Throughout the last decades many criticisms have appeared against the practices that psychiatry was used to perform at certain moments of its history. For example, the anti-psychiatry movement, driven by referents such as R. D. Laing, denounced overmedication and humiliating treatment of many vulnerable people in mental health centres, as well as an approach that was too focused on the biological.

Today psychiatry has improved a lot and the criticism against it has lost a lot of strength, but there are still fronts. One of them is the idea that the psychiatric labels used to diagnose mental disorders are, in fact, stigmatizing , thus making the problem worse. But… how true is that? Let’s look at it.

Criticisms of Psychiatric Labels

This type of attack directed towards the use of diagnostic labels is usually based on two fundamental ideas.

The first is that mental disorders are not really anomalies that have an origin in the biological configuration of the person, that is, they are not a fixed characteristic of the person, in the same way that one has a nose of a certain shape or a hair of a certain colour. In any case, these mental problems would be the result of a system of interaction with the environment originated by one or several experiences that marked us in the past. Therefore, using labels is unjustified, because it indicates that the problem lies in the patient as being isolated from the environment.

The second is that, in the current social context, using these terms serves to place people in a position of disadvantage and vulnerability, which not only damages personal relationships but also influences the search for work, etc. In a way, it is criticized that these labels dehumanize the person who wears them , making that person pass for another individual diagnosed with a certain disorder, as if everything he does, feels and thinks was the result of the illness and his existence was totally interchangeable with that of any person with the same label.

These two ideas sound reasonable, and it is clear that people with mental disorders are clearly stigmatised even today. However, everything seems to indicate that it is not the use of such labels that produces such a bad image. Let us see what is known about the subject.

The influence of diagnostic categories

To begin with, it is necessary to point out that diagnostic labels are not adjectives, they are not useful to understand in general terms what a person is like. In any case, they are theoretical constructs developed by experts that help understand what kind of problems a person is most likely to suffer from; it’s not the same to have depression as an autistic disorder, and although these categories don’t tell us about someone’s personality, they do help us know how to intervene to improve the quality of life.

On the other hand, the stigmatization of mental disorders goes back many centuries before the emergence of medicine as we know it, let alone psychiatry. When they first appeared, these applied sciences acted in accordance with this marginalisation of minorities with disorders , but this discrimination already existed and is documented in very old texts. In fact, during certain stages of history it was believed that the symptoms were manifestations of Satan and that, consequently, the closeness of a person with mental disorders was dangerous.

Beyond this fact, there is no evidence that the quality of life of the diagnosed persons has worsened after their passage through the psychiatrist or clinical psychologist.

Going to the tests

Is there evidence behind the claim that diagnostic labels are harmful? If there is, it’s very weak. For example, David Rosenhan, one of the great critics of this practice in the health field, refused to provide empirically obtained data to prove this when another researcher named Robert Spitzer asked him to.

Years later, a writer named Lauren Slater claimed to have conducted an experiment by which she faked mental illness and managed to obtain a psychiatric diagnosis. However, she ended up acknowledging that such research did not exist.

On the other hand, much of the criticism points out that it is very easy to be diagnosed in some psychiatric category, or which one is uncertain. There are cases of people who fake their symptoms and manage to deceive the medical staff , but when they stop pretending, instead of leaving the medical history as it is, they add the observation that the disorder is on its way to disappear, something that is rarely left in writing in cases of real disorder. This fact points out that doctors are able, despite the willingness to deceive, to distinguish between severe cases and others that are on the road to recovery.

So it is better to take advantage of the good side of the tools that good psychiatry provides us, while not confusing ourselves into believing that these labels sum up who we are.

Bibliographic references:

  • Spitzer, R. L. (1976). More on the pseudoscience in science and the case for psychiatric diagnosis. Archives of General Psychiatry, 33, pp. 459 – 470.