Swank stated that not only was mental illness 0% genetic and 100% caused by environment, but that there is no such thing as mental illness anyway as none of the DSM diagnoses have any validity. In other words, none of the DSM disorders even exist at all.
The problem here is that people do not understand what critics mean when they say that these disorders have no validity. That validity stuff in the DSM is true for every single mental disorder on Earth no matter what diagnostic system they use.
No mental disorder has any validity yet. This is because there are not yet any tests, scans, lab results or biological markers that we can use to prove that someone has any mental illness at all. No mental illnesses have any biological markers. Instead, we simply diagnose them based on clusters of symptoms. The notion that mental disorders don’t exist because they don’t have biological markers is lunacy. Mental illnesses don’t have biological markers that we know of, so all we can do is diagnose off symptoms.
There is also a problem of changing diagnoses. This is because without biological markers and with only symptom clusters to go by, it is easy to get the diagnosis wrong. You can easily go to a dozen clinicians and get different diagnoses from different ones, and I have clients coming to me all the time who definitely have been diagnosed incorrectly, often by psychiatrists.
Diagnosis is hard but it is important. I know it is important because I have had cases where I had a hunch of the diagnosis even though the case was not typical at all. I had the client go on a medication for the diagnosis that I suspected. Wa-la, he got better for the first time in his life. Usually when I get people on meds, they get dramatically better. They get so much better because my diagnoses are generally spot on. However, I generally only diagnose one disorder, and I can’t give legal DSM diagnoses. But I can always say what my opinion is. Also I cannot put people on drugs. I just recommend that they ask their doc or pdoc for a particular drug, and they usually get it.
When you have someone on the diagnostic merry-go-round, at some point, a clinician will pin the diagnostic mess down and figure out what is really wrong with the person. In these cases, the person finally starts to get better because the diagnosis is correct.
Diagnosis is very hard because mental illness is so variable. A lot of people simply do not fit into neat little DSM categories. The books have the symptoms correct, as the people have symptoms that are described very well by the DSM. But a lot of people don’t meet full criteria for any DSM diagnosis. Instead it is more of a 1 symptom from Column A, two from Column B, three from Column C sort of thing.
That’s interesting, but really you can’t bake any sort of a disorder out of it, so you just have to treat symptoms, which is all clinicians ever do anyway. At any rate, despite the fact that someone may not meet full DSM criteria for any disorder, I assure you that they are still ill, often very ill.
The validity critics don’t have any answers. Ok, we don’t have biomarkers. Maybe mental illnesses don’t even have any biomarkers. Have they considered that? So we need to throw out the DSM because there are no biomarkers even though that might be just normal. Now how are clinicians supposed to do their jobs if they can’t diagnose? The only way to figure a client out is to diagnose. If you can’t diagnose, you can’t even figure out what’s wrong with them. It’s senseless.
Also a lot of DSM disorders do exist in their full-blown DSM nature. I have seen a number of people who met full criteria and often then some for various diagnoses, including Borderline Personality Disorder, Narcissistic Personality Disorder, Passive Aggressive Personality Disorder, Depressive Personality Disorder (yes, it is a real thing), Obsessive Compulsive Personality Disorder, Obsessive Compulsive Disorder, Panic Disorder, Bipolar 1 disorder, Bipolar 2 Disorder, and Paranoid Schizophrenia. I have seen picture perfect classic cases of all of these illnesses, and they are real existing entities all right.
