Abstract
In the wake of the publication of DSM-5, the debate around the validity, usefulness and meaning of psychiatric categories has revived to an extent that is reminiscent of the battles over psychiatry’s legitimacy waged in the 1960s and 1970s. However, what is distinctive about the current crisis of legitimacy are the multiple and varied critical positions that are deployed against a psychiatry that is uncertain about its own central paradigm. In this article, I outline five critical positions that respond to the contemporary crisis in psychiatry and that point towards different directions for the future of psychiatry. Finally, I draw some conclusions about the possibilities of a paradigm shift within psychiatry and the prospects for the survival of a different discipline in the twenty-first century.
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Andreasen, N. (2007) DSM and the death of phenomenology in America: An example of unintended consequences. Schizophrenia Bulletin 33 (1): 108–112.
Bentall, R. (2004) Madness Explained: Psychosis and Human Nature. London: Penguin.
Bentall, R.P. (2006) Madness explained: Why we must reject the Kraepelinian paradigm and replace it with a ‘complaint-oriented’ approach to understanding mental illness. Medical Hypotheses 66 (2): 220–233.
Bentall, R.P. (2009) Doctoring the Mind. Is Our Current Treatment of Mental Illness Really any Good? New York: New York University Press.
Bracken, P. and Thomas, P. (2005) Postpsychiatry – Mental Health in a Postmodern World. Oxford: Oxford University Press.
Bracken, P. and Thomas, P. (2010) From Szasz to Foucault: on the role of critical psychiatry. Philosophy, Psychiatry,Psychology 17 (3): 219–228.
Braver, L. (2007) A Thing of This World. A History of Continental Anti-Realism. Evanston, IL: Northwestern University Press.
Broome, M., Harland, R., Owen, G. and Stringaris, R. (eds.) (2013) The Maudsley Reader in Phenomenological Psychiatry. Cambridge, UK: Cambridge University Press.
Bullmore, E., Fletcher, P. and Jones, P. (2009) Why psychiatry can’t afford to be neurophobic? British Journal of Psychiatry 194: 293–295.
Burns, T. (2013) Our Necessary Shadow. The Nature and Meaning of Psychiatry. London: Penguin.
Callard, F. (2014) Psychiatric diagnosis: The indispensability of ambivalence. Journal of Medical Ethics 40 (8): 526–530.
Choudhury, S. and Slaby, J. (eds.) (2012) Critical Neuroscience. A Handbook of the Social and Cultural Contexts of Neuroscience. Chichester and Malden: Wiley- Blackwell.
Conrad, P. (2007) The Medicalisation of Society. On the Transformation of Human Conditions into Treatable Disorders. Baltimore, MD: Johns Hopkins University Press.
Cuthbert, B. and Insel, T. (2010) Toward new approaches to psychotic disorders: The NIMH research domain criteria project. Schizophrenia Bulletin 36 (6): 1061–1062.
Davidson, L. (2005) Recovery, self-management and the expert patient-changing the culture of mental health from a UK perspective. Journal of Mental Health 14 (1): 25–35.
Deegan, P. (2001) Recovery as a self-directed process of healing and transformation. Occupational Therapy in Mental Health 17 (3/4): 5–21.
Elliott, C. (2003) Better than Well: American Medicine Meets the American Dream. London and New York: W.W. Norton and co.
Frances, A. (2013) Saving Normal. New York: William Morrow.
Frith, C. (1992) The Cognitive Neuropsychology of Schizophrenia. East Sussex, UK: Lawrence Erlbaum.
Gallagher, S. and Zahavi, D. (2008) The Phenomenological Mind. An Introduction to the Philosophy of Mind and Cognitive Science. London and New York: Routledge.
Greenberg, G. (2013) The Book of Woe. The DSM and the Unmaking of Psychiatry. London and Melbourne: Scribe Press.
Heidegger, M. (2002) The Essence of Truth. London and New York: Continuum.
Hyman, S. (2003) Diagnosing disorders. Scientific American 289 (3): 96–103.
Hyman, S. (2010) The diagnosis of mental disorders: The problem of reification. Annual Review of Clinical Psychology 6: 155–179.
Insel, T. (2013) Transforming diagnosis, http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml, accessed 14 April 2014.
Insel, T. and Quirion, R. (2005) Psychiatry as a clinical neuroscience discipline. Journal of the American Medical Association 294 (17): 2221–2224.
Kandel, E. (1998) A new intellectual framework for psychiatry. American Journal of Psychiatry 155 (4): 457–469.
Katschnig, H. (2010) Are psychiatrists an endangered species? Observations on internal and external challenges to the profession. World Psychiatry 9 (1): 21–28.
Kays, J., Hurley, R. and Taber, K. (2012) The dynamic brain: neuroplasticity and mental health. Journal of Neuropsychiatry and Clinical Neurosciences 24 (2): 118–124.
Kinderman, P. (2014) A Prescription for Psychiatry. Why We Need a Whole New Approach to Mental Health and Wellbeing. Basingstoke, UK: Palgrave MacMillan.
Kirmayer, L. and Crafa, D. (2014) What kind of science for psychiatry? Frontiers in Human Neuroscience 8 (Article 435): 1–12.
Klerman, G.L. (1978) The evolution of a scientific nosology. In: J.C. Shershow (ed.) Schizophrenia, Science and Practice. Cambridge, MA: Harvard University Press.
