Most psychiatric diagnoses are more about doctors trying to agree with each other than actual medical discoveries.
March 19, 2026
Original Paper
No Biomarkers, Just Fear of the Unknown: Psychiatric Labeling, Epistemic Injustice, and the Coordination Invariant as a Framework for Clinical Reality Construction
SSRN · 6420578
The Takeaway
The paper argues that when a patient has an experience the system can't verify, doctors use labels like 'crazy' not as a medical fact, but as a way to translate the unknown into a billing code. This suggests that the psychiatric system's primary function is to erase individual reality to satisfy institutional requirements for categorization.
From the abstract
When a person reports an experience that exceeds available frameworks for verification-captivity, transcendence, contact with something genuinely other-the clinical system must respond. That response is shaped by forces that may have little to do with truth: billing codes, diagnostic categories without biomarkers, insurance protocols, and a longstanding institutional discomfort with the unknown, frequently dressed as scientific rigor. This paper applies the Coordination Invariant (S = C/V) to th