Antirealism Will Not Save the DSM From Empirical Inadequacy

1. Some therapists have an overly reductive understanding of psychiatric diagnosis. They seem to think a diagnosis of mental disorder necessarily implies there is some intrinsic brain abnormality. They think if someone’s symptoms can be explained with reference to a history of abuse or trauma, then a diagnosis doesn’t apply to them. The logic is so in

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Szaszians hold on to a fantasy where an objective definition of “disorder” not only exists, but it also successfully covers recognized disorders in general medicine while conveniently excluding mental illnesses as faux-disorders. Szaszians also commit themselves to some version of the idea that medical authority only applies to genuine disorders, a... See more

The same is true for any assumption that holds the mind or its pathologies to be inexplicable in some fundamental sense: it can only lead to extremely bad explanations. We have no choice but to treat mental illness as unknown but knowable .