness” is the problem then a doctor ought to be part of the solution. “Mental illness” also says since the problem is like a materialistic physical illness, then perhaps the solution ought to be physical too, such as a chemical or drug or electricity.
Please note a subtlety here: My call is not about opposing the medical model, or any other particular model. My call is about opposing domination by any model in this complex field. My call is about opposing bullying in mental health care.
So let’s also drop the use of other words that tend to confine us in the dominant model. Let’s stop legitimating the use of words and phrases like “patient” and “chemical imbalance” and “biologically-based” and “symptom” and “brain disease” and “relapse” and all the rest of the medical terminology when we are speaking about those of us who have been labeled with a psychiatric disability.
By the way, have you been noticing a few “quotation marks”? Since 1969 when the movement began, mad activists have questioned language. What some activists do to provide just a little bit of breathing room between us and mental health industry language, is the generous use of quotation marks. For example, for decades some in our movement have changed, People with schizophrenia, to People with “schizophrenia.”
Quotation marks like this help the activist writer a bit, to show that it’s not the writer’s word, that he or she is just quoting someone else….
Psychiatric diagnosis has a tremendous amount of undue power.
I was diagnosed schizophrenic and bipolar, and found myself under the catch-all label of psychosis. To admit one has been officially labeled psychotic is perhaps one of the deepest closets to come out of, because the discrimination against those with that “p-word” label is so immense.
I prefer to talk about “discrimination,” rather than “stigma,” because discrimination is something we can actually challenge and change, such as through legislation. The word stigma, of course, comes from “branded,” and implies that my identity as a psychiatrically-labeled person is inherently negative, which is not always the case.
I would rather ask, “Who is doing the branding?”….
I understand that many people define themselves as “mentally ill,” and accept a medical model. If you do this, that is your choice. I respect you.
However, at this time, the “medical model” is dominant. The medical model has become a bully in the room. Language that somehow encourages that domination isn’t helpful to the nonviolent revolution in the mental health system we need, a nonviolent revolution of choice, empowerment, self-determination.
What about the many other people who define their problems from a social, psychological, spiritual or other point of view? And what about those who don’t see their differences as problems, just as differences, or even as qualities?
In fact, what about the subject of defamation? According to an attorney we work with, to falsely claim an individual is officially “mentally ill” with intent to harm them has been used in law schools as a classic example of defamation….
I’ve heard that some feel that using alternatives to medical model language somehow diminishes the seriousness of people’s personal pain, that, for example, being diagnosed with “clinical depression” underlines the gravitas of a crisis better than, say, “sad.” But there are words in the English language more fierce than “sad.” How about, for example, “extreme and catastrophic life-threatening anguish”? That phrase has a lot more gravitas than any clinical language I’ve ever heard!….
Some activists, including me, at certain times have sought to reclaim the words society has thrown our way. I realize others may not choose to ever use words like “mad” or “lunatic” or “crazy” or “bonkers” to describe themselves. We probably ought not use those colloquial terms in certain contexts, like arguing our rights in front of the United Nations or in a court hearing. But now and again, some of us like to have some fun and be outrageous, such as at MAD PRIDE events, where it is okay to be creative and reclaim language that has been used against us….
An oppressed group often seeks to redefine themselves as a first step toward liberation. For instance, many leaders of people we have known as Gypsies are asking to be called Romani. Look at all the permutations of language for African Americans just in the past century.
Mental health academics, such as Linda Morrison, PhD with her dissertation-based book Talking Back to Psychiatry, have even written treatises exploring the history of our movement’s ongoing wrestling match with language.
Why bother to replace “mentally ill” with something else, with anything else?
- We can show we are at the very least trying to listen to psychiatric survivors (like me!) who have strong preferences for what we call them.
- We can show we are trying to include a wide diversity of perspectives, including those who have often been excluded because of the current dominant paradigm in mental health.
- We can show we are trying to care, and that we too seek a nonviolent revolution in the mental health system!
