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Straight Talk from Lucy Johnstone

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Straight Talk from Lucy Johnstone

PCCS Books Ltd has recently published A Straight Talking Introduction to Psychiatric Diagnosis, by Lucy Johnstone, PhD. Lucy is a consultant psychologist working in Wales, and has been an outspoken critic of psychiatry’s medical model.

Here are some quotes:

“…my own conclusion, based on extensive reading and clinical work and many enlightening discussions with service users, is that psychiatric diagnosis is not a valid or evidence-based way of understanding the difficulties and distress that people experience.”

“With the exception of a narrower set of criteria for autism spectrum disorder, the general effect of the DSM-5 revisions is to create a massive expansion of psychiatric ‘illness’. It has been calculated that the new diagnosis of binge eating disorder will create more than ten million new psychiatric ‘patients’, while disruptive mood dysregulation disorder will label millions of children as mentally ill. These changes lead to the increasing medicalization of everyday life, in which normal reactions and problems are turned into ‘illnesses’ to be treated by medication.”

“…UK clinical psychologists are saying that psychiatric diagnosis is not fit for purpose, and we need to develop other, non-medical ways of describing and understanding mental distress.”

“People typically collect a whole range of diagnoses as they progress through the system, and are often prescribed a whole range of different medications, on a basis that often seems like guesswork. We can now see how this situation comes about. If it seems like guesswork – well, that is pretty much what it is.”

“…the vast majority of psychiatric problems have no known biological causes. This includes conditions such as ‘schizophrenia’, ‘bipolar disorder’, ‘clinical depression’, ‘personality disorder’, ‘paranoia’, ‘obsessive compulsive disorder’ (OCD), ‘anorexia nervosa’ and ‘ADHD’. It also includes ‘psychosis’ which is an umbrella term for people who have unusual beliefs and experiences.”

“People sometimes say that they welcome a diagnosis because it gives them some kind of explanation. This is entirely understandable – everyone wants an explanation. My point is that psychiatric diagnosis does not actually explain anything. Moreover, as I will discuss later, there are much better explanations on offer.”

“There is nothing wrong with searching for patterns in experiences of distress – indeed, it is essential. The problem arises when we impose a preconceived classification system which does not account for people’s actual lived experiences and, moreover, does not even fit the evidence.”

“The simplest answer to the question of ‘What do we do instead of diagnosing people?’ is ‘Stop diagnosing people’. The argument that we need a fully worked-out alternative system before we can abandon something that is admitted to be non-valid even by the people who invented it is, in my view, a complete red herring. And the simplest current alternative is to ask people what their problems are, and start from there.”

“Whatever your view about the validity of psychiatric diagnosis, it is universally acknowledged that these labels lead to stigma and discrimination.”

“Psychiatry imposes a particular way of understanding your experiences. For some people this model is a helpful one…For others it is more damaging than the problems which brought them into services in the first place. It can be very hard to distance yourself from this powerful expert verdict which has such a profound effect on people’s lives.”

A Straight Talking Introduction to Psychiatric Diagnosis is a remarkable book. Although it explores the most profound issues in the diagnosis debate, the language is simple and unpretentious. There are numerous and informative quotes from people who have experienced the disempowering stigma of psychiatric “diagnoses”. And there are uplifting stories of people who have found other ways of describing and thinking about themselves.

The book is small – literally – it will fit in your coat pocket. It can be read straight through, or browsed every morning on the train. It is brimful of ideas, and I cannot think of a single issue related to psychiatric “diagnosis” that is not addressed clearly and thoughtfully
 

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A Straight Talking Introduction to Psychiatric Diagnosis (Straight Talking Introductions) Paperback – 17 Sep 2014
by Lucy Johnstone (Author)

Do you still need your psychiatric diagnosis? This book will help you to decide. A revolution is underway in mental health. If the authors of the diagnostic manuals are admitting that psychiatric diagnoses are not supported by evidence, then no one should be forced to accept them. If many mental health workers are openly questioning diagnosis and saying we need a different and better system, then service users and carers should be allowed to do so too. This book is about choice. It is about giving people the information to make up their own minds, and exploring alternatives for those who wish to do so.
Lucy Johnstone, Author at Mad In America

Beyond Psychiatric Diagnosis

Lucy Johnstone is a UK clinical psychologist, trainer, speaker and writer and a long-standing critic of biomedical model psychiatry. She has worked in Adult Mental Health settings for many years, alternating with academic posts. She is the former Programme Director of the Bristol Clinical Psychology Doctorate, a highly regarded course which was based on a critical, politically-aware and service-user informed philosophy, along with an emphasis on personal development. Sadly, it was forced to close in 2010, and Lucy has since returned to clinical work. The first edition of her book ‘Users and abusers of psychiatry: a critical look at psychiatric practice’ was published in 1989 and a revised (and updated) version came out in 2000. She has also authored a number of articles and chapters on topics such as psychiatric diagnosis, psychological effects of ECT, and the role of trauma in breakdown. The second edition of ‘Formulation in psychology and psychotherapy: making sense of people’s problems’, co-edited with Rudi Dallos, is due in August 2013. This, along with related articles and training events, reflects her interest in promoting a narrative or formulation-based alternative to psychiatric diagnosis. Lucy was a contributor to the British Psychological Society’s response to the proposed DSM 5 revisions. She is currently convening a group of leading UK clinical psychologists and mental health experts who are working to develop an evidence-based and conceptually coherent alternative to the current diagnostic systems.
 
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