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Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity
How can we reconsider the way in which we think about, treat and care for those in distress?
More and more people are being diagnosed with ADHD and autism.
More and more people are being diagnosed with mental disorders.
Young people are being medicalised for behaviours that might be explained as entirely normal in other parts of the world.
Distress has been commodified over many decades by pharmaceutical companies, the media and the psychiatric establishment.
So how can we know when distress is normal and when it is something that needs to be treated?
In Searching for Normal, Sami Timimi explores the political and cultural context of these phenomena and presents a deeply humane approach that looks at the person as a whole – their family context, their culture, their personal resilience – and advocates for a reframing of how we think about and treat distress.
More and more people are being diagnosed with ADHD and autism.
More and more people are being diagnosed with mental disorders.
Young people are being medicalised for behaviours that might be explained as entirely normal in other parts of the world.
Distress has been commodified over many decades by pharmaceutical companies, the media and the psychiatric establishment.
So how can we know when distress is normal and when it is something that needs to be treated?
In Searching for Normal, Sami Timimi explores the political and cultural context of these phenomena and presents a deeply humane approach that looks at the person as a whole – their family context, their culture, their personal resilience – and advocates for a reframing of how we think about and treat distress.
344 pages, Kindle Edition
Published March 20, 2025
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573 people want to read
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Displaying 1 - 25 of 25 reviews
September 30, 2025
I rarely give one star reviews.
In fact, in my last 500 books, I have only given one other.
This book started off deceptively well - shedding light on mental health I wasn’t as educated in, providing information and insights that I *thought* were enlightening.
Then we got to the topics I am more familiar with. Either through personal experience, my own research, friends and family accounts, or other non-fiction works.
What makes me so mad is how the author used facts and statistics, his own infield experience to twist things.
I have a few examples.
The author’s main argument is that your identity is socially constructed. I understand this to an extent, but then the author expanded this to mean identifiers such as autism, race, gender, sexuality, and anorexia. The author then proceeded to give reasons why they are, in fact, a social bandwagon or are false, I was ANGRY. FRUSTRATED.
Oh, and depression is a made-up illness from the Western sphere.
I get what he was trying to say - we are quick in our current society/culture to self-diagnose or come up with something to explain our problems. I know that being human comes with suffering which IS normal. However, this did not account for those people who truly do have these issues and rely on these labels.
In a mental health non-fiction from a professional in the field who spent the preface listing off his achievements and qualifications, you would want to believe and trust in whatever the author says.
Especially when I know most readers take things at face value. What damage might be done to assumptions and preconceptions?
Now I want to revisit what he said at the start with this mindset and do my own research because of how I now distrust everything he has said. How he distorts facts to his narrative.
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In fact, in my last 500 books, I have only given one other.
This book started off deceptively well - shedding light on mental health I wasn’t as educated in, providing information and insights that I *thought* were enlightening.
Then we got to the topics I am more familiar with. Either through personal experience, my own research, friends and family accounts, or other non-fiction works.
What makes me so mad is how the author used facts and statistics, his own infield experience to twist things.
I have a few examples.
The author’s main argument is that your identity is socially constructed. I understand this to an extent, but then the author expanded this to mean identifiers such as autism, race, gender, sexuality, and anorexia. The author then proceeded to give reasons why they are, in fact, a social bandwagon or are false, I was ANGRY. FRUSTRATED.
Oh, and depression is a made-up illness from the Western sphere.
I get what he was trying to say - we are quick in our current society/culture to self-diagnose or come up with something to explain our problems. I know that being human comes with suffering which IS normal. However, this did not account for those people who truly do have these issues and rely on these labels.
In a mental health non-fiction from a professional in the field who spent the preface listing off his achievements and qualifications, you would want to believe and trust in whatever the author says.
Especially when I know most readers take things at face value. What damage might be done to assumptions and preconceptions?
Now I want to revisit what he said at the start with this mindset and do my own research because of how I now distrust everything he has said. How he distorts facts to his narrative.