So please, become a pioneer, and together let’s drop the use of the phrase “mental illness,” and search for more inclusive and creative phrases. This is a reminder that our words and even our whole social reality of what is called “normal,” are not forced upon us God-given by the heavens, but are constructs that we mortals all co-create, in our imperfection, in our freedom, together.
David Oaks is currently working on a revision of his “Let’s Stop Saying ‘Mental Illness’” article which will soon be found on his davidwoaks.com blog.
My Reaction To Dave Oats’ Perspective
Mr. Oats is by no means the only one who dislikes the mental illness label.
We can see this plainly when Emma Barnes, the author of the article, “Neurodiversity Is a Scientific Revolution,” asked a group of people who view themselves as neurodiverse, “What do you feel when someone suggests you’re ‘living with a mental illness?’” They replied:
“Eye roll until my face turns inside-out.”
“That makes my stomach drop, extremities tingle, and ears ring.”
“I feel discounted, belittled, shamed & surprised.”
“I feel the RAGE.”
“It makes me feel like I have to explain things very slowly with very small words. I tense up, I experience irritation.”
“I’m never gonna talk to you again if you say that.”
“Shut down, like the lid of a box is closing on my head.”
“Frustrated, alienated, defensive, tense.”
“I feel dread, a sense of tightness and unease in my body.”
“Angry, rejected, tired as all hell.”
“I feel discredited and written off, like all my accomplishments are nothing. Like I’m just some crazy person.”
“Nauseated. Critiqued. Dismissed.”
“Oof, immediately activated and sick tummy, like I want to run.”
“Nauseous, pissed, unseen, dismissed, bullied.”
Ms. Barnes goes on to say:
These people are writhing against “the Personal Tragedy model” of neurodisability. I share their discomfort at being labelled “ill”. Although I experience distress acutely, I don’t have a disease, a bug, or an error. I have a body. I have a nervous system. And just like everyone else, when my circumstances are untenable, my body protests.
To me, if I hear that someone views themselves as being neurodiverse rather than having a mental illness, I have no problem with that. I look to find ways to treat people with respect rather than to demean them with terminology they abhor. But my personal dislike with the mental illness terminology extends well beyond the respect issue.
Most people who have come to believe they have a mental illness believe so because they were given a mental disorder “diagnosis” by a psychiatrist or other licensed mental health professional. In our society, a mental disorder and a mental illness are largely viewed as synonyms. My major objection to the word “diagnosis” when used to label someone as either having a mental disorder or mental illness is that the designated patient typically comes away thinking the doctor now knows what is wrong. They think, “The reason I’ve been feeling depressed is I have Major Depressive Disorder,” or “The reason I have high levels of anxiety is I have an Anxiety Disorder,” etc.
This is terribly misleading. The “diagnosis” system was created by psychiatrists funded largely by the pharmaceutical industry which has a financial interest in labelling as many people as possible. Rather than a real diagnosis system, it is just some medically sounding words that these psychiatrists agreed to use whenever a patient answers a series of questions in a particular manner. The label does not indicate the mental health professional now knows why the patient is dealing with the expressed concern that led to seeking help. It is just a label masquerading as a diagnosis, in contrast to when a doctor declares a diagnosis after determining, for example, that someone with high fever and sore throat has a covid virus in his or her system. In this example, the diagnosis is a covid virus infection. Here the doctor knows the reason for the high fever and sore throat.
In my opinion, whenever professionals think they do know why the patient is experiencing the concern that led to seeking help, the professional properly would say, “My theory of why you are dealing with this concern is….”
Human beings are way too complicated for anyone to declare with certainty knowing the reason why someone is experiencing the kinds of concerns people seek help from mental health professionals. The language I advocate for, by being framed as a theory rather than a diagnosis, would go a long way from preventing the dishonest type of communication now regularly employed in our mental health system.
My Best,
Jeff
Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.
But the research reveals that, over the long term, this benefit turns into a negative, and so, over the long-term, there are only negatives to be chalked up: the increased chronicity of psychotic symptoms, the impaired functional outcomes, the worse cognitive functioning, and, of course, a broad range of “side effects,” such as tardive dyskinesia, metabolic problems, sexual dysfunction, and so forth. Such is the bottom-line arithmetic that makes the case against antipsychotics.”
