Psychodiagnosis in Question
A Brief Overview

I. The Problematic Foundations of Diagnosis
A. The Social Construction of Mental Illness
B. Arbitrary Categories
C. Vague Formulations
D. Validity Issues
II. The Cultural and Historical Relativity of Diagnosis
III. The Politics of Diagnosis
A. Diagnosis as Professionally Self Serving
B. Power, Social Control and Diagnostics
    a. General Analysis
    b. Gender Bias
    c. Ethnic and Racial Biases
    d. Socioeconomic Bias
C. Psychiatry and the Construction of Selfhood
D. Religion and Psychiatry
IV. Effects of Diagnosis on Clients, Communities and Culture
A. Creation of Stereotypes
B. Deficit Labelling
C. Bias Toward Psychopharmacology
V. Expansion of Diagnostics
VI. Ex Mental Patients Responses
VII. Alternatives to Diagnosis
VIII. Alternative Treatments

Return to Contents


I. The Problematic Foundations of Diagnosis

A. The Social Construction of Mental Illness

Boyer, Robert. R.D. Laing and Anti-Psychiatry. Skidmore, New York: Skidmore College Press, 1971. A Collection of essays by, commentaries on and interviews with R.D. Laing, a noted Psychiatrist. Laing was a believer in psychiatry but not "disease models" or traditional, discrete Diagnostics. He
preferred to see patients as presenting with personality disturbances, problems with
"organization," brought on in combination with environmental stressors. 

Brandt, Anthony. Reality Police. New York: Morrow and Co. 1985. A
discussion of the ways in which social standards for behavior are defined into psychiatric
normality and the way that concept of the normal is enforced on the general populace by
psychiatrists, society , and the law.

Conrad, Peter. Deviance and Medicalization: from Badness to Sickness. Philadelphia: Temple University Press, 1992. A book focussing on how mental"illness" as a medical entity has been constructed and the ways
in which this construction depoliticizes an otherwise clearly subjective assessment of the

Daniels, Arlene K. "The Social Construction of Psychiatric Diagnosis."
In H. Drezel, ed. Recent Sociology No. 2. New York: Macmillan, 1970. A
paper discussing the ways in which deviance is controlled via the construction of
diagnostic criteria defining said behavior as mental illness. Author looks at the
construction and attribution of diagnostics in the military because of this subculture's rigid
and documented set of norms and mores.

Denzin, Norman K. and Stephan R. Spitzer. The Mental Patient --
Studies in the Sociology of Deviance. New York: McGraw-Hill Book Co.
1968. A wide ranging text-book discussing mental illness not as a medical diagnosis but 
as a label ascribed to certain people as a result of arbitrary cultural categories for
certain deviant behavior. Chapters analyze the derivations of these categories as
well as the effects they have on the individual and society. 

Dunham, H. Warren. Sociological Theory and Mental Disorder. Detroit: Wayne State University Press, 1959. 

Farber, Seth. Madness, Heresy, and the Rumor of Angels: the Revolt against the Mental Health Care System. Chicago: Open Court Publishing Co., 1993. A collection and analysis of seven case
studies of people diagnosed with chronic and debilitating mental illnesses who later came
to see their "illness" as an expansion of possibilities. Author explores implications of this
idea for psychodiagnostics and drug therapy.

Farber, Seth. "Transcending Medicalism." Journal of Mind and Behavior
v. 8(1) (Win 1987) pp. 105-132. An argument that psychiatric diagnostics are
internally flawed and anti-therapeutic. Author argues for a more culturally informed
conception of mental problems beginning from an understanding of these entities not as
an epidemic but as a sign of human change and evolution. 

Foucault, Michel. Mental Illness and Psychology. Los Angeles: University of California Press, 1987. An early work by a very influential French philosopher in which he critiques psychology's view of the
human -- as an entity whose workings can be understood as a system, and which
can equally well be fixed when something is broken. Author argues that there is
no essential "human nature," thus there can be no malfunction in the state of
being human. 

Gross, Martin C. The Psychological Society: A Critical Analysis of
Psychiatry, Psychotherapy, Psychoanalysis and the Psychological
Revolution. New York: Random House, 1978. An examination of the negative
repercussions of many of the underlying concepts guiding the mental health professions. 
Examination includes discussion of the importance of setting a boundary between normal
and ill, locating mental health problems within individuals, and the concomitant belief
that individuals must rely on professionals to assess their emotional state and "decide"
whether they are normal or in need of treatment. Author suggests that problems in
society result from the very concepts of psychological and psychiatric distress. 

Horwitz, Allan. The Social Control of Mental Illness. New York:
Academy Press, 1984. A synthesis of the perspectives of sociology,
anthropology and history in considering the question of mental illness and its relationship
to culture. Authors discuss the changing meaning of mental illness, how it is constructed
how it is assigned, by whom, why, and how it is responded to and/or treated. At the core
of discussion is the question of why is one society's prophet another's lunatic. 

Kiev, Ari, ed. Magic, Faith and Healing . New York: Free Press,
1974. A far ranging set of articles discussing the healing practices of non-
western and often third world countries and how these cultures conceptualize and
treat "mental illness." Editor focusses interest on the argument that witch,
shaman, and psychiatrist all draw most of their power to cure from the status
accorded to them by their respective societies as healers, and not from any
particular element of "truth" in their culture's conception or treatment. 

Kirmayer, Laurence J. "Improvisation and Authority in
Illness Meaning." Culture Medicine and Psychiatry , v.
18, (Dec. 1994), p. 183-209. A discussion of the role played by
interpretation of meaning in the creation and treatment of mental illness. 
Author sees interpretation as fundamental to mental health care, and sees a
constant interplay between the authoritative diagnosis and the meanings created
in the therapeutic alliance as an important area for thought and study. 

Lebra, William P. Culture Bound Syndromes. Honolulu:
University of Hawaii Press, 1976. A collection of paper's theorizing
syndromes that are found only in certain societies -- including our own -- and
how treatments other than modern psychiatry are effective in treating both these
syndromes as a well as problems oft observed in the West.

Modrow, John. How to Become a Schizophrenic: The Case
Against Biological Psychiatry. Everett, WA.: Apollyon Press,
1995. Author argues that biological psychiatry is an inappropriate means
towards helping schizophrenic patients because it obviates the possibility of
understanding their worlds. It is the author's position that without that
understanding, it is impossible to help people with schizophrenia.

Moerman, Daniel E. et al eds. The Anthropology of Medicine: From
Culture to Method. New York: Bergin and Garvey, 1991.

Macsween, Morag. Anorexic Bodies: A Feminist and
Sociological Perspective on Eating Disorders. New York:
Routledge, 1993. A discussion of Anorexia Nervosa as a socially constructed
concept rather than an empirically based "medical diagnosis." Author highlights
the role played by cultural construction of gender and the body in the symptom
formation and evaluation of this concept as disease. 

Pallone, Nathaniel J. On the Social Utility of Psychopathology: a
Deviant Majority and its Keepers? New Brunswick, N.J.: Transaction
Books, 1986. A collection of essays discussing the social functions of the DSM,
seeing it as a dogmaticization of the "good life" and depicting treatment as a
method for enforcing psychiatric -- and dominant social -- ideology. 

Parsons, Anne. Belief, Magic, and Anomie: Essays in
Psychosocial Anthropology. New York: Free Press, 1969. A
series of articles discussing the formation of belief in different cultures and
groups and relating this analysis of the subjective to the psychological and
psychiatric concepts of normality.

Pfohl, Stephen J. Predicting Dangerousness : the Social
Construction of Psychiatric Reality. Lexington, Mass.: Lexington Books,
1978. An empirical study and critical analysis of the way psychiatrists assess
the "inner psychic lives" of mental patients. Study focuses on the lack of valid
criteria for doctor's diagnosis, particularly with respect to the assertion of " a
danger to others and/or himself" which would warrant involuntary

Price, Richard H and Bruce Denner and Richard H. Price, comp. The
Making of a Mental Patient. New York: Holt, Rhinehart and
Winston, 1973. A series of articles discussing the process of identification,
diagnosis, and eventual commitment to a mental institution. Articles discuss the
stages in a mental patient's life chronologically, pointing out the effects of this
process on society and upon the individual lives of people diagnosed with mental
illness and entered into the system. 

Rogers, Rex Stanton. "The Psychologization of narrating hard
times.'" Studia Psychologica v. 37(3) (1995), pp. 180-182. An
argument that psychology has become so entrenched in 20th century culture that
people now narrate their difficulties as psychological problems rather than as
life. Author suggests that there are no transcendent' behaviors to be quantified
by psychology, and the medical model is therefore an inappropriate and domineering
system for encoding and treating the human. 

Scull, Andrew. Social Order/ Mental Disorder. London: Routledge,
1989. An historically based discussion of the ways in which psychiatrists
function as "the community screen;" that is, as experts who define and diagnose
deviance as illness, thereby shielding society from its own prejudices and
keeping in place a given social order. 

