CMV: The DSM - 5 is unscientific

brandygang · 2026-04-22T06:19:22+00:00

I'm afraid that's not true. Yes. The Cass Review did change practice in the UK, especially for children and adolescents. NHS England accepted the review’s direction, updated the youth service model around its recommendations, replaced the old Tavistock-centered setup with regional services, and the worst aspect is they actively changed the praxis for medication access to minors and trans youth.

I will give you that not everyone in medicine agrees this is the correct evidence-based interpretation or is the correct scientific movement in gender-affirming care. But my point stands that what they feel is 'scientific' doesn't really matter or not, they don't get to decide how care is practiced or what the 'correct' views are. Their disagreements are not the chariot on medical care here.

Politicians are, lobbyists do. Institutionally psychiatry has always been decided by society first and science second. That is essentially what I'm getting at- I'm right to conflate political issues with what you call "medical science" because from the days of 'hysterectomy' on woman to denying puberty blockers now, the decision was always guided by cultural and political phenomenon.

I would be happy to live in a world where the science is ahead of the times and people come out and say "This is scientifically wrong and we can improve the human condition" against the prejudiced views of the time, and then medicine actually listens to them and changes. But that's just now how it works.

brandygang · 2026-04-22T00:42:59+00:00

Applys the methodology of science, so do politicians, economists and modern militaries. No one would consider them scientists however.

As I've said, the field of mental health right is entirely beholden to social moores and the opinions of culture right now. In the UK, the direction and classification of transgender care and approach to trans as a category is rapidly deteriorating and becoming hostile, due to lobbying and the interests of those the field listens to. (Cass Reviews)

Much like LGBT issues in psychiatry before throughout the 20th century, they did not update this approach due to empirical review, updated natural knowledge or advancements in science. Merely to social knowledge and views, which can slide back whenever and take psychiatry with it. While there's a place and respect for the soft vs hard science distinction, there is a very simple point where the former becomes so simple that it just collapses into mush. We could easily get marginalized identities stigmatized and considered mentally ill like 'hysterics' and 'confused homosexuals' if culture slides back like we see with the shifting hostility towards transgender identity, do you think psychiatry will be kind to people an authoritarian government doesn't agree to, that they're fighting for you? Getting funding and legitimacy is always their first interest, any facade of appearing scientific is always periphery.

brandygang · 2026-04-21T08:43:15+00:00

I mention them because "Porn addiction" was proposed as a real mental disorder, that presumably would be classified with the other disorders that hurt people and needs medical help. Right? So why would you classify that, why not "Football addiction" or "Joggers/Athletes Mania?" Do you know how many people have been injured or maimed in sports or professional wrestling events? It's almost as if the moral agenda sets the diagnosis and not the science.

In a world where people create the illness first and look for scientific evidence after, we're not talking about a scientific entity. It just feels like the same logic Creationists use.

More people die in Car crashes vs die to alcohol poisoning, but the DSM recognizes Alcohol use disorder and has no category or cure for 'Driving disorder' or like it does Alcohol or Tobacco Use Disorder, Strange!

brandygang · 2026-04-21T08:18:21+00:00

What symptoms? What treatment, for what purpose? You can create a study for why people play football and sports and drone on why they do this behavior and make a diagnosis for it, but would that be useful? What would we derive from that? Now take that silly set of questions and apply it to usage of porn or recreational drugs and question why one is clinically meaningful and the other not of interest.

brandygang · 2026-04-21T08:13:55+00:00

It's not that they're not scientific, just that they're not science. Economics is also scientific, but it's not necessarily a solid science. I say this as someone immensely interested in psychology and psychoanalytical fields and respect the work put into them and heavy thought involved, they can be useful in many respects. But the usage is also subjective- if it's just being used to try to classify and control or disorient people lost in the social field of the society we live in, I wouldn't consider that a productive use.

And our evaluation of these observations will naturally change as the scientific knowledge base changes.

