Patienthood can become a way of life and rationale for people who are struggling for other reasons.

Our classification of mental disorders is no more than a collection of fallible and limited constructs that seeks but never finds the truth - but this remains our best current way of communicating about, treating, and researching mental disorders.[...] It is good to know and use the DSM definitions, but not to reify or worship them.

Psychiatric disorder consists of symptoms and behaviors that are not self-correcting - a breakdown in the normal homeostatic healing process. Diagnostic inflation occurs when we confuse the typical perturbations that are part of everyone's life with true psychiatric disorder[.]

[D]iagnosis needed to rest in order to let research catch up. It made no sense to keep rearranging the furniture of descriptive psychiatry, creating new diagnoses or altering the thresholds of existing ones, based only on the whims of the experts who happened to be in the room. [...] Changes in diagnoses should be few and far between until we gained much deeper understanding of what causes the mental disorders and how best to define and treat them.

The technical skills of medicine are becoming increasingly routine and may soon be done better by computer programs - but the shamanic skills of medicine will always be important to patients and to society.

[T]he DSM alone does not establish standards. Physicians, other mental health workers, drug companies, advocacy groups, school systems, the courts, the Internet, and cable TV all get to vote on how the written word will actually be used and misused.

We should not have the ambition to label as mental disorder every inconvenient or distressing aspect of childhood.

[E]ligibility for disability and other benefits should depend more on the person't actual level of functional impairment, less on whether or not he has a psychiatric diagnosis.

We need either to get the primary care doctors out of psychiatry or to teach them how to do it and give them sufficient time to do it properly.