Why I Won’t Diagnose

A madhouse in Vienna. It's not a prison at all, oh no. For their own good!

A madhouse in Vienna. It’s not a prison at all, oh no. For their own good!

We have a terrible history of using diagnoses of mental illnesses to oppress minorities and silence people with little political power. Everything that was considered undesirable or threatening could be called ‘crazy’, and once you’re considered crazy you lose it all. Your credibility, your voice, your rights. Obviously some people are so disturbed that they need intervention, people who become a threat to others or need to be protected from themselves. But as psychologists and psychiatrists we have this huge power, the power to label someone unwell, to hold them in psychiatric hospitals against their will and without a trial. Historically, this power has been abused greatly. And when I say greatly I mean terribly and on such a huge scale it will take your breath away. Psychiatry has often been a tool of social control, medicalising unwanted behaviours like going against the existing establishment. Label a political prisoner a mental patient and you can keep them against their will in a psychiatric hospital indefinitely.

I’m not against psychiatry at all. I believe mental disorders are a real thing and that therapy can provide real help. But I recognise the dangerous position we’ve placed psychiatry in, with too much power and too little restrictions. And I recognise the complicated and unfair position of people suffering from a mental illness.

One of the big problems is that psychological disorders are not treated the same as a¬†physical disorder. Saying someone has a broken leg is non-judgemental, but calling a person crazy invalidates them. If a person is crazy it means what they say is of no importance at all, that we don’t have to listen to them, that their experiences can be ignored. We see this with sex workers a lot, anti-prostitution activists will accuse prostitutes of being victims of violence. They will accuse sex workers of being psychologically unwell, of suffering from PTSD, accuse them of needing help. They use this accusation to argue that sex workers do not need to be listened to. They might say they want rights, but they’re crazy, what do they know. They might say they chose this work, but they’re traumatised, so what they think they know about themselves is irrelevant.

Sex workers often counter this by stating (correctly) that sex work does not necessarily correlate with psychological problems, but that is beside the point. People who have experienced trauma, who are suffering from PTSD or are battling some mental illness should simply not be reduced to objects that can be done to. The fact that someone is traumatised does not mean it is okay to rob them of their agency, rob them of their voice, rob them of their power and do with them as you wish. We should not use psychiatric diagnoses as a form of violence.

In some situations, criminals have more rights and credibility than psychiatric patients do. I mean, let that sink in.

A nice long soak, that should calm him down! Yay psychiatry!

A nice long soak, that should calm him down! Yay psychiatry!

Accusing someone of being crazy is the ultimate way of silencing them. Obviously this is harmful to sex workers and other groups with little political power, as they’re on the receiving end of the insult. But it’s harmful to people suffering from a mental disorder as well. The underlying argument of prohibitionists (people with a mental disorder do not need to be listened to) is prevalent still, and it’s exclusively harmful. It does no good at all.

I understand the desire to lash out, to use their own nasty tricks against them, so I understand when sex workers and their allies accuse prohibitionists of being crazy. More than once I’ve been asked to confirm that prohibitionists are often traumatised, that they have a sexual disorder or something wrong with their personality, as if that would be of any relevance at all. I’ve always declined because I believe people who have suffered trauma are not automatically wrong. Even if you were raped by half the world does not mean you’re not right. Doesn’t mean you’re not wrong either, it’s just not relevant. Perhaps some prohibitionists do suffer from some mental illness, some probably do, and some might suffer from diabetes as well. It changes nothing.

The wonderful Maggie McNeill argued that some beliefs are so obviously untrue, it’s easy to conclude that person is either lying or mentally ill. She mentioned someone who believed penis-in-vagina penetrative sex is unnatural, so obviously that person must have lost contact with reality somehow. But I disagree. The thing is, the healthy human mind is very capable of making an ass of itself. Our healthy brains can hold contradictory beliefs, ignore obvious facts, believe in things that logically cannot be true. A healthy mind can be a nasty, mean-spirited mind. A horrible person with crappy ideas might be genuinely unwell, as can a lovely and logical person. It changes nothing about their arguments.

