Another Critique of the Schizophrenia Diagnosis

In January 2014, the journal Research on Social Work Practice ran a special issue called A Critical Appraisal of the DSM-5: Social Work Perspectives.  There are fifteen articles on this general theme, and together they present a wide range of arguments against the DSM system.

Social workers represent the numerically biggest group of mental health practitioners in the US, and it is particularly gratifying to see a major social work journal addressing this topic so forthrightly.

In this post, I want to focus on one of the articles:  A Critique of the Diagnostic Construct Schizophrenia, by Stephen Wong, PhD, BCBA-D, of the Florida International University in Miami.

Here are some quotes:

“Characterizing the many emotional, behavioral, functional, and social concerns listed in the manual as physical ‘diseases’ is a theoretical and ideological assertion.  And even though this assertion is repeated endlessly in professional and commercial media, the claim rests on faulty definitions, logical fallacies, and weak empirical evidence (Boyle, 2002; Moncrieff, 2008; Read, Mosher, & Bentall, 2004; Valenstein, 1998)”

“Equipped with the knowledge of these and other therapeutic techniques, social workers can take a more active role in the design and implementation of effective psychosocial interventions, rather than being handmaidens of psychiatrists and relying on the finite benefits of their pharmacological treatments (Cohen, 1997; Harrow & Job, 2007; Hegarty, Baldessarini, Tohen, Watternaux & Oepen, 1994; Whitaker, 2010).”

“While current mental health services focus primarily on treating unconfirmed biological or neurological diseases (Gomory, Wong, Cohen, & Lacasse, 2011; Kingdon & Young, 2007; Whitaker, 2010), social workers and other mental health professionals should not confine themselves to this narrow, reductionist perspective and should be sensitive to other factors contributing to severe mental and behavioral disturbances.”

“There is abundant research on environmental and social adversity factors contributing to the development of schizophrenic symptoms and psychosis to guide our practice in social advocacy, prevention, and treatment of mental and behavioral disorders.”

“The biggest question is, given the many conceptual, scientific, and technical shortcomings of the diagnosis of schizophrenia, and of DSM diagnoses in general, why are social workers, psychologists, and other mental health professionals so dutiful in their use of the DSM and not more outspoken in their criticism of these psychiatric labels?”

“However, simply acquiescing to this medical ideology also has direct consequences for individual clinicians and their professions.  For social workers, it means putting aside our person-in-the-environment approach, our appreciation of how life experiences and living conditions shape peoples’ thoughts and actions, and our professional independence.”

“Open criticism and resistance to the DSM would be a fitting starting point for organizing and opposing medical dominance and the biomedical hegemony over mental health services, and thereby better assisting members of our society with mental, emotional, and behavioral disturbances.”

I found Dr. Wong’s paper particularly encouraging not only for its intrinsic merit, but also for its rallying call to social workers to distance themselves from the DSM and from the concept of psychiatric illness generally.

I have often expressed the belief that a grassroots rebellion within the social work profession could be the tipping point in the marginalization of psychiatry, and in the development of an effective and truly person-centered framework for helping people in distress.


  • Anonymous

    Social workers claiming to possess something like “professional independence” is a laughing stock. Yes, there is some promising critical attitudes blossoming in social work, but for the most part they should hang their heads in shame. Most of them are nothing but the overseers of forced drugging plantations, and turn up to people’s homes to “make sure they are taking their”… you fill in the blank.

    Nice collection of quotes though. Apart from the one that mindlessly assumes they have a right to use the word “symptom”. No, silly, that’s reserved for real doctors and real medicine not “mental health”. They need to learn their place, it’s a place that has absolutely not a shred to do with “health”, or “medicine”, or “healthcare”, at all. Any pretense to that, is nothing but pure propaganda, and an insult to real physicians who deal in real symptoms and real diseases.

    And one of the worst cancers afflicting social work, is the sheer number of people who get into that line of work because they believe they had a relative who “was mentally ill” and they “wanted to help the mentally ill”. You’re not helping if you come prepackaged with spurious dogma and a set of “just so” stories that you falsely believe explains your relative’s life problems.

    Nobody should feel safe in the presence of a social worker. If you dare say the wrong thing, they feel “obligated” to report you to their bosses, the “brain disease psychiatrists”.

    One of the most honest subcategories of social work is the ones who work with refugees. If you’re currently in social work and you’re nothing but a forced drugging plantation overseer, quit, and go get a refugee resettlement job. Your moral compass will thank you.

    We need to see more people quitting these professions in disgust. Anybody who does this should know they will win the tranquility of mind that comes with the cessation of evildoing. If I were a billionaire I’d publicly pay people to quit.

    At this point in time, the less people entering the “mental health professions”, the better off society will be. We don’t need another 16 brigades added to the global occupying imperial army of true believer fanatics who believe “mental illness”, is a thing.

    Mental illness is a harmful, failed idea that exists only in the minds of those that choose to adopt a belief in mental illness. Obligatory spoon feeding for the masses raised on this thin gruel of an ideology to follow:

    This is not to say that the thoughts, feelings and behaviors that currently get conceptualized as “illnesses” don’t exist, it is merely to say they haven’t been discovered to be “medical” “illnesses”, merely declared so by a generations-long propaganda campaign at the hands of a pseudoscientific profession of charlatans.

    Cue the firing squad peanut gallery of “you don’t know my uncle, if you saw my daughter, if you had a son die, if you had suffered yourself you wouldn’t be saying that”, yep, your extreme anecdotes about behaviors are apparently in your mind just as good as empirical evidence that tumors in cancerous bodies exist. I’ve got a bridge to sell you.

  • Francesca Allan

    I’m encouraged by this. In my experience, psychiatric social workers are a smarmy bunch who do nothing but offer platitudes and encourage the patient to submit to the doctor. They also have way, way too much power and are sometimes responsible for declaring who’s at risk of violence and who’s not.

    In our local paper, there was an article describing how someone was treated for acting strangely downtown. This stupid bitch who teaches social work at our local community college wrote in to say how “thrilled” she was that the article used enlightened words like “apprehended” under the Mental Health Act and “accompanied” by the police to the hospital when what was much more likely was that this person was likely arrested, handcuffed, thrown into the back of a cruiser, taken to the hospital, stripped and forcibly injected.

  • Anonymous

    She wrote in to say how pleased she was by the mainstream media’s use of regime-speak, language she and her fellow deniers of psychiatry’s violence would rather use to paper over the vicious reality of state sanctioned brain rape. You’re not under arrest you’re “apprehended and accompanied”, like going to the Prom!

  • Francesca Allan

    Actually, a friend of mine wrote to her and pointed out that if a police officer offers you a voluntary ride to the hospital then, yes, he is accompanying you but, in the situation described in the newspaper article, arrest would be the only appropriate word. Instructor wrote back to correct him — it was an “apprehension.” If this is the kind of thing that thrills her (her words), then I’d suggest she has a rather low threshold for thrills. She clearly doesn’t want to change the system; she just wants to apply euphemisms to it. And the frightening thing is she is educating a whole new crop of students every year.

  • Anonymous

    Now that is a woman who is a danger to others, teaching lies.

  • Francesca Allan

    She’s not really lying because she actually believes this crap is the truth but she’s certainly unknowingly spreading misinformation.

  • Schizophrenia is cruel joke to those of us who suffer from knowing the truth. Below and here