Diagnosis and reality: a noun is a terrible thing to waste

The use of a diagnosis for identifying disease processes has been crucial in the field of medicine. But it is essential that the diagnostic noun represent real processes. In psychiatry, to meet the important criterion of reliability we have focused on objective phenomena. But since psychiatric disorders are human processes and a major aspect of being human is our subjectivity, we also need to pay far more attention to subjective phenomena, even those difficult to define reliably. The arts have much to teach us about the nature of those processes. It is essential that we learn from these and other sources to focus more effectively on subjectivity, and thereby understand the factors that underlie and define psychiatric disorders.