1/ I do think a lot of problems with current practices in psychiatry have to be do with system issues, however, these system issues have been synergistic with a variety of conceptual, scientific, & ethical problems that have to do with reductionism, diagnostic reification...

2/ ... eclecticism, manipulation of "evidence-based" medicine, neglect of phenomenology, lack of attention to power imbalances and systemic coercion, neglect of iatrogenic harm, & unreflective reliance on medicalization as the default for mental health care.

3/ An examination of these issues is not about blaming individual clinicians or researchers, or even about blaming psychiatry as a medical profession isolated from other disciplines, law, and society. These are larger forces that transcend any single individual or profession.

4/ People may disagree with my assessment & many do. They may think that baring system issues, everything is hunky-dory from a conceptual, ethical, and scientific perspective. I can only state that my assessment is different & articulate why I think so.

5/ These issues alluded to in the tweets above have been discussed in greater detail in my on-going series for @PsychTimes, "Conversations in Critical Psychiatry". I would welcome you to check out the discussions: https://awaisaftab.blogspot.com/2019/12/conversations-in-critical-psychiatry.html

6/ Here is a related article arguing for the need for "conceptual competence" in psychiatric education and training https://link.springer.com/article/10.1007/s40596-020-01183-3