Consequently, some of my readers showered me with praise for having the courage to stand up to the powerful pharmaceutical-psychiatric institutions, while others showered me with the most disrespectful insults known to the human race. 
And then there were those who disagreed with me but did so in a respectful manner. I believe it is my responsibility to now provide them a respectful response.
Any pill prescribed by a doctor will lead many to experience a placebo effect, which can be, for a period of time, helpful. I hasten to point out that a person can get a placebo effect with non-drug treatment approaches as well, and this would avoid the various harms associated with this type of drug.
These drugs are not only known as “antipsychotics,” but also “major tranquilizers,” because they sometimes do appear to calm someone in distress.
Unfortunately, once someone begins to take these drugs to help with agitation, when they try to come off of the drug, they are left with drug withdrawal experiences that have been described as awful. I hasten to point out that there are other ways to help someone to calm down that need not rely on these types of drugs. I have worked on many occasions with people who are agitated, and without the aid of a drug prescription I listened in a caring way, and in time the person eventually calmed down. If, however, you give someone a drug that calms the person down, it is sometimes much easier, and less time consuming. For people who witness someone they care about in high distress drift into a calmer state upon taking an “antipsychotic,” this can seem enormously helpful.
Some of them would have recovered in a fairly short period without the drug, but because they recovered while taking the drug, they, and their loved ones, attribute the improvement to the effectiveness of the drug. If the person tries to see whether the improvement was due to the drug or the natural recovery process, he or she may try to stop ingesting the drug.
However, the withdrawal from the drug, as I mentioned above, often causes a nasty physiological reaction which, in some ways, is similar to someone who is a coffee drinker who suddenly decides to stop, cold turkey. However, the “antipsychotic” physiological withdrawal reaction can be experienced as much worse. When people who care about this person see the downward spiral that occurs from the physiological withdrawal reactions, they may come to attribute it to the person’s “mental illness” returning, and thus, the illusion of long term effectiveness is now deeply entrenched.
Another way in which the illusion of the long term effectiveness of the drugs can occur has to do with the fact that even when the “diagnosed” person is not functioning well on a drug treatment regimen, human beings can always imagine that the patient would be doing even worse without taking the drug. And of course, when the patient does try to go off the drug, the raging physiological withdrawal process occurs. So, in this way, the combination of the belief that the patient could be doing worse, and upon becoming worse when trying to do without the drug, it convinces people that the drug treatment is helpful.
Once they take that position, and tell others what they had done, information that comes their way in the form of the distressed person having bad side-effects, or hearing from people who take the position that the drugs may be more harmful than helpful, a psychological phenomenon known as cognitive dissonance occurs. The principle of cognitive dissonance states that human beings strive for internal psychological consistency. When they experience internal inconsistency they become psychologically uncomfortable and a major way that they try to reduce the discomfort is by avoiding circumstances and contradictory information likely to increase the magnitude of the cognitive dissonance.
I have publicly supported the argument that these drugs cause more harm than good. Therefore it can be argued, it is I who suffer from cognitive dissonance whenever evidence comes my way that might support the idea that these drugs are helpful in the long run.
By the late 1990s, investigators had reported that antipsychotics caused basal ganglion structures and the thalamus to swell, and the frontal lobes to shrink, with these changes in brain volumes “dose related.” Then, in 1998, Raquel Gur, from the University of Pennsylvania, reported that the swelling of the basal ganglia and thalamus was “associated with greater severity of symptoms.”
The MRI studies provide objective evidence that antipsychotics cause changes in brain volumes that are associated with a worsening of symptoms, and a worsening of functional impairment.
