Since the ‘Psychiatrists’ Bible,’ DSM-5 was published in May 2013, children are leaving clinics everyday around the Western World with stigmatising and often unhelpful labels of mental disorders tied tightly around their young necks. See my, ‘All around the world’ poem earlier this month. We know from the field of Attribution Theory that people become more like the characteristics that significant others donate to them in childhood and over time this creates a vicious cycle of progressive pathologisation with a young person’s spiraling downwards self-esteem and self-efficacy.

DSM-5 graphic iox1L9zC8PnMSo a child who may be a little shy when given the label of Social Anxiety Disorder by a Psychiatrist may indeed due to a societal ‘self-fulfilling prophecy’ become more acutely aware of being anxious in a range of social situations. The key question is, “Is this label helpful or unhelpful to the young person maximising their human potentials and going forward in life as a confident adolescent or adult?” Many psychologists would say that raising the young person’s awareness about the potential stressors could indeed backfire and contribute to a sensitive and suggestible individual understandably deteriorating further in this regard.

Also, does a child who is experiencing significant loss of a family member respond well to a label of Temporary Grief Syndrome where drugs, such as Anti-depressants with all their risks, can now be prescribed within two weeks of the sudden death. This is due to the removal of the ‘Bereavement Exclusion clause’ that had previously protected such children and young people from such an eventuality. Does this potentially pejorative label of being a sick individual who needs anti-depressants, so soon after the bereavement, cause long-term mental harm and create psycho-pharmaceutical dependency in their future life?

Likewise in a third scenario does a child who is acutely anxious about family dynamics and domestic violence that they have witnessed benefit from having the pattern of presenting behaviours diagnosed as ADHD when then medication used for that condition is contra-indicated in severe anxiety cases. Sadly many cases occur where this clinical guidance is ignored and again the child’s normal pattern of behaviour is pathologised by being labelled a clinical disorder.

DSM-magnifying-glass-FJ‘Medical Model’ explanations that locate the problem as ‘within the child’ are just as questionable as the preferred media explanation of the regular mass shootings, which occur all too frequently in the U.S., being due to a disorder in the perpetrator rather than being caused by a complex interaction of factors. These often include trauma, significant life-events and environmental stressors along with of course the fact that the side effects of the psychotropic drugs that they are on often cause the young person to do harm to themselves or others.

The majority of  psychologists today believe in the concept of Social Constructivism and the fact that patterns of serious behaviour often the result from the interaction and influence of a range of  understandable stressors affecting the young mind. As eminent psychologists like Lucy Johnstone say, mental distress is an interactive response often to early childhood trauma, many times witnessing domestic violence or familial bullying within a context of attachment difficulties. Certainly, systemmatic abuse of adult power will invariably be a major feature. So what do we do as a progressive society – exactly – we model another abuse of adult power called Psychiatric Diagnosis when a softer and more collaborative Psychological Formulation is what would be more helpful to client and professionals alike. Many worry that this misuse of power is neo-colonial in nature and can ‘retraumatise the client’ which is a reasonable term when considering Electro Convulsive Therapy or very toxic ‘drug cocktails’ which are becoming more prevalent these days.

I have coined the term ‘Psycho-Economic Imperialism’ which I have defined as the biochemical colonisation of young developing minds for huge commercial profits and wider social control. Although this sounds a very politicised and strong statement, I feel that on reflection since I wrote this definition, that it has held true and no evidence has come to my attention to disprove this critical assertion. Many colleagues from a wide range of child related disciplines have also concurred with this definition of what I feel certain is one of the most cynical and corrosive social policy decisions of our time i.e. the drive to stigmatise, classify and treat normal childhood behavioural presentations as organic medical disorders that need pharmaceutical intervention.

I would like to end with a quote from one of the cultural heroes of out time Nelson Mandella when he said,

There is no better way to judge a society than by the way it chooses to treat its children.

So how do we want our societies to be judged in the twenty first century?

Useful Sources:

  •  Formulation in Psychology and Psychotherapy – making sense of people’s problems by  Lucy Johnstone and Rudi Dallos (Second Edition 2014) Routledge, London.
  • Safeguarding a Generation of Children from Over-diagnosis and Prescription of Psychotropic Drugs – by Dave Traxson – dxsummit.org website – 30th October, 2013.
Dave Traxson

About Dave Traxson

I am a Chartered Educational Psychologist (BPS),who has seen the questionable practice of over-diagnosis and prescription of psychotropic drugs for children, increase exponentially in my thirty year career. I am a member of the Division of Educational and Child Psychologists Committee of the British Psychological Society. Now is the time to appropriately challenge doctors in cases where psychologists have ethical concerns about the Emotional Wellbeing of the children with whom they work. This is supported by the Health Professionals Council "Duties as a Registrant."(2009) = "You must not do anything or allow someone else to do something that you may have good reason to believe will put the health or safety of a service user in danger." We all therefore have a "Duty of Care to be Aware" of these issues in the schools where we work and to discuss concerns with a linkworker there and with the prescribing doctor. The National Committees of the Association of Educational Psychologists and the Division of Educational and Child Psychology of the British Psychological Society actively support my position of raising concerns about the impact of psychotropic drugs on the Safeguarding of Children in the U.K. from the potential short and longer term physical and psychological harm. I believe this is a key issue in promoting wellbeing of children within a progressive society. I was pleased to contribute to the BPS response to the American Psychiatric Association's consultation on DSM-5 and the paper was called "The Future of Psychiatric Diagnosis," (BPS 2012.)