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Alternatives to diagnosis



In recent years there has been growing interest in offering alternative systems to psychiatric diagnoses. 


Here are a couple of articles that introduce some of these ideas. One is about an alternative called "psychological formulation" which is offered by a growing number of psychologists (particularly in Britain). The other is by a psychiatrist, who reflects on the way things are and how psychiatry might move beyond the current paradigm.


Formulation - the Psychological Alternative to Diagnosis


Psychiatry Beyond the Current Paradigm

(Click on "view html" or the Adobe acrobat symbol to read the free full-text)


Re: Alternatives to diagnosis

Thanks for doing all the research for us @fred50! Very interesting indeed - how are you?

Re: Alternatives to diagnosis

Hi sjay, not so well I'm afraid. I ended up getting my phone and email
hacked while trying to research and contribute to discussion about this
issue and other relevant social issues.

I went to two local Victorian public hospitals for help with stress, trauma
and lack of sleep and ended up being mistreated, forced drugged and
secluded for trying to speak out and for some personality problems I am
still working on that are much better after 18 months of therapy but which
still resurface at times of extreme fear and trauma. It reminded me that
forced treatment in public hospitals is like the prisoners and guards
experiment repeated over and over again

But it seems things are getting better now. I'm recovering from the trauma
of trying to get help in a very sick mental health system dominated by
forced drugging and "diagnosis".

I was very glad to see that Daniel Andrews is calling for a royal
commission into Mental Health and only hope that true change or a coming
out of the truth of the emotional, chemical and sometimes even physical
torture that occurs in mental health wards and is an inevitable consequence
of involuntary treatment won't be blocked by the social indoctrination that
so many have received about extreme sadness, extreme fear, trauma,
confusion, unorthodox beliefs, personality difficulties, spiritual
experiences, and all the things that unfortunately get labelled as "mental

Did you know that the idea of "educating" the public about "mental illness"
was originally funded by big pharmaceutical companies that had a vested
interest in promoting this very hopeless way of looking at diffucult
emotional experience? I can find a reference for you one day if you would
like to see it but for now I have to rest.

I hope that SANE Australia will continue to learn about alternate
frameworks that are hopeful, empathetic, compassionate and healing as well
as the wider social and historical context for experiences that get called
"mental illness", as well as the potentially irresponsible consequences of
promoting the "mental illness" paradigm as if it were a "fact".

The power of suggestion bis so strong that any drug, even for a genuinely
physical problem, needs to be tested against a placebo. There is quite a
bit of research which indicates that "antidepressants" work primarily as an
"activated placebo".

Given this knowledge, the negative power of suggestion in telling a person
they have a thing called a "mental illness" when they are going through a
difficult life crisis is potentially very damaging to that person. It is
plausible that such things can prevent the person from properly identifying
and healing from the true causes behind their life crisis.

I do very dearly hope your content team will take these ideas seriously and
stop presenting "mental illness" and "diagnosis" and "treatment" as though
they are "facts" and not merely one, potentially very damaging, way of
looking at life crises and extreme emotional experiences.

Thanks very much to your team for taking the time to read the research I
sent you.

All the very best,

Re: Alternatives to diagnosis

Hi @Fredd50 - sorry to hear that you haven't been doing so well, what are some of the things that you do to look after yourself?


Thanks so much for sharing all your thoughts on this. Like you, we are also really pleased to hear about the call for a royal commission into the mental health system and here would work to make sure that people with a lived experience and their carers had their voices heard.



Re: Alternatives to diagnosis

I do hope so but I also hope there will be input from those who consider
themselves survivours of psychiatric abuse and their supporters.

Unfortunately there has been much indoctrination in our western societies
over the past few decades. Many people who experience severe emotional
difficulties are told that they have a "mental illness" and taught to
believe that adopting the identity of a "mentally ill person" is the
responsible thing, and perhaps thing, to do in order to receive support or
relief from emotional distress.

Trauma-informed, and Family system bases for therapy and support to recover
from emotional distress look not just at the individual but their history
and family and social context. These often involve other family members
either needing to take part in understanding their own behaviour and the
distress it can cause or support for the person facing distress to be able
to distance and/or cope with the behaviour of other family or society

Sometimes the "mental illness" model can be favoured by families because it
allows family members to blame biology for emotional distress. The
alternative is often viewed as "parent blaming", which it is not, when done
properly because parents and other family members are seen wholistically
with all their strengths and weaknesses as well as their own history and
social context.

There is often intergenerational trauma involved in the development of
distress that gets labelled "mental illness".

As someone who has had the benefit of very good support both from within
and outside my family in facing and healing from some very difficult issues
over the past two years, I have the luxury of being able to contrast the
different modalities and practices that I have tried or been subjected to.