In the article, Dr. Szasz put forth his belief that the behaviors and experiences that are considered “mental illnesses” are more accurately construed as problems in living. As someone whose family narrowly escaped the violent, inhumane actions of Hitler in 1938, he expressed a concern about society giving psychiatrists the authority to convert these problems into a language of illness. As he saw it, his own profession has a financial interest in converting more and more problems in living into illnesses that require its services to reach some vague harmonious state thought of as mental health. However, according to Szasz,
To Dr. Szasz, it is logically absurd to expect that it will help solve these types of problems by prescribing tranquilizers and other drugs as if they were like a bacterial infection, or the growth of a tumor. To be sure, people on their own have tried to deal with these problems by taking a wide range of drugs, such as alcohol, tobacco products, stimulants, and heroin. Such approaches, rather than promoting healthy outcomes, tend to lead to less healthy outcomes. 
To Szasz, changing to the drugs doctors prescribe to deal with these problems in living is like changing seats on the Titanic.
Dr. Szasz’s book, Law, Liberty, and Psychiatry, also was met with high praise. In a review published in the New York Times, Edward de Grazia wrote;
One boy had recently become depressed. When I asked him why he thought he was depressed, he said that his mother was making him take Ritalin to treat his ADHD. The boy didn’t believe he had ADHD, and when the drug’s stimulant effects began to wear off each evening, he was left feeling awful, with waves of sadness, stomach aches, and difficulty falling asleep.
At the same time, I had become concerned that so many of the kids referred to me who were in foster care were on drugs typically prescribed for people diagnosed as psychotic. These students typically were dealing with serious emotional challenges involving being taken from their parents’ home. A couple of these cases involved parental child abuse, others involved parents being sent to prison, and I had another case of a boy dealing with his parents dying in a car accident. My efforts to help these grieving kids became ever more difficult because of the side effects of the psychiatric drugs prescribed to them. Some of the side effects were known to be life threatening.
Regarding the October 3rd Binghamton Conference, I am writing in great dismay and utter incredulity that so much mental health money would be spent in this fashion. The money for the needed basic services has been so sharply reduced for our ill family members; plus with the number of mentally ill homeless ever increasing, then to see the large number of participants in such a program was definitely upsetting to me.
This time I did add to the panel a family member who belonged to the local chapter of the National Alliance On Mental Illness. Despite that, I received a letter from the president of that organization’s New York State chapter asking that the debate be cancelled. In his letter, he specifically objects to Dr. Szasz expressing his views.
Over the years, I found his love for his two daughters particularly heartwarming. I could easily relate to his feelings toward them because I have two dear sons.
So, what do you do in a situation like this, that is, a situation in which some people highly respect your friend, while others don’t? As for me, when I meet someone saying negative things about Dr. Szasz, I take some time to listen carefully, and I respectfully summarize the person’s position. I then gently say a few supportive things about Dr. Szasz, while bracing myself to deal with the person’s reaction. As the other person replies, I again listen, seeking to be as empathic as possible.
Many people have come to feel that the psychiatric profession has failed to treat them respectfully. Several issues have inflamed them, arguably the most emotional being involuntary drug treatment which, to them, is often viewed as torture.
“(a) Review the anti-torture framework in relation to persons with disabilities in line with the Convention on the Rights of Persons with Disabilities as authoritative guidance regarding their rights in the context of health-care;
Involuntary psychiatric interventions are legitimized under national laws, and may enjoy wide public support as being in the alleged “best interest” of the person concerned, or because it protects people in the community from the violence that some people labelled mentally ill will carry out. Nevertheless, according to the UN report, “…to the extent that they inflict severe pain and suffering, they violate the absolute prohibition of torture and cruel, inhuman and degrading treatment.
When people are forced to take psychiatric drugs, it often feels like torture because of a number of their side effects. For example, akathisia makes it hard to stay still. It causes an urge to move that you can’t control. You might need to fidget all the time, walk in place, or cross and uncross your legs. Akathisia is often hard to describe, and it can take over a person’s life and feel awful.
Tardive dyskinesia occurs at a cumulative rate of 4-7% per year in otherwise healthy, relatively young patients treated with many of the so-called antipsychotic drugs. After only a few years, 20% or more of those treated will be afflicted with tardive dyskinesia. Older patients have an even higher risk.
According to the 
Individuals who are male teenagers or young adults are also more at risk of violence than the average person in a given population. Thankfully, for my two sons, our society does not require that all of these at risk individuals be placed on psychiatric drugs.