Scheff, Thomas J. Mental Illness and Social Process. New
York: Harper and Row, 1967. A collection of papers discussing how social
processes shape the definition of mental illness and analyzing society's response
to that conception.

Sedgewick, Peter. Psycho Politics. New York: Harper and
Row, 1982. Commentary on selected readings by Laing, Foucault, Goffman, and
Szasz. Chapters focus on "Mental Illness" as a Socially Constructed Icon, and the social
impact and import of medicalization in mental health.

Silverstein, Harry. The Social Control of Mental Illness. New York: 
Thomas Y. Cromwell Company, 1968. An anthology of interdisciplinary texts
exploring the functions of the psychiatrist and mental patient in society and in the
asylum. Authors focus on why society's labels certain behaviors as illness and how labels
function to reify themselves. 

Siegler, Miriam. Models of Madness, Models of Medicine. New York:
Macmillan, 1974. An outline of a number if models of mental illness and an analysis of
the stereotypes they embrace and propagate in society.

Szasz, Thomas. Law, Liberty and Psychiatry: An Inquiry into the Social
Use of Mental Health Practices. New York: Collier Books, 1972. An
analysis of the political and moral basis of diagnostic categories and the way these
diagnoses serve to reify existing social taboos and enforce social norms in the name of
mental health. 

Szasz, Thomas S. Ideology and Insanity. Garden City, New
York: Doubleday and Co., 1970. A Collection of Essays discussing "Mental
Illness," stemming from the premise that"psychiatric terms are inadequate and
unsatisfactory, for each neglects, or deflects attention from the essentially moral and
political " character of such categories. 

Weitz, Don. "Schizophrenia, Exploding the Myth." Issues in Radical
Therapy v..11(4) (1985), pp. 10-13. An inquiry into the historic development of
the diagnosis of schizophrenia as an umbrella term for unwanted behavior. Author also
attempts to expose the lack of empirical support for the diagnosis and critiques the
diagnostic criteria.

Widom, Kathy S. Sex Roles and Psychopathology. New York: Plenum
Press, 1984. An examination of the ways in which sex roles and cultural produced
gender biases affect the " development, manifestation, and maintenance of abnormal
behavior" and the impact of these biases on the construction and assessment of

Wing, J.K. Reasoning About Madness. New York: Oxford University
Press, 1978. An analysis of the ways in which the scientific method has been
inappropriately applied to schizophrenia and other "social problems" to make them
medical entities. Discussion also includes a section on alternatives to the medical model
of mental illness. 

B. Arbitrary Categories 

Addison, Wesley. They Say You're Crazy: How the World's Most
Powerful Psychiatrists Decide Who is Normal. Reading,
Massachusetts: 1995.

Bean, Philip. Mental Illness: Changes and Trends. New York:
John Wiley and Sons, 1983. A collection of interdisciplinary articles
discussing various and varied issues in mental health, including the difficulty of
a "scientific" psychiatry, and the effects of diagnosis on patients, and a fleshing
out of the difficulties implied by finding a definition for normality. 

Bentall, Richard P. "A Proposal to Classify Happiness as a
Psychiatric Disorder." Journal of Modern Ethics v. 18 (1992), 
pp. 94-98. 

Channabasavanna, S. M. "Ethnography of Psychiatric Illness: a
Pilot Study." NIMHANS-Journal v. 11(1) (1993), pp. 1-10. 

Denzin, op. cit. 

Foucault, op. cit. 

Horwitz,op. cit. 

Japenga, Ann. "Rewriting the Dictionary of Madness; Is the DSM a Work
of Science or Just a List of Dangerous Labels." Los Angeles Times: June
5, 1994, v. 113. 

Kirk, Stuart A. The Selling of the DSM: the Rhetoric of Science in
Psychiatry. New York: A. de Gruyter, 1992. "The Selling of DSM is a well-
documented expose of the pretense that psychiatric diagnoses are the names of
genuine diseases and of the authentification of this fraud by an unholy alliance of
the media, the government, and psychiatry." -- Thomas Szasz. 

Kleinman, Arthur. Rethinking Psychiatry: From Cultural
Category to Personal Experience. New York: Free Press, 1988. 
An Anthropological discussion of cross-cultural perspectives of psychiatric
problems. Author holds that such an analysis leads to a theoretical emphasis on
the subjective assessment of mental illness as social production rather than on
the biomedical aspects of these entities. 

Mazzoni, Cristine. Saint Hysteria: Neurosis, Mysticism and
Gender in European Culture. Ithaca, New York: Cornell
University Press, 1996. A discussion of the division between the neurotic
and the saint. Author proposes through historical analysis that no such division
can truly be made. As said elsewhere, one epoch's psychotic is another's prophet.

Offer, Daniel and Sabshin, Melvin eds. The Diversity of
Normal Behavior : Further Contributions to Normatology. New
York: Basic Books, 1991. A compilation of articles examining the
definition of normality from different theoretical and professional perspectives. 
Although written from a decidedly clinical/psychiatric perspective, these
articles clarify and examine many of the key issues in the debate over
psychiatric conceptions of illness, health, and abnormality. 

Pallone, op. cit. 

Plog, Stanley C. and Robert B. Edgeton, eds. Changing
Perspectives in Mental Illness. New York: Holt, Rinehart and
Winston, 1969. A collection of essays examining "The Scientific Status of
the Mental Illness Metaphor" and the role and implications of diagnostics in
treatment and society.

Radden, Jennifer. Madness and Reason. London: G. Allen and
Unwin, 1985. An attempt to invalidate both medical and dominant social views of
madness as conceptually and practically flawed, and then propone a move back to
an older conception of madness as a lack of reason. 

Ross, Colin A. and Alvin Pam. Psudoscience in Biological Psychiatry:
Blaming the Body. New York: Wiley and Sons, 1995. A discussion of the
many and varied errors in conception and fact that have developed as a result of the
unacknowledged interplay between psychiatric science and cultural biases. Although
authors eventually argue for a more "scientific" approach to biological psychiatry -- rather
than a complete redefinition -- the insight presented into the often fraudulant and
dangerous practice of psychiatric research is instructive. 

Skodol, Andrew E. et al eds. International Perspectives of DSM III. 
Washington D.C. : American Psychiatric Press, 1983. A collection of essays
by psychiatrists around the world. Though written in an effort to edit and improve
diagnostic systems, contributions highlight a number of the biases in American Psychiatry
as well as the arbitrary character of a number of diagnoses. 

Szasz, Thomas Stephen. Insanity: the Idea and Its
Consequences. New York: Wiley, 1987. An attempt to invalidate the
medical model of mental illness and to point out reasons why the model has become so
widely accepted. Authors also focuses on the social implication of that acceptance. 

C. Vague Formulations

Beahrs, John O. Limits of Scientific Psychiatry:The Role of Uncertainty
in Mental Health . New York: Bruner/Mazel, 1986. Although written primarily
in support of psychiatric practice, the author discusses the ways in which Psychiatry holds
to many of the simplistic and inappropriate presumptions of causality borrowed from the
scientific method and classical mechanics. Author seeks to show that psychiatry's current
formulation oversteps its ability to explain because there is no room for uncertainty and
ambiguity in diagnostic criteria. 

Bean, op. cit. 

Bures, Zbynek and Ondrej Kondas. "Pitfalls and Perspectives of
Psychodiagnosis." Studia Psychologica v.35(2) (1993), pp. 195-203. 

Cooper, J. E. Psychiatric Diagnosis in New York and London: a
Comparative study of Mental Hospital Admissions. London: Oxford
University Press, 1972. Study showing large differences among patient
populations admitted to hospitals in U.S. and Great Britain. Researchers seek to
show that disparities result from differences in assessment and diagnosis rather
than differences in symptom presentation. 

Dumont, Matthew P. "The Non-specificity of Mental Illness." 
The American Journal of Orthopsychiatry v. 54 (1984), pp.
326-34. A discussion of the ways in which traditional diagnostic procedures
with concrete distinctions between illness and wellness might be holding back a
fuller understanding of the human and how to help and understand mental
problems. Author discusses the philosophical underpinnings of this issue in
western thought, and suggests the need for a "paradigm shift" in the
conceptualization of mental illness. 

Katz, M.M. "Non-specificity of Diagnosis of Paranoid
Schizophrenia." Archives of General Psychiatry v. 11 (1964),
pp. 197-202. A study designed to show that even when
the diagnosis of schizophrenia is agreed upon by a number of psychiatrists
operating independently, pt.'s so diagnosed still present with very different
problems . The diagnosis of schizophrenia, then, means little with regard to
onset, etiology or treatment. 

Lewis, Michael. "Many Minds Make Madness: Judgement Under
Uncertainty and Certainty." Psychological Inquiry v. 3(2) .

Miriam, Azaunce. "Is it Schizophrenia or Spirit Possession." Journal
of Social Distress and the Homeless v.4(3) (1995), pp.255-263.

Offer, Daniel and Sabshin, Melvin eds., op. cit. 

