If the basic logic of the DSM is flawed, it should be abandoned. Instead, psychiatrists should move towards a system that looks at an individual’s mental experiences in context, alongside their unique developmental vulnerabilities and strengths, as the main source for analysing and responding to their distress. Diagnosis would no longer name a disorder but map what kinds of support, relationships and learning processes are most likely to help a person regain agency, coherence and a sense of future.


The DSM isn’t a scientific document, but rather a medical and legal one. It is meant to help doctors correlate patients to find potential treatments, and provides language useful for billing and legal purposes.
Schizophrenia may not be an entirely accurate term, but if its use leads to patients who need medicine getting medicine and those not responsible for their actions not being held responsible then it’s hardly useless. But it does make it a good candidate for revision in the next DSM.
Which is beside the point, though. Somebody whose historical notability is half “thing contained in $BOOK is wrong” should not be presumed to be unbiased if they write a “$BOOK is bad” article.