The best scientific analysis that looks at whether or not the drugs significantly reduce violence when involuntarily administered has been provided by the nonprofit group called Cochrane (see 
The best predictors of future violence are a history of past violent crime, victimization, involvement with illegal drugs and drug markets, poverty, life trauma exposure, and ambient neighborhood crime. When these factors are not present for an individual, being classified as mentally ill is not related to violence. Rather than the vague notion of mental illness, it appears that these are the real factors that lead to the statistically modest increased risk of violence among those labelled as mentally ill because such labelled individuals are more likely to be exposed to these risk factors (see 
Clearly, people in our communities have justification to want to keep people from harming themselves or others. I know I don’t want violent people running around my neighborhood. However, the use of psychiatric drugs too often lead people to think that the mental health professionals did what was needed, and thus reduces the necessary motivation to advocate for more helpful action. In my view, there are far better ways to address these concerns without any need for involuntary treatment or torturing anyone.
First of all, we already have laws for someone who commits a violent crime. I support these laws because without them many people who might otherwise act violently find that to avoid prison time they can choose a nonviolent alternative, thus making our communities safer. For those who fail to choose nonviolent ways to deal with life challenges, the law requires that they serve time in prison. Removing them from our communities for a period of time leads to our communities being safer, and gives the person who committed the crime an opportunity to consider better alternatives to deal with the type of situation that led to their incarceration. Moreover, as they serve time in prison, they become older, thus they enter an age range that leads to more thoughtful considerations and a much lower likelihood of choosing violent options.
Now, I hasten to point out that many prison officials believe that when people serve time they should be punished in degrading ways. But most people placed in prison, whether they are displaying behavior that often leads one to receive a mental illness label or not, are best treated with respect and dignity. The vast majority will eventually return to our neighborhoods and to traumatize them with abusive actions while they are in prison increases the risk that they will become less than ideal citizens. There are a number of countries that have been trying out more humanistic approaches to treating prisoners and the results have been very promising.
For those people who are at risk of violence, we can incentivize them to learn nonviolent ways to deal with the kinds of anger arousing situations that they may potentially face. For example, people who have been convicted of a violent crime and are serving out their sentence can be incentivized to learn prosocial skills by reducing their sentence a month if they demonstrate mastery of the skills. People at risk who are not incarcerated may be offered some other incentives such as access to better housing, or even be provided a monetary incentive that is about the same amount as the combined cost of a drug management program. Drug management typically includes the cost for the drugs plus the time for professionals to assess, prescribe, and monitor the patient. Monitoring the patient includes regular meetings to assess drug side-effects, readjust the medication dose, prescribe a different or additional drug, and sending out a social worker or nurse to remind patients to take their prescriptions. These costs are significant and if redirected to incentivizing people at risk, it would lead to a significant level of voluntary participation.
What would a program that teaches nonviolent ways to deal with anger arousing situations look like? Teachers would identify their student’s pattern of anger expression and the situations in which the student typically experiences anger. Responding to criticism and providing criticism are particularly hot spots, so they would be the focus of early lessons (see 
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Welcome to From Insults to Respect.
A mock funeral mourning those lost to psychiatry or who have had their spirits broken and struggle to survive is to be held as protesters deliver a public message to psychiatrists at the annual meeting of the American Psychiatric Association on Sunday, May 6, 2018. “First, Do No Harm” is the message that protesters hope will go viral and get people to think twice before getting involved with psychiatry.
I became interested in the conflict about the use of psychiatric drugs very early in my career as a psychologist. I began to discuss the issues with psychiatrists as well as those who objected to this form of treatment. A broad outline of what I heard follows:
In contrast, critics of psychiatric drugs have made the following counter claims: The use of psychiatric drugs has unleashed the worst medically induced disaster in history. They have caused millions of people to become addicted to them, suffering debilitating, life threatening side effects. Rather than promoting mental health, these drugs are being used to promote social control and conformity. Reduction in hospitalization, moreover, occurred not because of the use of these drugs, but because of a deinstitutionalization policy that became known as “dumping.” Problems now being handled with psychiatric drugs can be more effectively, safely, and humanely handled with a variety of social support systems, counseling, mindfulness, healthy diet, and physical exercise techniques.
