If we don't learn from history, we are doomed to repeat it
To get an idea of both the problems with diagnosis and how we could live without it, consider the history of how psychiatry has regarded homosexuality. In early versions of psychiatric diagnostic manuals, 'homosexuality' was listed as a mental illness. We have more enlightened ideas now, thankfully. It was while I was writing this book that the World War II code-breaker Alan Turing finally won an official pardon from the UK Government. Turing committed suicide after being prosecuted for an indecency offence - he had been the victim of a theft by his lover and when he reported it to the police, his sexuality was both criminalised and pathologised. Forced to take female sex hormones to emasculate himself, Turing killed himself with a bite from a cyanide- coated apple. If homosexuality were still categorised as a 'mental illness', no doubt we would be seeing frequent publication of academic articles exploring the genetic basis of the 'disorder', its biochemical and neurotransmitter profile and randomised controlled trials of medication designed to 'cure' it. We do see occasional attempts by religiously motivated therapists to this end. But largely, we celebrate peoples' rights to live their lives and express their sexuality as they see fit. We can see life beyond the diagnostic paradigm.
We (or most of us) have learned to view homosexuality as part of a spectrum of sexual identities. So, why can't we see depression, anxiety or paranoia as points on a continuum of normal reactions to distress? People feel and behave differently as a result of trauma, life experiences, upbringing, social status, environment and so on, and often need help to deal with that. Giving these reactions a name - and, consequently, medical 'treatments' - doesn't make living with those human consequences any easier.
So, why are we, as a society, so convinced of the importance of diagnosis?