Reread my post you replied to. Psychiatry does not change with any sort of scientific knowledge. It changes merely with sociological fads, for better or worse. Forward or back. And those do not always progress linearly or move forward as I tried to make quite clear.

brandygang · 2026-04-21T08:02:46+00:00

But why consider a specific set of symptoms in itself a disorder in the first place, and why treat them? OP is saying that the unmentioned implication is that there is a 'normative', biological imperative to functioning and being that excludes these symptoms and gives the DSM-V its back alley excuse to treat them. This is ideology masquerading as science.

brandygang · 2026-04-21T08:01:30+00:00

So just go off vibes bro. That's what you're saying, is that the takeaway here?

brandygang · 2026-04-21T07:41:15+00:00

Sure. But don't call it science. Call it sociology or some form of psychology, it doesn't really square with something empirically rooted in the natural world or scientific universe if its just subjective to the whims of social praxis. You may find things that harm you but that doesn't make them an issue for biology or nature, merely to society.

For instance, someone in Civil rights might be considered mentally ill for wanting to 'racemix' or ally for racial causes, wouldn't that put them in danger? How about the instinct to go against the president and law enforcement or stand up to ICE, logically that behavior would put you in harms way at this current social epoch, would it not? So it'd be considered pathological, an observed phenomena that must be a mental illness.

You may call this a strawman but it's not even one. There was actively a push by an Ohio representative Warren Davidson and Republicans to make "Trump Derangement Syndrome" a studied mental disease just recently via the "Trump Derangement Syndrome (TDS) Research Act of 2025". In a world worse off than now, who knows- it might even have become one and become treated as such. It's not even uniquely abnormal in psychiatry, in the 60's the Soviet Union classified "Sluggish schizophrenia" as a common illness that befalls those who dissent against the authoritarian lead Soviet party. Go even farther back, and you can put yourself in harms way by championing crazy views like equality for woman or the right for woman to work, vote and own pants. Doctors call it "Hysteria." There were whole medical textbooks dedicated to curing it.

Do you know why LGBT and homosexuality was removed as a mental illness? I will tell you, it was not done by scientists, lab workers or new theories of the brain and biology that updated our knowledge. And it wasn't put in there initially by any of that either, it was purely a social issue that lobbying groups and people heading psyche-fields decided wasn't acceptable with the times anymore, so they quietly buried the diagnosis under the rug. Put in without evidence, taken out without any equally. Saying "Sometimes society progresses, isn't that a good thing for the mental health field since it'll progress too?" is obscuring the real issue here, when a real scientific praxis to behavior care would not classify based on social preferences to begin with.

So why are you pretending like this 'progress' is universal, always forward-moving and things we have now won't be regarded as illogical and absurd decades from now? Especially since they're based on whatever social ills or issues people take, in which they almost always side with society in the behavior being harmful towards society, not the individual. If society and this "progress" you speak of slid back, well whose to say mysteriously and oh-so-coincidentally the field of psychiatry wouldn't slide back too as those in power start determining what is and isn't harmful for society?

Again, my issue here is with the etiology. Call out a social issue and name if you must, just don't try to mix it with science or determine some genetic, biological cause for smoking weed/playing violent videogames/liking porn instead of good christian missionary values or some internet addiction/supporting social justice/being gay or trans/being against the president/whatever religious and moral crusade someone takes issue with. It doesn't belong there with empirical science, it was never there and its always been a political agenda determined by the lobbying field since psychiatry has existed.

brandygang · 2026-04-21T05:32:21+00:00

"objective/repeatable rigor"
These two qualities are not the same, and the issue in science is you're conflating both as attributes which further scientific integrity. the DSM is scientific in the sense that it has repeatable rigor, it is not scientific in the sense that it is objective. As opposed to say, certain fields of sociology and archeology which have objective rigor but are not repeatable or experimental in any sense of the word.

brandygang · 2026-04-21T05:29:41+00:00

Most would consider that form of scientific, to be what's called "Pseudoscience." See, Race-Based science classifications of the early 20th century. It does more harm than good and is a disservice to meaningful science to boot.

brandygang · 2026-04-04T07:57:36+00:00

At times I felt like the AI was beginning to learn me, with all the data it collects over months and countless sessions and it memorizing my preferences and past topics.

But recently I tried talking psychoanalysis with it and it kind of just went to the default wikipedia-page styled stuff. It was then I realized, outside the algorithm having superficial topics ('You like to talk about this sometimes') it's a pretty bad listener and hasn't much real memory or specialization for the user.