Plog, Stanley C. and Robert B. Edgeton, eds., op. cit.

Sadler, John Z. et al. Philosophical Perspectives on Psychiatric
Diagnostic Classification . Baltimore: Johns Hopkins University Press,
1994. A collection of essays discussing essential problems in and barriers to the
construction of system of diagnostics in psychiatry. Authors also discuss specific
problems and biases embedded in the DSM IV and ICD.

Sarbin, Theodore. " Schizophrenia is a Myth Born of Metaphor,
Meaninglessness." Psychology Today (June, 1972), p.18. A
discussion of the way the diagnosis of schizophrenia has become a myth, a reified
metaphor that has no clinical use or scientific value. Author argues this point
via both historical analysis and empirical study. 

Sass, Louis A. "`My so-called Delusions':Solipsism, Madness and
the Schreber Case. Special Issue: Phenomenology and Schizophrenia." 
Journal of Phenomenolgical Psychology v. 25(1) (1994), pp. 70- 103.

Silverman, Irwin. Pure Types are Rare: Myths and Meanings of
Madness. New York: Praegar, 1994. A discussion of mental illness and
psychiatric diagnostics as icons constructed to exercise social control over problematic
populations for the good of the larger society and not for the individual sufferer. Author
reformulated madness as an oblique but explicable response to conflict, real or imagined,
internal or external. 

D. Validity Issues

Ash, P. "The Reliability of Psychiatric Diagnosis. " Journal of
Abnormal Social Psychology v. 44 (1949), pp. 272-276. A study
focussing on three psychiatrists and the degree to which they disagreed on
diagnosis of the same patients. Study focussed on a number of variables including
the seriousness of pathology and the interaction between these variables and
consistency. Results show a very low percentage of consistent diagnoses for all
three doctors. 

Barbour, Allen B. Caring for Patients: a Critique of the Medical Model. 
Stanford, Ca.: Stanford University Press, 1995. An attempt to relegate the
medical model of illness to at least a less primary role in the conceptualization and
treatment of problems. Author argues that "when applied without perspective" the
medical model and discrete diagnostics are invalid, and that "a better understanding of
the relation of the illness to the life of the patient" can obviate many of the problems the
model otherwise incurs. Book is a careful analysis that highlights many of the key issues,
though ultimately settling for a reframing rather than a rethinking of the medical model. 

Bean, op. cit.

Beahrs, op. cit. 

Beck, A.T. et al. "Reliability of Psychiatric Diagnosis."
American Journal of Psychiatry v. 119 (October), pp. 351-357.
A research study assessing the degree of diagnostic agreement among 4
psychiatrists diagnosing patients in an inpatient facility. Results showed a level
of concordance of 54%, high enough to be clearly non-random, but low enough to
raise questions about the utility of diagnostics as a treatment or research tool. 

Bolton, Derek. Mind ,Meaning and Mental Disorder: the
Nature of Causal Explanation in Psychology and Psychiatry. 
New York: Oxford University Press, 1996. A philosophical analysis
of the question of how best to explain and treat human behavior, and a concurrent
discussion of the implications of that argument for the theory and practice of
psychiatry. Author argues that the key issue in this discussion is the question of
whether abnormal behavior can be explained as "non-intentional," the result of
a malfunction in normal psychological and/or biological functioning. Author
argues that such an explanation is difficult to uphold.

Brown, Phil. " The Name Game."Journal of Mind and Behavior v.
11(3-4) (Sum-Fal 1990), pp. 385-406. An analysis of the essential empirical
failures of psychiatric diagnosis and the biases and flaws of the system. Author also
discusses the ways in which psychiatry dominates mental health and how this domination
is passed on to patient. Author argues that a more comprehensive understanding of
mental problems may be gained from "a sociology of diagnosis" that takes into account these key

Breggin, Peter. Toxic Psychiatry. New York: Saint Martin's
Press, 1991. A wide-ranging discussion of the validity of various psychiatric
diagnoses and the ethical, moral, and empirical value of psychiatric treatment for these

Bullough, Vern. "Is Homosexuality an Illness." Humanist
(Nov/Dec, 1974), pp.27-30.

Dawber, Thomas. "Unproved Hypothesis." New England Journal of
Medicine v. 299 (1978), p. 455.

Dawes Robyn M. House of Cards: Psychology and Psychiatry
Built on Myth . New York: Macmillan International, 1984. 
Discussion criticizing many aspects of psychological assessment for their
unscientific basis and feigned objectivity. 

Dumont,"The Non-specificity of Mental Illness," op. cit. 

Farber, Seth. Madness, Heresy, and the Rumor of Angels, op.

Fisher, Walter, et al. Power , Greed and Stupidity in the Mental Health
Racket. Philadelphia: Westminster Press, 1973. An argument that the
medical model is inappropriate as ascribed to deviant behavior, and that this model -- a
result of greed, power and incompetence among mental health professionals -- needs to
be cased out in favor of a more socially sensitive theoretical frame. 

Gove, Walter R. The Labelling of Deviance. Beverly Hills, California:
Sage Publications, 1980. A set of essays discussing labelling theory, the evolution
of psychiatric diagnostics, the difficulty of making "accurate diagnoses, and some reasons
to be skeptical of psychiatry as a self-aware entity.

Hall, Beverly A. "The Psychiatric model: a critical analysis." Advances in
Nursing Science v. 18 (3) (March 1996), pp. 16-26. An examination of the
ways in which the medical model and diagnostics serve to disempower and control
patients rather than help them. The focus of the article is on the ways in which psychiatric
treatment and particularly nursing is adversely effected by diagnostics and what values
need to be recognized and reified over "objectivity" in mental health care. 

Johnstone, Lucy. Users and Abusers of Psychiatry: A Critical Look at
Traditional Psychiatric Practice. New York: Routledge, 1989. A series of
case studies and concurrent analysis examining the problems that all arise in treatment
based on the medical model. Author also analyzes the evolution of psychiatry,
diagnostics, and psychopharmacology. 

Katz, op. cit.

Kick, H. "Anti-psychiatry and the crisis of self-conception in
psychiatry" Fortschritte der Neurilogie -Psychiatrie v. 58 (10)
(Oct. 1990), pp. 367-74. "Describes the history and concerns of the
antipsychiatry movement and considers its consequences for the medical model of
mental disorders and for conceptualizations of the role of the psychiatrist." --
PsychInfo Data Base. 

Leifer, Ronald. In the Name of Mental Health:. New York:
Science House, 1969. An attempt to both describe the underlying political
meaning and functions of the medical model of mental illness and to recast the
role of psychiatrists in society as something other than "physicians who
diagnose, treat, and prevent metal illness."

Mehlman, B. "The Reliability of Psychiatric Diagnosis." Journal
of Abnormal and Social Psychology v. 47 (1952), pp. 577-578. 
A study showing that individual psychiatrists have individualized patterns of
diagnosis which vary from psychiatrist to psychiatrist. This indicates the degree
to which subjectivity enters into diagnosis even at the level of implementation,
much less formulation.

Miller, Milton H. If the Patient is You: Psychiatry Inside-Out. New York : 
Scribner, 1977.

Nunokawa, Walther D. Human Values and Abnormal Behavior. 
Glenview, Illinois: Scott, Foresman and Company, 1965. A collection of
essays discussing the boundary between the normal and the abnormal and how
this boundary is policed by a cooperation between psychiatry and the law. 

Offer, Daniel. Normality and the Life Cycle : a Critical Integration. New
York: Basic Books, 1984. An examination of the concept of normality and the
changes that occur therein through various stages in what the authors see as the human
life cycle. Authors ultimately question whether biology , sociology, and psychology can
be used in their current incarnation to justify a concept of normality where "the known can
be separated from the valued" and discuss the implications of this observations for the
above disciplines. 

Pfohl, op. cit.

Plog, Stanley C. and Robert B. Edgeton, eds., op. cit.

Quinton, Anthony. "Homosexuality;" in Philosophy,
Psychology and Psychiatry, by A. Philips Griffiths. New York:
Press Syndicate of Caimbridge (1994), pp.213- 239. Article
discusses the implications and fallacies implied by diagnosing homosexuality as a
biological dysfunction or illness. Quinton does a precise job of articulating the
ways in which diagnostics can and does cloak moral and political judgements of
deviance in the garb of medical entities. 

Radden, op. cit. 

Rosencrance, John. "Compulsive Gambling and the
Medicalization of Deviance." Social Problems v.32(3) (Feb.
1985), pp. 275-284. An argument that treatment programs based on the
addictions model of behavior and on the labelling of individuals as "pathological"
are inaccurate, based on a non-representative group of cases who believe they
have a problem. Author argues that the resulting conception is more political
than scientific, having achieved acceptance by virtue of its moral sense and not
by empirical support.

Reznek, Lawrie. The Nature of Disease. New York: 
Routledge and Kegan Paul, 1987. An inquiry into the concept of disease. 
Author engages both medical and psychiatric diagnoses with the intention of
determining what is objective evaluation of an existing condition and what is
descriptive, biased analysis of behavior, habit and thought.