Unfortunately, many other people and their families have not been so lucky.
As a result, hearing only from people who identity as having a lived
experience of "mental illness" and their "carers" might bias any inquiry
against much needed change.

There is also the issue that not everyone who identified as having a "lived
experience" has ever been subject to the worst abuses that occur in the
most locked parts of involuntary treatment facilities, or that those who
have have often been so traumatised that they might not have the strength
or the wherewithal to speak out about them.

Unfortunately, showcasing 'positive' stories of 'mental health treatment'
has often been one of the ways in which the abuses of locked mental health
facilities or the impact of the hegemony (dominance) of the "mental
illness" paradigm has been hidden from view for such a long time.

It is difficult to speak out against a paradigm when there has been no
experience to contrast it with.

I only hope that there is room for everyone to speak out against what has
been happening, and not a competition between those who want to keep the
system as it is and those who want to see an end to involuntary treatment.

At the end of the day, there are many modalities on offer. Involuntarily
forcing a person to receive "help" would not be necessary in an environment
that genuinelt offered emotional safety, comfort and assistance, while
allowing people to be themselves and recognising we are all different.

If there are people who want to be treated involuntarily under certain
circumstances it should be up to them at the very most to "opt in" to such
a system. It should never be forced on everyone just because a few people
may have come, by whatever journey, to wish that others would take control
of their movements or actions at certain times. A problem with such an "opt
in" system might be family or social pressure or what happens if a person
changes their minds?

Whichever way I look at it, I can see no justification for an involuntary
mental health treatment system. Especially under a paradigm that is
increasingly recognised to have failed in achieving an end to extreme
emotional suffering - and rather begins with the expectation that the
suffering will continue indefinitely and can, at best, be "managed" rather
than truly healed.....

Re: Alternatives to diagnosis

It was good to read your posts @Fredd50

I will check articles later.

The forum acts share ideas and give support to people who are suffering.

Sometimes the desire to project a helpful optimistic service is at odds with dealing with the contentious issues around mental health and illness.

Sorry you have had a hard time recently, but I am glad that you have had some good supports.

I was posting about Psychological Formulations after I did a UK course in caring for people with Psychosis.

Life is not getting any simpler .....

Regards Apple

Re: Alternatives to diagnosis

Thanks @Appleblossom,


Yes, I didn't actually remember making those posts ;-?

I had a very rough time, going up to visit family and deciding to open the door to some very long repressed anger. It was difficult but ultimately a pretty important learning experience.  The anger had lingered in the background as some terrifying 'other self' but it's pretty much just passed now with a lot more clarity. It's about the first time in my life I have just not felt angry anymore as opposed to pushing the anger away/down because it felt terrifying and/or wrong.


I'm a bit cringing at the venom in those posts, so my apologies if they came across badly.


I wasn't sure from your post if you were saying life wasn't getting any simpler because you were busy a lot, or because there was such an abundance of alternatives or because psychological formulation didn't really answer anything for you? 


To be honest, if it was the latter I didn't get much out of it either, except a moment of gratification at the principle. I mentioned it to my psychiatrist and we tried it and it proceeded to be quite frustrating and simplistic ;-) Things have been getting slowly simpler for me as they slowly find their place a bit more organically, without preconceptions although reading all of these things does help a lot with developing lots of different perspectives, each one seems somehow validating and another piece of the puzzle.


how have things been going for you?

Re: Alternatives to diagnosis


I found your posts honestly portraying difficulties .... with insight .... ahem ... but thats only my opinion and it does not count a lot in the broad scheme of things. lol

Re Life not getting simpler ....

It seems to be more complicated in the level of technology ad understanding needed to flourish ... more complicated for young people.

Smiley Sad

In many ways I am simplifying things ... but that is my active attitude after I have been able to sort out the basics .. getting long in the tooth ... lol ..... so now I can do more of what I like ... rather than struggle to provide all the many needs.

Smiley Happy


Re - formulations - they are better than just handing out pills without grappling with a patients lived experience.

Its late and I am supposed to take the sleep at night thing seriously ... lol

Take Care and Good Night

Smiley Happy



Re: Alternatives to diagnosis



thanks for your lovely insights and goodnight

I agree re: formulation, I liked the PTM network too-though still slowly working through the 180 page book of it ;-). As far as frameworks go they make much more sense then olde worlde diagnosis and are a blessing - open dialogue is very good too. I am just very spoiled with my people at the moment and get to read these things and sythesise something individualised out of all the influences. They are much better to work through than any diagnositic lens I agree though I do hope that one day everyone does get to truly experience the 'person centred' approach, not just in name.


sweet dreams :-)


Re: Alternatives to diagnosis

Aaaah PTM

Power Threat Meaning



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