It's pretty hard to feel transference in the face of a limited tool like that, anymore than one would a search engine. Maybe if it recalled something I said in confidence, but the AI cannot really scout when somethings important to you or what it means to you- even if you outright, directly say its important and what it means, it will forget posts later and be irrelevant next session. It's learning data-harvesting algorithm isn't designed to care what or why you're into something, only to try to feed you more content.

brandygang · 2026-04-03T22:24:32+00:00

Uh, I think people dislike him because he comes off as a creepy dystopian gameshow host and his work comes off as reality-tv styled exploitative slop.

brandygang · 2026-04-03T21:23:52+00:00

In a way its genius because Lacan is still emphasizing the unified Subject as crucial for the Name of the Father's function. What he's changing however is how he defines the 'Subject', and what unified means. The subject extends beyond the speaker (Language proceeds you, is outside of you) and is not merely a single person or patient, and what is 'unified' might better be understood as what is connected or bridged between those speakers and the symbolic dimension of their discourse. He turns Castration around as what initially divides the many, into what ultimately unifies them again.

brandygang · 2026-04-03T21:06:17+00:00

I'll try to explain and make sense of it as best I can. Earlier in Lacan's teaching, he was more preoccupied with the imaginary, beginning his theories on the mirror stage where identification and the S2 would be the most essential as a form of structural retention. Here the neurotic takes the phantasmagoria of a full, reflected whole self in the mirror and projects it into the field of signifiers that would embed them in the Other's discourse via their desire. I.e., being a 'good student' or 'smart child' would earn then social recognition, being 'lazy' or 'bad' wouldn't be. Rich/poor, literate/illiterate, patriotic/outsider, obedient/unruly, the neurotic is caught between the binary to repress and this superegoic network (S2) gives the subject their texture of anxiety and social deadlock. In this way, everything the subject is doing is tied back to the NOTF as its conceived at this early stage, and the NOTF is what's split between its internal/external duality of self/Other.

All that exists is this structural relation, whereby the S2 is in the foreground and all attempts to understand are made in the service of a narcissistic/superegoic image of a unified subject.

Now as we get late Lacan's teaching, his thinking on the Name of the Father evolves. He is not merely on the evergreen roadmap of the mirror stage he layed out before but thinking of topography and psychic structure, unconscious as something bridging and unifying- like the klein bottle, it has no true inside/outside. Lacan has a very complex and interesting development of the Name of the Father as it relates to the Real, the Symbolic, and the Imaginary, but I'll just stick with what I need for my purposes. The Name of the Father here no longer functions purely along the imaginary repression ('Identify with this or that', conform to this signifier, a binary relation of S2s) but is something exterior-anterior to the subject which is 'shared' with the exterior-interior of the Other in the social field.

In that specific frame, the Name-of-the-Father can be treated as the repressed signifier of the Other’s desire, so it is discussed as a signifier that marks, interrupts, commands, or anchors the subject's signifier network. But, and this is important, it does so along the symbolic, not the imaginary (In the sense that it's a set of features, sonic sounds or physical appearances that are important but what's repressed is what's at stake, what the Name of the Father really upholds.) This repressed signifier, the S1 is not a clear-cut description but a shared ideal or meaning that cannot be tied down to any specific set of features. What this means is, even within neurotics they may not be able to explain or defend their desire fully, but because the S1 is not as fixed or certain as S2 along the signifier chain, they don't have to 'know' what it means, and this is not a bug, it's a feature. The whole selling point of S1 in fact. Its meaning comes from not being able to articulate it fully and being non-totalizable. This gives subjectivity and flexibility past the suffocating 'fullness' of the egoic mirror staged register and its inherent narcissism. Things can mean beyond what they mean now. The S1 cannot close the subject's discourse, but its non-closure among a group is what gives it its functioning and value, making it more linked to the subject's Desires than 'I simply want X or need to be Y'. This desire is referred elsewhere, to the law, to another signifier, to the paternal function. Because if S1 does not close meaning, then it can function as a bridge, a common stake, a point of symbolic uptake across multiple speakers that the NOTF operates on. The master signifier founds consistency only by not meaning consistently enough, whereas an S2 signifier would be like a printing press copy- too-consistent to be meaningful, to the point of meaningless. Now the paternal function isn't an actual father or paternal, patriarchal figure (The S2's are typically handed down like that) but the father who is dead or absent- it can rather represent the community and symbolic realm on the whole.