So I will not diagnose your opposition. As immoral and disgusting I believe some people are, that does not mean I will label them with a mental illness. And just because someone is suffering from a mental illness, does not mean we get to ignore them, silence them or speak for them. A mental illness is not an insult. And being wrong or mean is not an illness.

10 thoughts on “Why I Won’t Diagnose

  1. Anonymous

    The terrible history of psychiatry is not over! I dont understand why in this story an artificial line is made between the past and now?? The fundamentals are still exactly the same.

    Sure psychiatrist don’t act exactly like in the film, one flew over the cuckoo’s nest. But have psychiatric hospitals really changed in a fundamental way?

    Why are so much people and children still put in solitary(isoleercel)? When we already know that with a more loving approach this nearly isn’t needed anymore. Still the same coersive approach, with to little love/empathy.

    Why are there proscribed more pills than ever?

    Is there solid proof for any of the pills? If interested watch this very informational video about this: https://www.youtube.com/watch?v=5VBXWdhabuQ

    Is there enough proof these pills are safe enough?

    Why did till recently handicapped people with behavior problems prescribed a lot of sedating pills called antipsychotics?

    Why do psychiatrist impersonate dokters? Does it help when you are broken by life you get called sick, patient? No it makes you feel worse. Especially if you really believe the biological sickness as explanation. Or do you need someone who deeply cares about you, understands you, makes you feel stronger, doesnt act as the expert who knows it better than you, someone gives you hope? That is the opposite. Everybody can be broken by life, what people then need is safe heavens filled with love and empathy. The psychiatric, coersive,biologic,patriarch sharply contrasts this. They haven’t even learnt the basics in there very long study period.

    Where is the evidence based proof of the psychiatrist 10 year long training?

    Psychiatry hasn’t really changed. The damage they do is more subtle, but still very very damaging.

  2. Marijke Vonk Post author

    “Why do psychiatrist impersonate dokters?”

    Erm, because they literally are?

    I agree a loving, stable environment can do a world of good. But brains can malfunction, and although parents and partners have tried to love people back to health, it doesn’t always work. Brains are part of our body, just like our lungs and heart are, and you can’t love every illness away.

  3. Anonymous

    I find it a bit offending you use the word illness. Please give me the medical test to proof these DSM diagnoses before you start using the dokters terminology.

    Yes they misuse the dokter paradigma while being mentally broken is very different. Ofcourse the overburden of stress that happens is life breaks you also effects the body/brain. A conflict in your thinking/feeling or society will really whipe you out and give rize to all does so called DSM diagnoses even schizophrenia. But what do psychiatrist do? They invent ilnesses. I am not joking. Every new DSM new ilnesses come into existence. The whole paradisma is very damaging! If you think you are sick and something is broken, it doesnt help you and mobilize your inner resiliency. Using terms like dokter, diagnoses illness and treatment are all misleading. Make people feel dependant, stigmatized, look for the wrong solutions.

    Watch the link of Robert whitaker, lets start evaluating on a evidence based way if their approach is working or is very damaging. Its 2016 its about time! The whole medication story is much worse than we have ever thought and this will come out, it cannot be stopped anymore. I understand that these so called dokters don’t want to see al this because there whole life and money and beliefsystem is confronted.

    Lets not change psychiatry a little bit again but lets see the whole spectrum of what psychiatry has done and is doing.

    I don’t mean that loving back to health is enough. I am noting lots of points where these braindokters misuse there power and if they really cared more these things really wouldnt happen.Children in solitary, sedating difficult handicapped children and elderly, mass shooting because of pills, worsening of problems by use of pills and invention of disease that do not exist. If you look critical at the proof of these pills what we are doing is really really bad. The last years there is coming more and more proof: https://www.youtube.com/watch?v=5VBXWdhabuQ

    When you only diagnose and give pills, and there is enough proof this happens alot, you havn’t undersood something at a really fundamental level. If you really care and don’t imporsonate the expert, things would be a lot different.