Rogers, op. cit. 

Rosenhan, D. L. "On Being Sane in Insane Places." Science,
January 19, 1973, pp. 250-278. 

Ross, op. cit. 

Sadler, op. cit.

Sarbin, op. cit. 

Saubidet, Roberto O. "What is Healing?" Acta Psiquiatrica y
Psicologica de America Latina, 34(2), pp. 109-112. "Discusses
the concept of cure' in mental disease, emphasizing the long term sequalae of
mental illness. With mental diseases, the only means of evaluating the degree of
healing or rehabilitation achieved is by studying the patient for pathognomic
signs. Implications for medical model are noted." -- PsychINFO database,

Scull, Andrew, ed. Madhouses , Mad-doctors, and Madmen: 
the Social History of Psychiatry in the Victorian Era. 
Philadelphia: University of Pennsylvania Press, 1981. A
compilation of papers discussing mental health in the Victorian age. The
collection highlights the historically prominent struggle over the legitimacy of
psychiatry and the concept of psychiatric "Illness." 

Shader, R. I. et al. "Biasing Factors in Diagnosis and
Disposition." Comprehensive Psychiatry v. 10 (1969), pp. 81-9.

Smead, Valerie S. "Anorexia Nervosa, Bulimarexia, and Bulimia."
Women and Therapy v.2(1) (Spr. 1983), pp.19-35. An examination of the ways
in which diagnostics are inaccurate and countertherapeutic in their assessment of women
with eating disorders. Author asserts that labelling effects and the importance of discrete
symptoms lead to inaccurate understandings of particular cases as well as individual and
group responses to the diagnosis. Author also emphasizes the social implications of
blaming the individual for socially derived -- but deviant -- behavior. 

Svensson, Tommy. On the Notion of Mental Illness . Aldershot, England:
Avebury Publishing Co., 1995. An inquiry into the validity and importance of the
criticisms that have been voiced against the medical model of mental illness. Article
reviews much of the significant literature from the 60's and 70's in moving toward the
conclusion that the issue of validity is far from settled and requires further thought. 

Szasz, Thomas S. "Mental Illness is Still a Myth." Society 
v. 31(4) (1994), pp. 34-9. A fairly recent article by one of the most
influential anti-psychiatric thinkers of the past 50 years. Author discusses his
major theoretical stances, including the socio/political derivation of diagnostics. 
Author also describes changes that have occurred in the past 40 years in
psychiatry's treatment of the mentally ill as a result of the anti-psychiatric

Teigen, Karl H. "From Fallacies and Illusions to Heuristics and
Biases." In Basic Issues in Psychology. Forlag, Sigma. 
Soreidgrend, Norway: Publisher Unknown, 1989.

Torrey, E. Fuller. The Death of Psychiatry. Radnor, Pennsylvania: 
Chilton Book Co. 1974. An attack on psychiatry as an emperor fully decked out in
the finest nonexistent threads. Author attempts to invalidate the medical model,
diagnostics, and diagnostic tests; and then articulate an alternative conception.

Trafford, Abigail. "Putting Mental Illness on a Par With the
Physical?" The Washington Post. May, 1996 v.119, n. 15: p. WH6, col. 

Van Praag, Herman M. Make Believes in Psychiatry . New York: 
Bruner/Mazel, 1993. A critical analysis of some of the foundations of psychiatry --
including empiricism and the medical model -- and a call to move toward an acceptance of
the "subjective" elements which do and must exist in any science of the human. 

Wade, Terence C. "Biopsychiatric attacks on Women." Women and
Therapy, v.16(1) (1995), pp. 143-61. A wide ranging paper attacking psychiatry's
tendency to pathologize women and attempt to exorcise them of immoral behavior via
medication and medicalized methods of social control. Author confronts therapists,
expounds on the lack of empirical support for the medical model, and calls for a
reconceptualization of mental illness with an eye toward correcting for the power
imbalance reified and enforced by psychiatry.

Ward, Colleen A. Altered States of Consciousness and Mental Health:
a Cross Cultural Perspective. Beverly Hills California: Sage Productions,

Wing, op. cit.

II. The Cultural and Historical Relativity of Diagnosis

Castel, Robert. The Regulation of Madness. Berkeley, California: 
University of California Press, 1988. A discussion of the psychiatric
establishment in France and its close ties to the state. Author attempts to
document the ways in which psychiatry was formed and functions to control
undesirables under the guise of medicine without formal sanctioning from the people. 

Donnelly, Michael. Managing the Mind: a Study of Medical Psychology
in Early Nineteenth Century Britain. London: 1983. A discussion of the
beginnings of psychiatry in the "medical psychology" of 19th century Britain. Author
argues that cultural currents of the time accorded particular importance to the "medical,"
and it was as a direct result of this prestige that the categories of insanity and even the
modern concept of "inanity" itself was created. 

Gamwell, Lynn. Madness in America: Cultural and Medical
Perceptions of Mental Illness Before 1914. Ithaca, New York:
Cornell University Press, 1995. An examination of the ways in which
cultural preoccupations informed and were reified in the early development of 
American psychiatry in the period directly following World War One. 

Gould, Stephen Jay. The Mismeasure of Man . New York, 1981.

Grob, Gerald N. Mental Illness and American Society. Princeton, N.J.:
Princeton University Press, 1983. An historical account of Psychiatry and Mental
Health as a political and professional movement rather than its avowed growth as a
scientific enterprise moving toward proper care for "ill" patients.

Gross, op. cit.

Jimenez, Mary Ann. Changing Faces of Madness. A
sociological/anthropological examination of the changes in cultural representation and
treatment of "madness" in Massachusetts from 1700 to 1840. 

Masson, Moussaieff, J. (compiled by). A Dark Science : 
Women Sexuality, and Psychiatry in the Nineteenth Century. 
New York: Farrar, Straus, Giroux, 1986. A compilation of 19th
century journal articles discussing treatment and diagnosis of several illnesses
of the period which can be seen as enactments of eroticized misogyny. Author
believes these articles to be instructive as documenting the historically
prominent attempts of male dominated society to construct and dominate the
female psyche while discounting women's pain and experience.

Mazzoni, op. cit.

McGovern, Constance M. Masters of Madness: Social Origins of the
American Psychiatric Profession. Hanover, New Hampshire: University
Press of New England, 1985. An historical analysis of the origins of the
American Asylum and Psychiatric profession, the central theme of which is that
the Psychiatric establishment was built not on "truth," but on the personal
ambitions of the men who created, marketed, and performed American

Micale, Mark S. Discovering the History of Psychiatry. New
York: Oxford University Press, 1994. An examination of the ways in
which histories of psychiatry can be seen as themselves constructions and an
exploration of the ways inwhich psychiatry and historiography are inextricably
linked to socio-political ideologies. 

Parsons, op. cit. 

Porter, Roy. Mind Forged Manacles. Caimbridge, Mass.: Harvard
University Press, 1987. A history of madness in England -- restoration to
regency -- focussing on the evolution of the concept of mental illness, the
coincident arrival of the asylum and the psychiatrist, and the relationship
between these three entities. 

Ripa, Yannick. Women and Madness. Minneapolis, Minnesota: 
University of Minnesota Press, 1990. An historical analysis of the beginnings
of the psychiatric establishment in France in the 19th century, and the ways in
which development of diagnostics and other "philanthropic" gestures credited to
French physicians during this period functioned to control the minds and bodies
of women. 

Scull, Social Order/Mental Disorder, op. cit. 

Scull, Andrew. The Most Solitary of Afflictions: Madness and
Society in Britain 1700-1900, op. cit. 

Scull, Andrew. "A Gothic Tale of Madness and Modern
Medicine." Lectures on the History of Psychiatry. R.M. Murray et
al. eds. Washington D.C.: American Psychiatric Press, 1990.

Scull, Andrew, ed., op. cit. 

Scull, Andrew. Museums of Madness. New York: St. Martin's
Press, 1979. A discussion of the medicalization and incarceration of deviance,
mental illness in nineteenth century England. Discussion focuses on how capitalism in
particular and other cultural currents converged to make psychiatry an expedient and
acceptable method for controlling certain deviant populations. 

Showalter, Elaine. The Female Malady. New York: Random
House, 1985. A history of women and mental illness in England from 1830 to 1980,
focussing on the oppressive social circumstance of women in culture and how this
becomes enmeshed in and obscured by the "female malady" of madness. 

Skultans, Vieda. Madness and Morals: Ideas on Insanity in the
nineteenth Century. Boston: Routledge and Kegan Paul, 1975. A
collection of foundational articles by nineteenth century Psychiatrists. Essays
include discussions of the prevalence, causes, and treatment of mental illness as it was
understood at the beginning of modern psychiatry. 

