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Why Labelling The Child As ‘Mentally Ill’ Can Be Unhelpful


In his critically acclaimed book: ‘Cracked: Why Psychiatry Is Doing More Harm Than Good’, the author, James Davies, argues that psychiatry is a pseudo-science which :

  • over-medicalizes human behaviour, labelling individuals as mentally ‘ill’ when it is not appropriate to do so

In order to illustrate this argument, one of the examples that Davies presents us with is that of a child displaying behaviours that would traditionally be associated with attention deficit hyperactivity disorder (ADHD), leading to two, alternative treatment scenarios (Davies recommends the second scenario) :


In the first case scenario, the child would be treated according to the traditional, medical model: i.e. assessed by a psychiatrist, and, if he met the diagnostic criteria, as designated by DSM V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), diagnosed with ADHD, ‘labelled’ as having ADHD, and put on psychoactive medication.



However, Davies proposes that a better, initial approach would be as follows :

The psychiatrist does NOT diagnose the child with ADHD, but, instead, interviews his mother to ascertain the family’s history.

From this interview, the following transpires :

  • The mother and the son had been living with a household in which there was domestic violence for several years before the physically abusive man responsible for this violence finally left the home.
  • As a result, the child incurred psychological damage which led to his behaviour becoming ‘chaotic’ / angry/hypervigilant 

However, in this scenario, rather than diagnosing the child with ADHD and putting him on medication, the psychiatrist focuses on helping him and his mother gain insight into the underlying reasons for the child’s behavioural difficulties.

Davies then expands upon this second case scenario :

  • Whilst the psychiatrist, in one session, is trying to help the mother and son gain insight into the reasons for the boy’s problems, the mother begins to feel guilty about having exposed her son to a violent environment, and starts to cry.
  • In response to his mother’s tears, the boy is quick to rebuke the psychiatrist, perceiving him (i.e. the psychiatrist) to be ‘yet another man hurting his mother.’
  • This event then opens up the opportunity for the psychiatrist to discuss with the boy and the mother that such hypervigilance reflected by the boy’s quickness to rebuke the psychiatrist was quite understandable given how he (i.e. the boy) would have had to have learned to become hypervigilant whilst living with the physically abusive man as a matter of self-preservation so that now such behaviour had become automatic in situations in which he perceives himself or his mother to be under threat (whether the ‘threat’ is real or imagined).
  • In other words, his hypervigilance has become an unconsciously motivated survival response in situations which remind him, even on an unconscious level, of the danger once posed to him and his mother by the physically abusive man who used to live with them.

Armed with this information, the psychiatrist, during further sessions, is then able to develop a meaningful relationship with the boy and his mother and help them to understand the reasons behind his (i.e. the boy’s) behaviour (chaotic, angry, hypervigilant etc) and talk through his issues. In this way, the boy is able to gain insight into his own psychological issues which, in turn, leads to an improvement both in his behaviour and in how he feels about himself. And this is achieved without the need for a diagnosis or medication.

N.B. The above does not imply, nor is intended to imply, that medication for psychological conditions is always inappropriate. Davies himself accepts that medication in psychiatry still has its place in certain situations.

You may also wish to my related article :


David Hosier BSc Hons; MSc; PGDE(FAHE).

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