As I heard these conflicting claims, I initially thought that psychiatrists had principles of science on their side. With my graduate training in research methods and statistics, I thought that by doing a thorough job finding out the scientific research that backs up the psychiatric drug supporters I could explain in an easy to understand language why psychiatric drugs are necessary. With such an explanation, perhaps the conflict would be resolved.
I began with researching Ritalin because I was working in Rochester, NY’s school system. This was from 1974 to 1979. It was a time when drugs were just beginning to be prescribed more and more to treat students who had teachers dissatisfied with their activity level or ability to pay attention. I had witnessed a time when schools managed to deal with such problems without the use of this drug and life went on reasonably well. With the rise in its use, some thought it was a wonderful advancement, while others were expressing great discomfort at this new trend.
Not all of the findings were supportive. At the time I initially did my research, there was only one study that looked at the long-term results of Ritalin use. It compared children placed on methylphenidate, the generic version of Ritalin, with those who received no treatment. The children in the two groups were matched with respect to age, IQ, socioeconomic class and sex. After 3 to 5 years, no statistically significant differences were found between the two groups on the following outcome measures: emotion maladjustment, delinquency, Wechsler Intelligence Scale for Children, Bender gestalt visual-motor test, and academic performance.
Perhaps most troubling of all was the recognition that the safety of long term use of Ritalin had not been established despite many students being treated for years.
In the end, I discovered that although the approval process of the FDA had in its documents the available scientific evidence in making its decision to approve Ritalin, the reviewers’ decision nevertheless relied more on their personal values. It seemed to me, and it still does, that different people looking over the same scientific evidence could, depending on their values, come to completely different conclusions about whether or not the drug should be approved.
For example, Marcia Angell, M.D., is a former editor in chief of The New England Journal of Medicine, and now is a member of Harvard’s Medical School. In her insightful book, The Truth About the Drug Companies: How They Deceive Us and What to Do About It, she writes, “Is there some way companies can rig clinical trials to make their drugs look better than they are? Unfortunately, the answer is yes. Trials can be rigged in a dozen ways, and it happens all the time” (p. 95).
Civil rights activists worked for generations to make some progress in achieving their goals. Among the most successful of these advocates was Martin Luther King, Jr. When advocating for civil rights, he avoided throwing insults at those who resisted the changes he was after. Instead, he focussed on painting his dream in beautiful, hopeful phrases and demonstrating in nonviolent, but impossible to ignore, peaceful resistance.
There is something similar to this when it comes to how Americans feel about psychiatrists. There are many people who hold the belief that psychiatrists are enormously helpful to our society by relieving suffering while others believe that psychiatrists have sold out to the pharmaceutical industry, consequently leading to enormous harm.
We get to see and hear favorable positions for the psychiatric point of view from the numerous ads on TV, radio, and print media sponsored by the fabulously wealthy pharmaceutical industry, which has the biggest lobbyist group in Washington, DC (see 
Psychiatrists have become addicted to the enormous financial benefits of transforming human suffering into a language of mental illness and then convincing people that they need to spend the rest of their life on psychiatric drugs. The consequences to society of this mental illness/drug approach is an enormous increase in people becoming disabled due to the negative drug effects. There is also some recent research suggesting that when women on these drugs become pregnant, there is an increased risk of miscarriages, and if the infant is brought into this world alive, she or he is at an increased risk of serious health consequences.
In my opinion, one of the best places to obtain the arguments about the harmful approach of psychiatric drugs is at the “Mad In America” site that readers can access 
The latest version of what is viewed by psychiatrists as the most authoritative American text on mental illness is the DSM-5. It tells us that mental disorders “are usually associated with significant distress in social, occupational, or other important activities (APA, 2013, p. 20).” There is some additional vague wording here about also having a “dysfunction.” Although my focus here is on the suffering component of the definition, I will say a few words about the functioning part of the definition shortly.
n case this vague definition does not provide enough wiggle room for clinicians to label all people seeking their services as having a mental disorder and to prescribe a drug for it, the ICD tells the clinician, “When the requirements are only partially fulfilled, it is nevertheless useful to record a diagnosis for most purposes” (p. 8). This type of double talk is one of the reasons why many people view the mental illness construct as too vague for scientific purposes.