Southart, E. E. and Mary Jarret. Kingdom of Evils. New York: 
Macmillan Company, 1922. An extensive set of case histories and commentary
presented by a psychiatrist working at the turn of the century. Text is instructive as it is an
early attempt to deal with the problems of how to diagnose, treat, and conceptualize 
mental illness in a time before biology and "science" became the pre-eminent discourse
in psychiatry; author's idiosyncratic dialogue is very different and often antithetical tocurrent perspectives.

III. The Politics of Diagnosis

A. Diagnosis as Professionally Self Serving 

Burton, Thomas M. "Lilly Sales Rise as Use of Prozac Keeps
Growing." The Wall Street Journal. Jan. 31, 1996: pB1(W)-(E), col.6. 

Coleman, Lee. Reign of Error: Psychiatry, Authority, and the Law. 
Boston: Beacon Press, 1972. A discussion of psychiatry's power over the
courts, mental hospitals and prisons; and an argument that there is no scientific
basis or justification for this power. Author focusses on the misuse of medical
credentials and terminology to justify authoritarian rule over mental health.

Cushman, Philip. Constructing the Self, Constructing
America: a Cultural History of Psychotherapy. Boston, Mass.:
Addison Wesley Pub., 1995. An historical analysis focussing on the idea that
"there have been several healing professions that used various healing technologies in
order to create, shape, and maintain a particular historical self, that all of these selves have
had important political and economic functions within their eras...[each profession
holding] that the self of its era is the only proper self, that its technologies have a
transcendent warrant...from God, from natural law, or from the natural sciences." 

"Depression Awareness or Prozac Pitch?" Washington Post,
Feb. 5 1995 v. 118: p. C6 Col. 4. 

Dumont, Matthew. "In Bed Together at the Market: 
Psychiatry and the Pharmaceutical Industry." American 
Journal of Orthopsychiatry 60 (1990), pp. 484-485. An opinion
piece discussing the degree to which psychiatric research and practice have
become enmeshed in and dependant on the psychopharmaceutical marketplace. 

Freudenheim, Milt. "The Drug Makers are Listening to Prozac; a
Host of Similar Antidepressants May Soon Join the Fight in a $3 Billion
Market." Then New York Times. Jan. 9, 1994 v. 143, s.3: p. F7(N)-(L),
col. 1.

Kirk, op. cit.

McGovern, op. cit. 

Miller, Michael W. "Creating a Buzz: with Remedy in Hand, Drug
Firms Get Ready to Popularize an Illness; Obsessive Compulsive
Disease Will be Exposed to Blitz of Ads, Polls, Talk Shows; Quest for a
Celebrity Patient." The Wall Street Journal. April, 25, 1994: pp.
A1(W)-(E), col. 6.

Schwartz, Harold I. Psychiatric Practice Under Fire: The Influence of
Government, the Media, and Special Interests on Somatic Therapies. 
Washington D.C. 1994. 

Warner, Richard. Recover From Schizophrenia: Psychiatry and
Political Economy. New York: Routledge, 1994.

Wiseman, Bruce. Psychiatry: The Ultimate Betrayal. Los
Angeles, California: Freedom Publishing, 1995.

B. Power, Social Control and Diagnostics

a. General Analysis 

Banton, Raghild. The Politics of Mental Health. London:
Macmillan, 1985. An attempt to articulate a "subversive" "radical" approach to
mental health care based on principles laid out by feminist and anti-psychiatric
scholars and fundamentally guided by socialist principles. Book posits "mental
health" as a bourgeois and capitalist conception, and therapy as a capitalist

Bloch, Sidney and Peter Reddaway. Psychiatric Terror. New
York: Basic Books, 1977. Discussion of the use of psychiatry in the Soviet
Union as a means of covert -- and even overt -- social control. Author discusses
the reasons why psychiatry in its current formulation is so well constructed for
such a purpose.

Breggin, Peter. " Psychiatry and Psychotherapy as Political
Process." American Journal of Psychotherapy v. 29 (1975), pp. 

Brandt, op. cit.

Castel, op. cit. 

Coleman, op. cit.

Daniels, op. cit.

Horwitz, op. cit. 

Ingleby, David. Critical Psychiatry: the Politics of Mental Health. 
New York: Pantheon Books, 1980. A discussion of psychiatry as a social
institution that evolved to provide individually based and therefore straightforward
short-term solutions to problems that are complex and essentially sociopolitical in

Leifer, Ronald. "The medical model as the ideology of the
therapeutic state." Journal of Mind and Behavior v. 11(3-
4) (Sum-Fall 1990), pp.247 -258. An argument that diagnostics
and psychiatry arose out of a need for extralegal measures of social
control for behavior outside the parameters of moral incarceration but
still regarded as bizarre or threatening. Author also argues that the
system is inept and impotent in treating or changing the people it has
so diagnosed because it fails to be consistent in its attribution of moral
responsibility for behavior. 

Leifer, Ronald. In the Name of Mental Health, op cit. 

Robitscher, Jonas B. The Powers of Psychiatry. Boston: 
Houghton/Mifflin, 1980. A discussion of the sociopolitical reasons
behind the phenomenal growth of psychiatric authority in the
determination of normality and the codification of morality. Discussion
includes analysis of the concept of mental disorder and of diagnostics as a
form of social control "only occasionally" medical or scientific.

Schrag, Peter. Mind Control. New York: Pantheon
Books, 1978. Book discusses the ways in which medicalization of
"mental illness" has become the paradigm of social control -- rather
than more overt methods such as moral codes and legal decree. Discussion
includes sections on the use of psychotropic medications and on the
function of psychiatric labels in society. 

Scull, Andrew. Museums of Madness., op cit. 

Silverstein, op. cit. 

Szasz, Thomas. Therapeutic State. Buffalo, New York: 
Prometheus Books, 1984. A collection of essays beginning from the
premise that mental illness is merely metaphorically related to physical illness but
has been reified as a medical entity to achieve political ends. Discussion includes
sections on psychotropic medications, sexual disturbance and psychiatry as a

Szasz, Thomas. Law, Liberty and Psychiatry: An Inquiry into the
Social Use of Mental Health Practices, op. cit. 

Turner, Bryan S. Medical Power and Social
Knowledge. Newbury Park, California: Sage Publications,

b. Gender Bias

Al-Issa, Ihsan. The Psychopathology of Women. Englewood
Cliffs, New Jersey: Prentice Hall, 1980. An analysis of the reasons
behind and the extent of women's over-representation in psychiatric settings. 
Author explores how powerlessness and low social class -- often both embodied
in gender -- can "make people more vulnerable to the accusation of madness."

Busfield, Joan. Men, Women, and Madness:
Understanding gender and mental disorder. 
Washington Sq., New York: New York University Press,
1995. A review and extension of 20 years of feminist scholarship centered on
the ways in which gender and oppression are implicated in the presentation and
treatment of mental illness as well as the ways in which gender is implicated in the
concept of "mental Illness" itself. 

Chesler, Phyllis. "Twenty Years Since Women
and Madness: Toward a Feminist Institute of
Mental Health and Healing. Journal of Mind and
Behavior v. 11(3-4) (1990), pp. 313-322.

Chesler, Phyllis. Women and Madness. Garden City, New
York: Doubleday and Company, 1972. A collection of interviews,
prose, and analytic work centered on the ways in which stigmatization of "female"
behavior has led to women's incarceration, abuse, and the reification of social
oppression in the form of "mental illness." 

Etorre, Elizabeth et al. "Psychotropic Drugs: Long Term Use
Dependency and the Gender Factor." Social Science and
Medicine v. 39(12) (Dec. 1994), pp. 1667-1673.

Gardiner, Judith K. "Can Ms. Prozac Talk Back? 
Feminism Drugs and Social Constructionism." Feminist
Studies v. 21 (1995), pp. 501-17. A clear, concise summary of key
issues surrounding psychopharmaceutical, discussed primarily from the
perspective of when and how are anti-depressants empowering as opposed to

Hamilton, Jean A. and Margaret F. Jensvold. "Sex and
Gender as Critical Variables in Feminist
Psychopharmacology Research and Pharmacotherapy. 
Special Issue: Psychopharmacology from a Feminist
Perspective." Women and Therapy v. 16(1) (1995), pp. 9-30. A
discussion of the ways in which therapists should be sensitive to gender issues
and why these issues are significant. 

Jodelet, Denise. Madness and Social Representations. Los
Angeles, California: University of California Press, 1989. A scholarly
analysis of the reception and relationship between "civilian" and the "insane" in a
French Community in which the groups interact regularly. The book discusses
both social representations of insanity and personal interactions between "sane"
and "insane" parties, and how these relationships are or are not shaped by the
"otherness" of the insane. 

Lerman, Hannah. Pigeonholing Women's Misery: A
History and Critical Analysis of the Psychodiagnosis of
Women in the Twentieth Century. New York: Basic Books,
1996. An analysis of psychiatric diagnostics, problematizing the covert
subjectivity and counter-therapeutic ends served by the U.S.
classification system. 