Kuhn, S. (2012) The Structure of Scientific Revolutions, with an introductory essay by Ian Hacking Chicago; London: University of Chicago Press.
Kupfer, D., First, M. and Regier, D. (eds.) (2002) A Research Agenda for DSM-V. Washington DC: American Psychiatric Association.
Kupfer, D. and Regier, D. (2011) Neuroscience, clinical evidence and the future of psychiatric classification in DSM-5. American Journal of Psychiatry 168 (7): 672–674.
Leader, D. (2011) What is Madness? London: Penguin.
Leader, D. (2013) Strictly Bipolar. London: Penguin.
Leff, J. (2010) The historical development of social psychiatry. In: C. Morgan and D. Bhugra (eds.) Principles of Social Psychiatry. Oxford: Wiley Blackwell.
Lewis, B. (2000) Psychiatry and postmodern theory. Journal of Medical Humanities 21 (2): 71–84.
Mathalon, D. and Ford, J. (2012) Neurobiology of schizophrenia: Search for the elusive correlation with symptoms. Frontiers of Human Neuroscience 6: 20–25.
Middleton, H. (2007) Critical psychiatry. Mental Health Review Journal 12 (2): 40–44.
Moncrieff, J. (2010) Psychiatric diagnosis as a political device. Social Theory and Health 8 (4): 370–382.
National Institute of Mental Health. (2011) NIMH research domain criteria (RDoC), http://www.nimh.nih.gov/research-priorities/rdoc/nimh-research-domain-criteria-rdoc.shtml, accessed 14 April 2014.
Parnas, J., Sass, L. and Zahavi, D. (2013) Rediscovering psychopathology: The epistemology and phenomenology of the psychiatric object. Schizophrenia Bulletin 39 (2): 270–277.
Phillips, A. (2012) Missing out. In praise of the unlived life. London: Hamish Hamilton.
Pilgrim, D. and Rogers, A. (2009) Survival and its discontents: The case of British psychiatry. Sociology of Health and Illness 31 (7): 947–961.
Repper, J. and Perkins, R. (2009) Recovery and social inclusion: Changing the mental health agenda. In: C. Brooker and J. Repper (eds.) Mental Health From Policy to Practice. Edinburgh, UK: Churchill Livingstone.
Rose, N. (2003) Neurochemical Selves. Society 41 (1): 46–59.
Rose, N. (2006) The Politics of Life Itself: Biomedicine, Power and Subjectivity in the 21st Century. Princeton, NJ: Princeton University Press.
Rose, N. (2007) Beyond medicalisation. Lancet 369 (9562): 700–701.
Rose, N. (2010) Screen and intervene; Governing risky brains. History of the Human Sciences 23 (1): 79–105.
Rose, N. and Abi-Rached, J. (2013) Neuro. The New Brain Sciences and the Management of the Mind. Princeton and Oxford: Princeton University Press.
Rose, N. and Novas, C. (2004) Biological citizenship. In: A. Ong and S. Collier (eds.) Global Assemblages: Technology, Politics and Ethics as Anthropological Problems. Oxford: Blackwell, pp. 439–463.
Rose, S. (2012) The need for a critical neuroscience. From neuroideology to neurotechnology. In: J. Slaby and S. Choudhury (eds.) Critical Neuroscience. A Handbook of the Social and Cultural Contexts of Neuroscience. Chichester, UK: Wiley- Blackwell.
Rowlands, M. (2010) The New Science of the Mind. From Extended Mind to Embodied Phenomenology. Cambridge, MA: MIT Press.
Sass, L. (2014) Self-disturbance and schizophrenia: Structure, specificity, pathogenesis (current issues, new directions). Schizophrenia Research 152 (1): 5–11.
Sass, L. and Parnas, J. (2003) Schizophrenia, consciousness and the self. Schizophrenia Bulletin 29 (3): 427–444.
Spitzer, R. (2009) APA and DSM-V: Empty promises, Psychiatric Times 2 July, http://www.psychiatrictimes.com/articles/apa-and-dsm-v-empty-promises, accessed 23 April 2014.
Stanghellini, G. (2013) The ethics of incomprehensibility. In: G. Stanghellini and T. Fuchs (2013) One Century of Karl Jaspers’ General Psychopathology. Oxford: Oxford University Press.
Timimi, S. (2013) No more psychiatric labels: Campaign to abolish psychiatric diagnostic systems such as ICD and DSM ( CAPSID). Self and Society 40 (4): 6–14.
Vidal, F. (2009) Brainhood, anthropological figure of modernity. History of the Human Sciences 22 (1): 5–36.
Wallcraft, J. and Michaelson, J. (2001) Developing a survivor discourse to replace the psychopathology of breakdown and crisis. Journal of Critical Psychology, Counselling and Psychotherapy 1 (4): 254–277.
Whitaker, R. (2010) Anatomy of an Epidemic – Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America. New York: Broadway paperbacks.
Woods, A. (2013) Rethinking ‘patient testimony’ in the medical humanities: the case of Schizophrenia Bulletin’s first person accounts. Journal of Literature and Science 6 (1): 38–54.
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Morgan, A. Is psychiatry dying? Crisis and critique in contemporary psychiatry. Soc Theory Health 13, 141–161 (2015). https://doi.org/10.1057/sth.2015.5
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DOI: https://doi.org/10.1057/sth.2015.5