Now, lets get back to the “suffering” component of the mental disorder definition. According to Buddhist philosophy, the first Noble Truth is that to live is to suffer. According to Christian philosophers that I have read, suffering is something to make us think. It is a tool to get our attention and to accomplish the Lord’s purposes in our lives in a way that would never occur without the trial or irritation. In Judaism, the Talmud teaches us that the righteous suffer in this world in order to increase their reward in the Eternal World. Rabbi Eliezer, in the Talmud, welcomed his suffering, calling his pains ”my friends.”
If we look outside the religious teachings, we find that giving birth is accompanied by suffering, and yet it makes more sense to classify this experience as a natural part of creating new life rather than a pathological condition. When writers receive rejections from publishers, or a loved one dies, suffering often accompanies these experiences.
Add to all of this the problems one encounters when one tries to decide objectively how much suffering, beyond the “normal” amount that one experiences during life’s parade of disappointments, is required to ascribe a diagnosis. In the end, can we really determine if one’s “suffering” is really a symptom of a disorder, or just life being life.
In saying this, I am not seeking to encourage people to be disrespectful to people who choose to take psychiatric drugs. It is their life, and it is their right to make the best decision they know how to make, and I wish them well. At the same time, I believe suffering may best be served by exploring what it could potentially provide. In my own life, I have seen numerous examples of people growing from their suffering. And one of the hardest lessons I had to learn, when seeking to be of help, is that there are times when it is best to address another’s suffering not by trying to fix it, but to stand respectfully beside the person’s misery and sharing what they are going through.
Dr. Kandel’s credentials are pretty impressive–he’s a Nobel Prize laureate and professor of brain science at Columbia University. Therefore, if you are among those who believe a person’s credentials should determine who is right and who is wrong, you need not read any further. You must simply conclude that what is referred to as mental illnesses are indeed brain diseases because you would be hard pressed to find someone with better credentials disagreeing with Dr. Kandel.
The argument that such labeling practices are not scientific, but, rather, value judgments, was intelligently made by William James when he defended the religious sentiment. He explained that pathologizing these sentiments as mental diseases was superficial medical talk. He called the reasoning doctors used to declare religious beliefs a type of mental illness, “medical materialism.”
assumes as a convenient hypothesis that the dependence of mental states on bodily conditions must be thoroughgoing and complete. If we adopt the assumption, then of course what medical materialism insists on must be true in a general way, if not every detail…. But now, I ask you, how can such an existential account of facts of mental history decide in one way or another on their spiritual significance? According to the general postulate of psychology just referred to, there is not a single one of our states of mind, high or low, healthy or morbid, that has not some organic process as its condition. Scientific theories are organically conditioned just as much as religious emotions are; and if we only knew the facts intimately enough, we should doubtless see “the liver” determining the dicta of the sturdy atheist as decisively as it does those of the Methodist under conviction anxious about his soul. When it alters one way the blood that percolates it, we get the Methodist, when in another way, we get the atheist form of mind. So of all our raptures and our drynesses, our longings and pantings, our questions and beliefs. They are equally organically founded, be they religious or of non-religious content.
All states of mind are related in extremely complex ways to neural functions. There is a crucial distinction to be made between a brain difference and a brain pathology. The significance of each state of mind must be tested, not by some neurological difference, but by the value of its fruits. When the term “pathological” is applied to an experience, rather than an identified physiological pathology, it wrongly implies a neutral science classification.
In contrast to biological arguments, 
Third party payer systems have a form that must be filled out whenever someone seeks mental health services under their plan. This form has a little box that currently says, “Diagnosis.” In that box, mental health professionals are required to fill in the DSM code that corresponds to their so-called diagnosis of the person seeking services.