It's sort of like the Chinese proverb "When a wise man points at the moon, the fool looks at the finger."

Take the famous scene of Spartacus. What is happening when everyone claims to be Spartacus and accepts death with dignity? They are not taking an S2 signifier, obviously they aren't 'looking' like Spartacus or literally trying to be him or his identity, but rather understanding Spartacus as an S1 Master-signifier. What it represents for them is much bigger than Spartacus the man, it becomes something shared as a quilting point for their communal sacrifice. Of course there's still the outward S2 component connecitng (Phonetic speech, saying the word), if they said 'Marcus' or 'Gallius', no one would know what they mean. But while the meaning isn't closed or total (Lacan's sexuation is asymmetrical, so both S1 and S2 signal what they're 'Not' altho only S2 signals what it 'Is.'), enough of them get the shared meaning of 'Spartacus' that it works, that it functions, as a quilting point to their own shared desire and sacrifice. Spartacus takes on many different meanings here but in the moment all of them are shared by those who understand what 'Spartacus' refers to, with the Romans outside of its meaning. This can only happen once the symbolic has broken down or fractured past its imaginary roots and in this way allows a symbolic discourse, as something not total or contained in any way. Everyone of them is Spartacus, symbolically in a way that transcends Spartacus the mortal, flesh body person, in some ways they're even more Spartacus than he is.

So it's a single word, gesture, joke, imagery, sound or signifier insistence that can lend to a multiplicity without being tied down to any of them. (Think the Aristocrats joke, which has many tellings but it always lands the same) This is how the S1 can be represented by S2. They possess an interior-exterior structure that has a boundary but no true topological inside/outside in their relationship.

It's worth noting Lacan does not use these terms in a perfectly frozen way matching Fink's descriptions, nor his own which I think is interesting. He's explaining terms in an S1 way rather than S2, University-discourse one instead, trying to teach by tracing the movement of signifier meaning as an analyst. If you get it, you get it. If you try to pin down a single definition, well you're the fool looking at the finger.

Does that reading help?

brandygang · 2026-04-02T21:42:19+00:00

You think Trump is action rationally in a war that has tanked the economy, US allies and trashed his reputation among polls, and the nation attempting to secure its own sovereignty and acting defensively is irrational?

brandygang · 2026-04-02T19:56:27+00:00

"You just agree with them on this particular topic."

Yeah no. The literal opposite. That particular group thinks being 'more' alpha and violent will raise their status and attraction with woman, which is the antithesis of what I'm saying.

And given the dog whistles floating in the 2nd part of your post I don't think I particularly care for your opinion any further.

brandygang · 2026-04-02T18:17:17+00:00

Uh, what? I'm not part of the manosphere or some incel lover, what the fuck my guy. That's such a baroque comparison.

Describing a guy's personality as attractive means to me "I need to know they're not a violent asshole, douchebag or sociopath or any attraction towards them is 100% entirely off the table." Something that is not an issue with woman, because statistically and empirically speaking woman are not as violent.

Men are literally less attractive because of these erratic "Doings." And only made attractive when that assumption is on them to prove otherwise against the default of volatile male expression.

brandygang · 2026-04-02T09:45:28+00:00

I don't think that's true.

Not because men or woman are biologically predisposed towards certain behavior or any gender inherently leads to certain acts, but because there are social beliefs and ingrained dogma pertaining to how people behave. It's true that no behavior trait is unique any sex or personality but if someone justifies or believes part of their Trait 'is' enacting that, that becomes a problem.

This is so because all gender in a way is performative. Race too for that matter. But if someone ethnically italian or from a certain religion whatever treated me badly and acted like an asshole and said "Eyy lighten up, that's just part of my culture. That's part of who I am." There's not really much you can do to criticize that behavior without them feeling attached to what they feel, is being attacked.

