The Problem of the Heap in Psychiatry

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Psychiatrists are making some kind of subjective decision. That's not really scientific. It's just like, that's enough. How do they make those decisions? The point usually is when there is undue sufferingsignificant enough suffering that your life is impaired. When you get from sadness to depression, that's when you can't sleep. And so that's when these diagnostic categories can become really useful,. because they do provide a framework that then motivates a certain kind of intervention.

For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In episode 161 of The Michael Shermer Show, Dr. Shermer speaks with anthropologist Dr. Roy Richard Grinker about his book Nobody’s Normal: How Culture Created the Stigma of Mental Illness which chronicles the progress and setbacks in the struggle against mental-illness stigma — from the 18th century, through America’s major wars, and into today’s high-tech economy. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Grinker takes readers on an international journey to discover the origins of, and variances in, our cultural response to neurodiversity. Shermer and Grinker discuss: the DSM, ADHD, PTSD, the autism spectrum, schizophrenia, labels and stigma, neuroses vs. psychoses, mental vs. medical models, brain/mind dualism, blacks and drapetomania, homelessness and mental illness, and the future of madness and normalcy.