The problem with “psychosis”

The term “psychosis” is used widely but uncritically in clinical work, psychiatric research, and common speech. “Psychosis” can serve as a diagnosis, name a symptom or category of symptoms, or provide a general term for “mental illness”, madness, or emotional crisis. Lacking scientific foundation, “psychosis” is a particularly problematic form of psychiatric knowledge, which enforces an overly rigid conception of “reality”, a medical reality largely of its own construction. The history of the term – particularly its disappearance from American Psychiatric Association’s Diagnostic and Statistical Manual in 1980 but not from the profession – helps account for its varied, uncritical use. Historians of “psychosis” and madness help restore a sense of the contingency and instability of psychiatric knowledge, and this opens the way to foreground the wisdom of people with lived experience, who often find the term more harmful than helpful.