One of the greatest strengths of any institution is the ability to keep the score of people lives and for that score to influence or even determine the way they and others define themselves, their role in life and ultimately the kind of life available to them.
For many people psychiatric diagnoses define and reflect the score given to their lives. And it is in this ability to count, to define how people stack up and to measure to what degree a person really matters that psychiatry finds its power. It does not simply reflect personal realities so much as it defines them.
Scores matter to the degree we believe they are really real, not just constructions or creations but diiscoveries of a basic reality. It is the fiction of discovery versus creation that makes the acceptance of any score seen to be a common sense definition of being realistic.
The ability to keep score and have that score matter justifies the existence and ultimately the power of whoever keeps score. Psychiatry matters because of its ability to define who we are and who we can be. It matters because of its claim that is diagnoses reflect an objective reality, a scientific fact about the kind of people we are and why we are that way. Because it can diagnose it can prescribe and in that prescription be given unfettered access to our lives.
According to psychiatry to be against psychiatry or even cynical of its claims is to be against reality and dangerous to the welfare of those psychiatry “only wants to help.” Psychiatric diagnoses are a created truth. They were not waiting in the real world to finally be found. They are not real in the sense that a nose or ear are real. They are a map, a human map trying to define and make sense of what it means to be a human being and have difficulty in life. They are an attempt to describe what goes wrong, what is hard and difficult in human life.
As a hypothesis it either works or doesn’t. It is either useful or not. It guides you to a place you want to go or leaves you lost. As a claim to the truth it ultimately oppresses the people it claims to help. It limits them to being “nothing but….” Nothing but what they are called, nothing but the label pinned to their shirt. It reduces life to a symptom of “what they got” and in the end excuses all manner of injustice, hurt and injury in their life. Life is not a reflection of what had happened to them as much as it is the result of the mental tools they bring to the table.
The way we make sense of things are not the things we make sense of. I…you…all of us are more than the sum of any attributes tallied to our account. We are more than anything we are called. We are more than any box or collection of boxes we are put into.
Psychiatry should have a sense of humility. What it doesn’t know is far more impressive than what it does know. As an arrogance it threatens the happiness and meaning of the lives of the people it claims to help. For too many it provides an injury as difficult to deal with and survive as the “diseases” they find themselves diagnosed with.