Liburd, Rosemary and Ester Rothblum. Ethical Decision
Making in Therapy: New York: Guilford Press, 1995. A
discussion of the ways in which women have been medicalized by the
psychiatric institution and an analysis of the ways in which a feminist
glance at PMS, Anorexia Nervosa and other psychiatric phenomenon leads
to ethical and moral questions of how to treat these women

Lunbeck, Elizabeth. The Psychiatric Persuasion: 
Knowledge Gender and Power in Modern America. 
Princeton, N.J. : Princeton University Press 1994. An
historical account of psychiatry's expansion from the limits of the
institution to the diagnosis of the entire spectrum of human behavior,
from the assessment of what "is" to what "should be." Issues of
particular interest are the role played by gender and power in the
evolution of psychiatric thought and professional roles.

Ripa, op. cit. 

Russel, Denise. Women, Madness and Medicine. Oxford,
England: Polity Press, 1995.

Showalter, op. cit.

Shafter, Roberta. "Women and Madness." Issues in Ego
Psychology v. 12(1) (1989), pp.77-82. 

Spender, Dale. "Women and Madness: a Justifiable
Response." Feminism and Psychology v. 4(2) (1994), p.280. A
discussion of Chesler's work, highlighting some of its key and foundational
contributions to an understanding of the social forces at work in constructing
madness and gender.

Ussher, Jane. Women's Madness: Misogyny or Mental
Illness. Amherst, Mass.: University of
Massachusetts Press, 1991. An analysis of the psychopathology of
women as understood by psychiatric, anti-psychiatric, and feminist theorists; and
an attempt to articulate a woman centric model of madness that leads to care
rather than control. 

Wade, op. cit. 

Warren, Carol A.B. Madwives: Schizophrenic Women
in the 1950's. New Brunswick, New Jersey:
Rutgers University Press, 1987. A commentary on data obtained
on 17 middle-class women institutionalized for schizophrenia between
1957 and 1961. Author emphasizes the argument that the stress
reactions to life in an oppressive, sexist society can and have been labeled
pathogenic without attention being paid to the environments that foster
such reactions. 

Wenegrat, Brant. Illness and Power. New York: New York
University Press, 1995. An examination of mental illness's prevalence
among women as a response to powerlessness and as a control apparatus for the
powerful elements in society. 

Widom, op. cit. 

c. Racial and Ethnic Biases

Comas-Diaz, Lilian et. al. eds. Women of Color: 
Integrating Ethnicity and Gender Identities in
Psychotherapy. New York : Guilford Press, 1994. 

Gilman, Sander L. Difference and Pathology: Stereotypes of
Sexuality , Race and Madness. Ithaca: Cornell University Press,

Thomas, Alexander. Racism and Psychiatry. Secaucus, N.J.: 
the ways psychiatry -- despite what are often the best of intentions -- has been
and continues to be informed by racism which colors its perspectives and shapes
its treatments. 

d. Socioeconomic Bias

Angermeyer, Matthias C. From Social Class to Social
Stress: New Developments in Psychiatric Epidemiology. 
New York: Springer-Verlag, 1987.

Dohrenwend, Bruce and Barbara Dohrenwend. Social Status and
Psychiatric Disorder. New York: John Wiley 1969. An attempt to
document through empirical studies the etiological factors leading to the well-
established relationship between social status and the prevalence of mental

Greenblatt, Milton et. al. eds. Poverty and Mental Health. 
Washington D.C.: American Psychiatric Association, 1967. A
collection of papers discussing poverty as a "stressor" leading to emotional
problems, and how to treat/prevent such an "illness."

Hollingshead, August B. and Frederick C. Redlich. 
Social Class and Mental Illness. New York: John Wiley ,
1958. A study of the relationship between social class and the prevalence,
treatment, and diagnosis of Mental Illness in New Haven Connecticut. Study is
one of the earlier American pieces that began to question the medicalization
of mental illness. 

Scheper Hughes, Nancy. Saints, Scholars, and
Schizophrenics. Berkeley, California: University of California
Press, 1979. An analysis of psychosocial factors leading to Ireland's
status as possessing "the highest hospital treatment rate for mental
illness in the world."

Schwab, John J. Social Order and Mental Health : the
Florida Health Study. New York: Brunnel/Mazel, 1979. A
study of one Florida county and how changes in social climate, class, and
cultural preoccupations function s risk factors for mental illness.

C. Psychiatry and the Construction of Selfhood

Cushman, op. cit.

Levin, David Michael. Pathologies of the Modern Self. New York: New
York University Press, 1987. A collection of essays discussing the historical
and cultural forces that intersect both to form the medical model of mental
illness and the "pathologies" that the medical model seeks to cure.

Leonard, Peter. Personality and Ideology: Toward a Materialist
Understanding of the Individual. London: Macmillan, ?.

D. Religion and Psychiatry

Barshinger, Clark E. "Christian Faith in the Age of Prozac." 
Harpers v. 291 (1995), pp. 16-18.I. 

Barshinger, Clark E. "The Gospel According to Prozac." 
Christianity Today v. 39 (1995), pp. 34-7. 

Breggin, Peter R. "Mental Health Versus Religion." The
Humanist v. 47 (1987), pp. 12-13.

Klausner. Psychiatry and Religion: A discussion of the
interrelationship and conflict between religious and psychiatric healers
in modern America. 

Summerlin, Florence A. Religion and Mental Health: a Bibliography. 
Washington D.C. : DHHS Publications, 1980.

 IV. Effects of Diagnosis on Clients, Communities and Culture

A. Creation of Stereotypes

Bates. Models of Madness, op. cit

Dalby, Thomas J. "Terms of Madness: Historical Linguistics."
Comprehensive Psychiatry v34 (6) (1993), 392-395.

Fink, Paul Jay and Tasman, Allan, eds. Stigma and Mental
Illness. Washington D.C. : American Psychiatric Press, 1992.
A discussion of the impact that negative stereotyping of and cultural biases against mental
illness have on both treatment and the interpersonal lives of those so diagnosed.

James, Norman M. "On the Perception of Madness." Australian and
New Zealand Journal of Psychiatry v. 27(2) (1993), pp. 192-199.

Leifer, Ronald. In the Name of Mental Health: New York:
Science House 1969. An attempt to both describe the underlying political
meaning and functions of the medical model of mental illness and to recast the
role of psychiatrists in society as something other than "physicians who
diagnose, treat, and prevent metal illness."

Littlewood, Roland. "The Imitation of Madness:The
Influence of Psychopathology upon Culture." Selected Essays on
Art and Art Therapy. Andrea Gilroy and Tessa Dalley eds. 
London: Routledge, 1989.

Perlman, Gerald. "Some Problems with the Medical Model."
Journal of Urban Psychiatry v. 2(1) (1982), pp.31-37. An argument
that the medicalization of mental illness results in and fosters a separation
between the sick and the normal that is counter-therapeutic. Author analyzes the
authoritarian and paternalistic functioning of mental institutions to exemplify
this point, and argues in favor of other psycho/social models to replace the
medical conception on which care is currently based. 

Price, et. al., op. cit. 

Rosen, George. Madness in Society: Chapters in the
Historical Sociology of Mental Illness. Chicago: Chicago
University Press, 1968. A collection of studies examining the place of the
mentally ill in different societies, organized around the author's belief in the
essential "recognition" of madness in Western Civilization as "alien," or

Scheff, Thomas J. "The Societal Reaction to Deviance:
Ascriptive Elements in the Psychiatric Screening of Mental
Patients in a Midwestern State." Social Problems v. 11
(Spring, 1964), pp. 401-13. A study pointing out the primary role of lay
conceptions of mental illness in the assessment of an individual as "ill" by the
medical and legal communities. Once an individual is entered into the system by
society, the author argues that the presumption of the system is that he/she is 
insane until proven otherwise. 

Scheper-Hughes, Nancy and Anne M. Lovell eds. Psychiatry
Inside Out: A selection of writings by Italian theorist Franco Basaglia
in which he discusses the destructive powers of the asylum and the labels
it promotes. Basaglia points to the construction of a rift between Normal
and Abnormal by psychiatry as a fundamental problem for healing and for

B. Deficit Labelling

Barnham, Peter and Robert Hayward. Relocating Madness:
From the Mental Patient to the Person. London: Free
Association Books Ltd. 1995. 

Cohen, David. Challenging the Therapeutic State: Critical
Perspectives on Psychiatry and the Mental Health Care System. 
Vol. 11, nos. 3 and 4 (1990) of the Journal of Mind and

Conrad, op. cit. 

Doherty, E. "Labelling Effects in Psychiatric Hospitalization." Archives of
General Psychiatry v. 32 (May `1975). A study documenting the effect that
denying or accepting the label of "mentally ill" had on 42 pt's in a psychiatric institution. 
Study found significant interaction between the rejection of the label and length of stay in
hospital. Possible implications of results are discussed. 

Goffman, Erving. Asylums. Garden City, New York: Anchor
Books, 1961. A foundational work discussing the ways in which the
institutional setting combined with the medical model function so as to construct
the self of the inmates. Author discusses implications of his research for the
medical model. 

