Debunking the Psychiatric Diagnosis Myth Workshop/Exercise

One of the greatest advances modern society has is medicine. Over the last hundred or so years we have refined the process of discovering and treating medical disorders, illnesses and disease to improve quality and longevity of life.

Something large to write on, such as a white board, chalk board, large pad of paper or computer with overhead projector. Writing implement.

Ladies and Gentlemen, are there anyone here currently today who has ever been treated for asthma, diabetes, bone fractures or a heart condition? [If not, continue for a few more common ailments]

That is excellent. Would anyone like to talk to us about what prompted them to get aid? That is, what led you to seek medical treatment?

[Listen to a few stories if possible, but try not to get lost in the nitty gritty of specific stories. Write on the board “Symptoms”. If someone is getting to bogged down in details, point to the word “Symptoms” and say ‘can we stick to this for now?’]

Thank you. Now I would like to ask you if the treating doctor suggested one or more ideas about what might be happening that caused your symptoms?

[Listen to the responses. Write on the board, under “Symptoms” the word “Formulation”]

Thank you. Did the doctor narrow down their theories to a specific cause? How did they determine this cause?

[Listen to the responses. Ask questions about diagnoses and tests if they are not volunteered. If there was no test, ask how the doctor knew that this is what caused the symptoms. Write on the board “Medical Tests” and under that “Diagnosis”]

Thank you. What treatment did you receive from this tested diagnosis?

[Listen to the responses. Write on the board “Treatment”]
Thank you. Is or did the treatment work? Is it ongoing and having a positive effect? If the treatment didn’t work, did the doctors go back and review your diagnosis?

[Listen to the responses, if any]

Thank you. Now, has anyone here received treatment for a psychiatric diagnosis? Would anyone like to talk about their experiences? [Hopefully someone will volunteer to talk about their experience. If not, relate yours]

Thank you. First, what led you to seek medical assistance?

[Point to the word “Symptoms” on the board. Listen to their stories.]

Thank you. Did the doctor offer a range of possible explanations?

[Point to the board where it says “Formulation”. If the individual was only given one option, ask why the doctor didn’t explore further options. After all, there are different types of diabetes, different types of fractures, different types of heart condition etc. Why is there only the one formulation for this person in this situation?]

Thank you. What medical tests were performed to determine a diagnosis?

[Point to the words “Medical Tests” and “Diagnosis” when appropriate on the board. Listen to the response.
– If there were none, ask how you know if the diagnosis is right if there was no test?
– If it is a subjective mental state test (rate yourself on this scale out of X), ask if you were having a good day or a bad day when you were tested since this is known to bias results. Was a secondary subjective mental state test done?
– If it is a DSM-IV TR style “you have x out of y symptoms” show the scope of permutations this style of ‘diagnosis’ has. Also discuss umbrella terms. For example: Dyslexia describes a range of learning disorders which can include mixed laterality, hearing difficulties, cognition difficulties, colour blindness etc. Each have similar symptoms – the learning disorder, but each have different treatments and tests.
– If it was physical tests of exclusion (blood test shows that it is not thyroid, not mineral deficiency, not etc) then ask how they know what it is when they have only shown what it isn’t.]

Thank you. What treatment was offered for the diagnosis?

[Point to the word “Treatment” on the board. Listen to the response]
Thank you. Is or did the treatment work? Is it ongoing and having a positive effect? If the treatment didn’t work, did the doctors go back and review your diagnosis?

[Listen to the discussion, if any]

Thank you for your part. Now we will open up the discussion to the group. What were the key differences between the physical diagnosis and the psychiatric diagnosis? How did the medical system break down?

I am not suggesting that you dispense with a treatment plan just because no objective test was performed to prove what you were diagnosed with. The idea of this discussion is to recognise the difference between an unproven formulation and a proven diagnosis. Doctors treat formulations all the time, but they are receptive to their hypothesis being wrong. If you find your treatment isn’t working, or feel you should get a review of your “diagnosis”, then perhaps you should have a conversation with your doctor/psychiatrist.

Your doctor/psychiatrist has great knowledge. Understand the medical process so that you can better use them.