Because of that, I don’t think it is problematic for anybody to say its controversial whether this disorder really exists.
This goes a bit further, though, claiming it probably doesn’t exist.
IMO, that isn’t saying the patients are faking having problems. It’s saying we don’t know much of mental illnesses, and that creating this label doesn’t help the world.
I think most in the field will acknowledge the first part of that statement. That’s why this is called a disorder (“a functional abnormality or disturbance”) and not a disease, a term we reserve for cases where we know what causes it.
As to the second part: I think a new label only makes sense if its definition groups people together not only because they have similar abnormalities, but also because they are helped by similar treatment. That’s very hard to judge for disorders, because “doesn’t respond to the standard treatment” can easily lead to a conclusion “diagnosis was incorrect”. That also is what those writing the DSM struggle with.
A problem, though, is that patients prefer hearing “you have foo” to “we don’t know”, even if there is no difference in treatment between the two.
I think that’s why those claiming “most people claiming to have foo don’t” (which I would say currently is true for such things as autism and ADHD), the stronger “foo is rarer than diagnosed” or the even stronger “foo doesn’t exist” are met with much resistance.
But again: I think the last two are statements about the state of psychiatry as a science, not about patients.
Just because it's more often contested doesn't exempt the author from the responsibility to grapple with (or at the very least make himself aware of) the reasons why it's included in the DSM and the ISD and why it's been acknowledged (if grudgingly) since the very beginnings of the discipline and before - including a long section in James "Principles of Psychology" - if he's going to make such a claim. He seems patently unaware of the long list of psychological principles that no one contests that align with the diagnosis - from the existence of discrete states in sleep and infancy, to brain microstates, to state-dependent learning, to extreme state switching in bipolar, periodic catonia and the other disassociative disorders, to the commonality of hypocrisy of which the individuals themselves are blithely unaware, and the trickiness of personality science.
And that's not even addressing the highly detailed and often highly public case studies of DID across time and cultures, the research showing dramatically different brain readings across the spectrum based on the current identity of the DID patient, ect, ect.
But he doesn't even attempt to address any of that because he has no idea what the hell he's taking about. It's a deflationary article with the populist message that psychologists and Tiktokers are the dumb. So I get why it's popular, but it adds all of nothing to the conversation. He's just another panderer milking the public for attention and money.
And as for the label, again one can acknowledge the existence of a biopsychosocial cluster without coming down on either side of the question of whether or not they are symptoms of an underlying disease. There's a long history of scholars doing this, particularly in the sociology of mental health. Additionally the author does not appear to be making any such argument here against the psychiatric nosology as a whole - just this one diagnosis.
That’s true, but this seems one of the more problematic ones. See for example https://en.wikipedia.org/wiki/Dissociative_identity_disorder....
Because of that, I don’t think it is problematic for anybody to say its controversial whether this disorder really exists.
This goes a bit further, though, claiming it probably doesn’t exist.
IMO, that isn’t saying the patients are faking having problems. It’s saying we don’t know much of mental illnesses, and that creating this label doesn’t help the world.
I think most in the field will acknowledge the first part of that statement. That’s why this is called a disorder (“a functional abnormality or disturbance”) and not a disease, a term we reserve for cases where we know what causes it.
As to the second part: I think a new label only makes sense if its definition groups people together not only because they have similar abnormalities, but also because they are helped by similar treatment. That’s very hard to judge for disorders, because “doesn’t respond to the standard treatment” can easily lead to a conclusion “diagnosis was incorrect”. That also is what those writing the DSM struggle with.
A problem, though, is that patients prefer hearing “you have foo” to “we don’t know”, even if there is no difference in treatment between the two.
I think that’s why those claiming “most people claiming to have foo don’t” (which I would say currently is true for such things as autism and ADHD), the stronger “foo is rarer than diagnosed” or the even stronger “foo doesn’t exist” are met with much resistance.
But again: I think the last two are statements about the state of psychiatry as a science, not about patients.