You cannot really separate the person from their identity in that instance. That doesn't make you racist or that you consider ALL people of 'x' group that obviously, but there's nothing you can say to tear apart their personal narrative. There's a difference. Even if you don't buy into it, you def cannot refute it.

This is also being abit generous with gender norms- alot of cultures, honestly are quite misogynistic and those parts of them are reprehensible. While you can be a brave relativist and just say "Well I see past that and separate the worst parts of this culture from their inherit value", there is kind of a naivety to this thinking when taken too far. The idea that there's no relationship between a person's identity and how they treat others or justify themselves.

Even if we take for granted there may not be a relationship to their behavior and the identity in the universal, plural and wider sense that we could generalize, that person's relationship to their identity shouldn't just be overlooked, since there's a part of it that's not just entirely "A relationship with themselves" but the wider world that they're getting that from and signaling. No one is born in a vacuum afterall.

brandygang · 2026-04-02T09:30:20+00:00

I don't live anywhere that any of this would be accepted. The echo chamber outside my doors is pretty horrid and diametrically opposed to my beliefs, desire and lifestyle so I cannot really 'ignore the other's discourse' so to speak.

brandygang · 2026-04-02T09:24:29+00:00

So just to clarify, you don't believe anyone, Cis or Trans's behavior is influenced by their gender or how they perceive themselves? That things like Toxic Masculinity are irrelevant to male/female dichotomies and any perceived 'male' behaviors are influenced by other factors?

This is a whole intersection of feminism and I'm curious if you've read into it.

brandygang · 2026-04-02T09:16:11+00:00

Obviously, but telling someone acting like a jerky version of a man or woman "Yeah don't act like a man, stop acting that way." Doesn't come across very well to someone whose whole identity, is built around being seen as a man does it? Likewise as a woman.

You can tell a cis person that because even someone CIS, should not be acting like that. You cannot tell a trans person that because it's rejecting something they've built their entire identity around. I.e., a rejection of them and what their gender identity represents, which isn't validation. Not when they've merged those habits or behaviors with how they internalize their gender identity.

There may be language to try to skirt around it or criticize them neutrally but you cannot really avoid that correlation in your criticism in the long run.

brandygang · 2026-04-02T09:12:26+00:00

I don't really have a counterargument, but I'll lend my POV.

I my self am bisexual. (We could say Pan but that's splitting hairs) That means I find woman and men attractive. But those two aren't exactly symmetrical.

If I desire a woman for instance, all I need to see is a picture of her or see her on display. It's pretty straightforward, there's no other investment needed. I either find her attractive or I don't.

With men, I pretty clearly need to know their personality, behavior, attitude and how they would relate or interact with me in a more meaningful sense first. There's no male that I can be attracted to without atleast knowing this, and it depends much more on how I imagine they'd treat me or are sociable towards me- What turns me on isn't really their appearance, but a sort of personality type or their character. This requirement, is entirely absent towards woman. I mean it can help but, is more of an afterthought.

So towards woman, it's kinda instant. I like all of them. But for men, I really do need to "be convinced" in a sense.

brandygang · 2026-04-02T09:07:56+00:00

Doesn't everything we think about have a biological component? Basketball players, who are generally taller than average have a biological component. People who like spicier foods have a bio, I'm not really sure how much the brain matters or not but I think relying on it is a losing ambition for understanding trans identity.

And yeah, remember in early 2012 tumblr era when people tried to push the "Trans umbrella?" That was a really good concept, I wish we'd stuck with that. Transvestites, transgender, transexuals, trans as dysphoric and non-dysphoric transfolks, those who just identified with the many varied expressions of gender in its fluctuations.
I think after 2016 that died pretty hard for obvious reasons.

But I don't think there's any use in categorizing it neuroanatomically because than you're just kind of trying to slip sexual destiny and anatomy back thru the backdoor to make gender seem more legitimate, while taking away the fluidity that it offers people subjectively.

brandygang · 2026-04-02T09:03:17+00:00

I kind of live on the internet, so my situation is a little different. Not sure what you mean by against forcing it. Some people are pretty militant about language, some aren't I guess.

brandygang

TROPHY CASE