    Just go the a psychiatric hospital and imagine how you would feel. Is it a loving place for vunerable people, lik for example the Moser house? Are there enough people who closely are with them so they can feel safe? Or do they quickly sedate and isolate?

    Ofcourse only love and empathy isn’t enough, but it goes a very very long way even with the most disturbed people: https://www.youtube.com/watch?v=0F_kLbtnWWM

    There might be a small use for pills, maybe but i would first like to see solid proof. I havnt seen it. For example watch this:

    Where is the proof of these so called dokters of the brain? Give me a bloodtest or a individual brain scan of misfunctioning? These are not found because there mostly a mental conflict between feelings,

    I am mentioning different damaging aspects of psychiatrist and there are many more. If you truely care about these people( NOT patients!) then these things wouldnt happen.

  4. Marijke Vonk Post author

    A psychiatrist is a doctor. They went to medical school, then specialised in psychiatry. They are literally doctors.

    If you want to know more about research on the physical aspects of psychological disorders, I’d encourage you to first do some googling yourself. You can critisize the research that has been done, absolutely. But read them first :).

  5. Anonymous

    Thank you for explaining to me what a psychiatrist is! You have not understood what I have written. I understand that because this is so big and so surprising. I have read all that stuff, thats why it’s so clearly wrong to me! I have gave you a link of a few minutes of Robert Whitaker so you could see about thorough research instead of pharmiceutal company research. He won a respectful prize for this, so maybe he knows something? Or watch psychiatrist Peter Breggin, Szasz or more recently Peter Gotzche on youtube. If you don’t believe the schizophrenia story watch Jim van Os psychiatrist, about ‘schizophrenie bestaat niet’ .

    I am afraid this scientific discussion can go on for ages if the proof is good enough. So i dont have much hope for that discussion. I hope normal people can see through that a lot is wrong big time.

    THe insight are already taking place. Not for nothing there is a lot of controversy in programs like zembla, the monitor etc in the netherlands. Al I wanted to present is how big this picture is, instead of that slowly a few things get changed. The public should wake up it seems to be the only way things will change.

    People like Breggin, Szasz have critized all there life and seen the damaging effects of psychiatry get worse and worse. Please just take a little bit of time. Its a spectacular story. Also a sad one I am afraid. I wish I could give better new. Id love to

  6. Anonymous

    O by the way I loved this writing of Marijke. I focused my arguments spefically too psychiatrists. Marijke you are not a psychiatrist so I am not criticizing you.

  7. Anonymous

    Sorry for flooding the forum a bit, but it is so important.

    The argument that someone is antipscychiatry is a way to silence people back then and now. We have to thank these people because or them the care is become more humane. Again the change had too come from the people not the psychiatrists!

    Antipsychiatry was effectivly demonized by who? Again you guessed it right eminent psychiatrists! Wow these people can make effective smokescreens! For good quality information of antipsychiatry read the dissertation of Phd Gemma Blok .

  8. Anonymous

    That is just a small part of the argument. That antidepression pills are no better than placebo and lead to deaths, that ritalin and schizoprhenia lead to brain atrophy long term is much bigger. But the medical way of thinking is damaging too. Antipsychiatry ofcourse happens now and then if everything you do is problematic. I guess it is now time to make new promises and new pills and we can start over again. At least then the psychiatrist is happy. He has studied so hard and looks so intelligent, ofcourse it is very important to spare him…
    Warning: commenting on psychiatrist as psychiatrist can be dangerous and cost your job, be mediawise like Bram Bakker and maybe you will survive.. Be anything lower than a psychiatrist and you wont be taken serious

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