Scheff, Thomas J. Labelling Madness. Englewood Cliffs, NJ:
Prentice Hall, 1976. A collection of essays depicting various situations in
which diagnostics and "labeling" are non-therapeutic and/or wholly incorrect. 
Scheff also articulates alternative ways of conceptualizing and treating mental

Scheff, Thomas J. Mental Illness and Social Process, op. cit. 

Silverstein, op. cit. 

Szasz, Thomas S. Ideology and Insanity, op. cit. 

Temerlin, Maurice K. " Suggestion Effects in Psychiatric
Diagnosis." Journal of Nervous and Mental Disease v. 147 (4)
(1968), pp. 349-53.

Townsend, John Marshall. Cultural Conceptions and Mental
Illness. Chicago: University of Chicago Press, 1978. An examination of the
split between "social role" theorists who argue that labels and cultural conceptions
designate certain people as "ill" and those who hold mental problems to be purely medical
entities. Author holds this to be a "fallacious" dichotomy that he attempts to unpack.

C. Bias Toward Psychopharmacology

"Anti-Drug Conterblast in Mental Health." Lancet v. 346
(1995), p. 323.

Barondes, Samuel H. "Thinking About Prozac." Science v. 263
(1994), pp.1102-3.

Black, Antonia. "The Drugging of America's Children." 
Redbook v. 184, (1994), pp. 41-2. 

Braslow, Ken. "Prozac is no Miracle Cure For Pressures of
Student Life."The Los Angeles Times. Jan. 1, 1995 v. 114: p. M3, col. 2.

Breggin, Peter. Talking Back To Prozac. 

Breggin, Peter. Toxic Psychiatry, op. cit.

Breggin, Peter R. Psychiatric Drugs: Hazards to the Brain. New
York: Springer Publishing Co. 1983. A discussion of psychotropic medication. 
Discussion includes information on the validity of the medical model for different
diagnoses as well as specific information on the use and problems with many of the more
commonly prescribed psychotropic medications. 

Critser, Greg. "Oh How Happy We Will Be: Pills, Paradise, and
the Profits of the Drug Companies." Harper's v. 292 (1996), p.
39-48. iii. An article discussing the benefits of anti-depressants as well as
the marketing and business aspect that has taken over the reigns for their
prescription from the therapeutic community. Author discusses how
psychopharmaceutical company's are making their products more available,
more prescribed, and more desirable to the world. 

Eichelman, Burr. "Ethical issues of Pharmacologic and Behavioral
interventions in Psychiatry: Aspects of Education and Respect for
Persons." Science and Morality, Clements, C. ed (1982), pp. 175-185. 

Fisher, Seymour. The Limits of Biological Treatments for Psychological
Distress: A series of monographs and empirical studies designed to assess the
effectiveness of pharmacological treatments for mental illness. Studies also stress an
acceptance of many of the underlying political/ideological implications of biological

Gardiner, op. cit.

Goleman, Daniel. "Coming Soon to a Prozac Nation." The New York
Times v. 147 s4 p. E2(N) -E2(L) (1996), col. 1.

Hamilton, Jean A. ed. Psychopharmacology from a Feminist
Perspective. New York: The Hayworth Press, 1995. A collection of
papers discussing the particular importance that must be paid to gender and race
issues when treating women with psychopharmaceuticals because of the slanted
ideologies implied by such treatment. 

Hansen, Josephine F. "Portrayal of Women and Elderly Patients in
Psychotropic Drug Advertisements. Special Issue: Psychopharmacology 
from a Feminist Perspective." Women and Therapy v. 16(1) (1995), pp.
129-141. Research Paper observing and analyzing an extremely significant over-
representation of women and elderly people in drug advertisements, including those
selling antidepressants. Author discusses the impact of such advertising both on
psychiatry and on public conceptions of mental illness. 

Johnstone, op. cit. 

Marsh, Marianne. "Feminist Psychopharmacology." Women and
Therapy v.16(1) (1995), pp.73-84. A discussion of the principles that
the author feels should guide prescription of psychopharmaceuticals. Author
focuses on the need for an understanding and a commitment to change of the gender
biases built into psychiatric practice as a means of guiding and informing the choice of
therapeutic intervention. 

Mauro, James. "And Prozac for All." Psychology Today v. 27
(1994), pp. 44-8. A discussion of the growth of prozac sales and the ways in
which prozac has become almost a panacea for psychological ills. Article
discusses pros and cons of the increase in acceptance of the drugs effectiveness
for a variety of problems. 

"One Pill Makes you Larger, and One Pill Makes you Small." 
Newsweek v. 123 (1994), pp. 36-40.

Pollock, Ellen J. "Side Effects; Managed Care's Focus on Drugs
Alarms Many Doctors; They Say Effort to Cut Costs Leads to Overuse,
Misuse of Pills for Mental Illnesses; Talk Therapy is Discouraged." 
The Wall Street Journal. Dec. 1, 1995, n. 240: pp. A1(W)-(E), col. 6.

Ross, op. cit.

Rubin, Jefferey. "Thomas Szasz, William James, and the
Psychiatric Drug Contraversy." The Journal of Humanist
Psychology v. 184 (1994), pp. 8-20.

Schrag, op. cit. 

Szasz, Thomas. Therapeutic State, op. cit. 

Wurtzel, Elizabeth. Prozac Nation. Boston: Houghton Mifflin
Co., 1994. An autobiographical narrative of one woman's struggle to cope with
the stressors and problems of her life and how reaction to these stressors
translates into mental illness in today's world. 

V. Expansion of Diagnostics

Angier, Natalie. "The Debilitating Malady Called Boyhood." The 
New York Times. July 24, 1994 v.143, s. 4: p. E1(N)-(L), c

Bayer, Ronald. Homosexuality and American Psychiatry: the Politics
of Diagnosis. Princeton, N.J.: Princeton University Press, 1987. A political
analysis of the supposedly "scientific" controversy within the American Psychiatric
Association over the validity of the diagnosis of "homosexuality" as a mental disorder.

Bental, Richard P. "A Proposal to Classify Happiness as a
Mental Disorder." Journal of Medical Ethics v. 18 (1992).

Chu, Franklin. The Madness Establishment. New York:
Grossman, 1974. A discussion of Ralph Nader's inquiry into NIMH and
community psychiatric care. Study argues that the expansion of diagnosis is a
direct result of sociopolitical pressures, and that NIMH is primarily a political -
- rather than medical -- institution supporting an increasingly authoritarian
mental health care system that places psychiatrists at the top of the hierarchy. 

Egan, Timothy. "A Washington City Full of Prozac." The New York
Times. Jan. 30, 1994 v. 143, s.1: p.F7(N)-(L), col. 1.

Katz, Martin M. and James W. Maas. "Psychopharmacology and the
Etiology of Psychopathologic States: Are We Looking in the Right Way." 
Neuropsychopharmacology v. 10 (2) (1994), pp.139-144. 

Kessler, Richard J. "Models of Disease and the Diagnosis of
Schizophrenia." Psychiatry v. 53 (1990), pp. 140-7. Paper does
not critique the medical model, except in so much as to say that its inattention to
the meanings of symptoms leads to an over-diagnosis of schizophrenia. A
problem which the author believes is best corrected by a new focus on
psychodynamic therapies with empathy and understanding as core constituents. 

Kirk, op. cit. 

Milloy, Courtland. "Depressing New World." The Washington Post. 
Jan. 22, 1995 v. 118: p. B, col.1.

Robitscher, op. cit. 

Szasz, Thomas. "Bad Habits are not Diseases." Lancet (July 8,
1972, pp. 83-84. 

Szasz, Thomas. Insanity the Idea and Its Consequences. New
York: Wiley, 1987. An attempt to invalidate the medical model of mental
illness and to point out reasons why the model has become so widely accepted. Author
also focuses on the social implication of that acceptance. 

Torrey, op. cit. 

VI. Ex Mental Patients Responses 

Ablow, Keith Russel. "Dr. Jekyll-Mr. Hyde: Patient Shows Psychiatry's
Shortcomings." Washington Post, Feb. 22, 1994 v.117: p. WH11, Col. 1.

Chamberlain, Judi. "A Psychiatric Survivor Speaks Out." Feminism
and Psychology v. 4(2) (May 1994), pp. 284-287. A former psychiatric
patient, now political reformer and activist, discusses anger she feels with all theorists --
psychiatrists, psychologists, feminists -- who attempt to categorize and treat mental
illness without thinking about or listening to the needs and experiences of those so

Chamberlain, Judi. "The Ex-Patient's Movement." Journal of Mind and
Behavior v.11(3-4) (Sum-Fall 1990), pp.323-336. A discussion of the goals,
achievements and development of the ex-patient's movement. The article questions the
validity of the medical model and focuses on the importance of developing non-medical
self-help approaches to mental problems that empower and advocate the humanity of the
individual as a counterbalance to the diagnostic imperialism of the Psychiatric

Donaldson, Kenneth. Insanity Inside Out. New York: Crown
Publishing, 1976. An autobiography of a man who spent 15 years in a mental
institution unable to convince doctors of his sanity. Donaldson was finally let out after a
controversial supreme court case. 

