The Diagnostic and Statistical Manual of Mental Disorders ( DSM) is one of the most successful technologies in modern times. In spite of well-argued critiques, the DSM and the idea of “mental illness” on which it is based flourish, with ever more (mis)behaviors labeled as brain diseases. Problems in living and related distress are converted into medical problems, obscuring the role of environmental factors such as poverty and related political, social, moral, and economic factors such as the interest of the state in controlling deviant behavior and maintaining the status quo. This view shrinks rather than expands opportunities for freedom, growth, and dignity. It ignores the vast literature showing that unusual environments create unusual behaviors and that by arranging learning opportunities we can change behavior. Reasons for this marketing success are discussed and alternatives suggested including consensual counseling regarding problems in living and drawing on a science of behavior attending to environmental learning opportunities.
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