Edwards, Henry. What Happened to My Mother. New York: Harper
and Row, 1981.

Elfenbein, Debra. Living with Prozac and Other Selective Serotonin
Reuptake Inhibitors: Personal Accounts of Life on Antidepressants. San
Francisco: Harper, 1995.

Geller, Jeff C. Women of the Asylum. New York: Doubleday, 1994. A
collection of 26 first hand accounts of psychiatric treatment received between 1849 and
1945. Authors also present commentary and analysis sections highlighting the socio-
political functions of psychiatric practice.

Gotkin, Janet and Paul Gotkin. Too Much Anger, Too Many
Tears: A Personal Triumph Over Psychiatry. New York:
Quadrangle, 1975. An autobiographical history of two people's bouts with mental
illness and the more difficult battle to survive the psychiatric assault bent on helping them. 

Grobe, Jeanine. Beyond Bedlam: Contemporary Women Psychiatric
Survivors Speak Out. Chicago: Third Side Press, 1995. Collection of work
written by women who have undergone psychiatric treatment critiquing the way the
psychiatric establishment diagnoses, treats and ultimately controls women. 

Kaysen, Susanna. Girl, Interrupted. New York: Turtle Bay Books,
1983. A funny but incisive personal narrative of a psychiatric patient in which
she problematize diagnostics as "not telling you much" and the underlying
assumptions of what is normal. 

Millet, Kate. The Looney Bin Trap. New York: Simon and Schuster,
1990. An autobiographical account of a woman's inappropriate hospitalization,
subsequent outpatient treatment with psychopharmaceuticals, and her recovery
from the "pronouncement" of her "incompetence and degenerative insanity."

Ostwald, Peter. " Genius, Madness and Health: Examples
From Psychobiography." In The Pleasures and Perils of Genius. 
Madison, Connecticut: International Universities Press Inc.

Porter, Roy. A Social History of Madness. New York: 
Weidenfeld and Nicholson, 1987. An "historian's" examination of the
writings and times of a small number of relatively famous "Madmen" and mad-
women, including George III and Virginia Woolf. 

Wood, Mary E. The Writing on the Wall: Women's Autobiography
and the Asylum. Champaign, Ill: University of Illinois Press,
1994. A compilation of six autobiographical narratives by women committed
against their will to life in an asylum. Editor focusses attention on the ways in
which the narratives illustrate the role played by gender biases in psychiatry's
construction of the normal.

VII. Alternatives to Diagnosis 

Bates, Erica M. Mental Disorder or Madness. St. Lucia,
Australia: University of Queensland Press, 1979. A thorough
introduction to both the psychiatric view of "mental illness" and the opposing social and
labelling theorists who argue against the idea that "madness" can be viewed as a strictly
medical entity. 

Banton, op. cit. 

Barbour, op. cit. 

Brown, op. cit. 

Boyer, op. cit. 

Dumont, "The Non-specificity of Mental Illness," op. cit. 

Dumont, Matthew, P. The Absurd Healer: Perspectives of a 
Community Psychiatrist. New York: Science House, 1968. 
One psychiatrist's perspective on the changes that must be made in psychiatry
in order to take into account and highlight the role of the environment in the
onset and symptomatology of mental illness. Author stresses the need to weigh
changes in an individual's social field as of equal importance to changing the
individual --emphasis on pathological environments rather than pathological

Fabrega, Horacio, Jr. "Toward a Social Theory of Psychiatric
Phenomena." Behavioral Science v. 38 (1993), pp. 75 - 100. 

Farber, Madness, Heresy , and the Rumor of Angels, op. cit. 

Farber, "Transcending Medicalism," op. cit. 

Fisher, Walter, op. cit. 

Frank, George. "Beyond the Psychiatric Principle: a Proposal
for a Psychological Paradigm for the Description and
Classification of Psychopathology." Psychological Reports v.
67 (1990), pp 131-6. A proposal to abandon symptom based, descriptive
systems of diagnosis and move towards a system of classification that looks at all
psychopathology not the presentation of isolated symptoms but a type of
personality -- with cognitive, emotive, social dimensions. A system that still
classifies, but based upon the individual's problems and the interactions in which
these problems present. 

Jaffe, Dennis T. Number Nine: an Autobiography of an
Alternative Counseling Service. New York: Harper and Row,
1975. An autobiographical account of the growth of an alternative counseling service
seeing itself as "counter-institutional." The group is dedicated to demystifying
counseling, centering it on the connection between individual and community healing,
and breaking away from the detached, medicalized model in which the doctor has no
accountability for the patient or the patient's world. 

Kiev, op. cit.

Kirmayer, op. cit. 

Kleinman, op. cit. 

Mannino, Fortune V. ad Milton F. Shore. Mental Health
and Social Change. New York. AMS Press Inc, 1975. A discussion
presented by members of the American Orthopsychiatric Association, a group
originally created to provide a forum for social and treatment issues that were
and are ignored by the APA. Authors focus on a commitment to social as well as
individual change, and point out the ways in which mainstream psychiatry's
biological bent is limiting and problematic. 

Modrow, op. cit. 

Perlman, op. cit. 

Persons, Jacqueline B. "The Advantages of Studying
Psychological Phenomena rather than Psychiatric Diagnoses."
American Psychiatrist v. 41 (1986), pp. 1252-60. An article
written in support of psychiatry and even of diagnostics, but explicating the
drawbacks in using diagnostics to define research parameters. Author argues
that for research purposes, studying a specific symptom -- rather than an
illness -- would lead to more fruitful research. 

Phillips, E. Lakin. The Social Skills Basis of Psychopathology:
Alternatives to Abnormal Psychology. New York: Grune and Stratton,
1978. An attempt to problematize diagnostics and the medical model as
ineffective and inaccurate. Author also attempts to articulate an alternative
conception of psychopathology based upon behavior rather than biology. 

Rosenberg, Morris. The Unread Mind. New York: Lexington
Books, 1992. An exploration of the question "what is madness" and attempt to
construct a conception of madness outside either the medical model or labelling
theory. Author locates madness in relationships, in the failure to take on
appropriate social roles. 

Scheff, Thomas. Being Mentally Ill: a Sociological Theory. New York:
Aldine Pub. Co. 1984. A discussion of the relative plausibility and utility of
individually based psychiatric diagnostics as opposed to labelling theory and more
socially derived explanations of mental illness. Author attempts to use this
dialectic to eventually synthesize an alternative conception. 

Sullivan, Henry Stack. The Interpersonal Theory of Psychiatry: A
collection of lectures presented by Sullivan discussing his theories both of therapy and
psychopathology. Sullivan believed that disorder was a result of a breakdown in
communication in an individual's relational field; thus, Sullivan sets up psychopathology
as lying directly in the interaction between the individual and society.

Torrey, op. cit. 

Ussher, op. cit. 

Weiss, Kenneth M. "Advantages of Abandoning Symptom Based
Diagnostic Systems of Research in Schizophrenia." American
Journal of Orthopsychiatry v. 59 (1989), pp.324-30. A discussion
of the ways in which symptom based diagnosis of mental illness -- in this case
schizophrenia -- leads to the reification of a heterogeneous group of people as
"ill" without saying anything about their treatment needs or etiological
background. Author opts for a search for an"underlying" cause for symptoms,
which is not as useful and as early discussion on diagnostics. 

Wing, op. cit.

VIII. Alternative Treatments

Chamberlain, Judi. On Our Own:Patient Controlled
Alternatives to the Mental Health System. New York:
Hawthorn, 1978. An attempt to articulate alternative ways of dealing with
mental illness without labelling, controlling, manipulating or otherwise
dehumanizing. Chamberlain is the founding member of the National Association
for Psychiatric Survivors. 

Haley, Jay. Uncommon Therapy. New York: Norton, 1986. A brief summary
and case survey of the alternative therapy techniques of Milton Erikson, one of the
principle figures in alternative psychiatric treatment and theory. 

Hall, op. cit.

Karp, David A. "Illness Ambiguity and the Search for Meaning: A
Case Study of a Self-Help Group For Affective Disorders." Journal of
Contemporary Ethnography v. 21(2) (1992), p.139-170. A description of
the ways in which a support group diagnosed with depression and manic
depression developed ways of making sense of and coping with their diagnoses,
their treatment, and their problems.

Lebra, op. cit.

Schaeff, Anne Wilson. Beyond Therapy, Beyond Science. San
Francisco: Harper, 1992. A description of one psychiatrist's struggle with
"assumptions that [she] was taught in [her ] training...that frequently exacerbated the
problem and facilitated [her] client's adjustment into an addictive , sexist, racist, self-
destructing society. " Author analyzes said assumptions and develops a holistic approach
to healing separate from psychiatry's traditional paradigm of diagnosis, control, and cure.