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November 19, 2025
I habitually pick up books about mental illness/health from the library's new acquisitions shelf. This is the latest and one of the most interesting. Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity is the strongest critique of psychiatry that I've read so far, written by an NHS consultant psychiatrist and psychologist. Timimi goes beyond the disciplinary dichotomy in treatment (psychiatry + drugs; psychology + therapy), to strike at the very concept of mental illness diagnosis. Moreover, he firmly places responsibility for the current poor state of population-level mental health and treatment for mental illness on capitalism. I found this very refreshing. It builds upon other critiques and reflections I've read, notably Can the Monster Speak? A Report to an Academy of Psychoanalysts and Our Necessary Shadow: The Nature and Meaning of Psychiatry, taking a more radical and polemic approach. From the start, Timimi is at pains to point out that the popularly accepted theory that mental illness is a 'chemical imbalance' in the brain is not supported by evidence:
These opening chapters reminded me of The Maps We Carry: Psychedelics, Trauma and Our New Path to Mental Health, a thoughtful and nuanced memoir of mental illness. In that, Rose Cartwright discusses her amazement upon realising that nearly everything she had believed about mental illness, both her own and more broadly, was speculative rather than scientific. Her book arrives at similar conclusions to Timimi's, from the direction of someone experiencing mental illness rather than treating it.
While these initial chapters were forthrightly expressed, they did not contain any points that were genuinely new to me. Towards the middle of the book, Timini expanded his arguments into more controversial territory, that of autism, ADHD, and neurodiversity. This was the most thought-provoking section for me and developed some thoughts I'd been struggling to articulate for myself. Timini makes the point that the word neurodiversity presupposes a neurological difference between neurodivergent and neurotypical people. No such physical brain difference has been found by medical researchers. Both autism and ADHD are diagnosed using questionnaires and observation by clinicians, in the same way as other mental disorders. However the nature of these diagnoses, which has led to the neurodiversity movement, is that they are framed as a permanent difference rather than a disorder that can come and go. In fact, like other mental illness diagnoses, they still do not have a physical basis and are therefore social constructs. Timini considers the implications:
In the past ten years, an increasing number of friends who I attended university with have either sought out diagnosis for ADHD and/or autism, or started referring to themselves as neurodivergent. Most recently, several have started describing our whole friends group as neurodivergent, tacitly including me. I've always felt a bit uncomfortable with having this label applied to me, without feeling able to talk about it. My discomfort centres upon not understanding the definition of neurodiversity or the limits of what is considered neurotypical. Even NeuroTribes: The Legacy of Autism and the Future of Neurodiversity did not really define for me what autism is. Reading Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity helped me to understand this confusion: there is no single clear definition of ADHD or autism, let alone neurodiversity. The diagnostic criteria for the former two are vague and culturally contingent. Indeed, a friend who has been through the diagnostic process for ADHD complained bitterly about the questionnaire used. Yet that is all there is - ADHD doesn't have some underlying neuroscientific truth that the questionnaire is trying to approximate. I know that neurodiversity means a lot to some of my friends, that they feel better able to understand themselves and live their lives as a neurodivergent person. As far as I can tell, the main elements to this are, a) finding a word to describe distress that they feel, b) feeling part of a community of people who experience similar difficulties and can share advice, c) in the case of ADHD, accessing medication that helps to manage symptoms. It feels like attacking something that my friends really care about to acknowledge that Timini's critique made sense to me. These are good questions:
I think the phrase 'a cruel kind of hope' applies across mental illness diagnosis. Being diagnosed with an illness by a doctor comes with expectations that some kind of treatment is available to help with the symptoms, maybe even cure it. That is much less likely to be the case for mental illness, where diagnosis, as Timini says, can often lead to worse outcomes by speciously placing borders on the patient's experience of distress. He also links the rising profile of neurodiversity with changes in the workplace:
Earlier this year my workplace held a neurodiversity training session. The trainer quoted an unsourced statistic that made my jaw drop: more than 70% of generation alpha identify as neurodivergent. I have two responses to this. Firstly, as a survey statistician I find it extremely hard to believe that this measure came from a robust random probability survey and is therefore truly representative of that age group. It is notoriously difficult to get under-21s to respond to surveys. Secondly, assuming it was true, how could more than half of a population cohort be considered 'divergent' from the norm. Surely this could only mean that what is normal is changing by generation, which is perfectly reasonable if you accept that the mental norm is socially constructed. Returning to the training, at no point was I as a line manager told what additional support or accommodations were available to neurodivergent people I might manage. (In my experience, you have to create your own accommodations in the workplace whenever you can, rather than trusting your employer to do so.)
The chapters on parenting were less personally relevant but no less radical in tone. Timini then examines what he calls the 'mental health industrial complex', which sells medication, therapy, wellbeing advice, workplace neurodiversity training, etc, etc. This section reminded me of how diagnostic categories of mental illness were formed as a consequence of drugs being developed to treat specific symptoms. Such a pharmaceutical-led approach leads to confusion about what these medicines actually do:
Incidentally, there is at least one illness with symptoms directly caused by a lack of dopamine in the brain, but it isn't depression. It is Parkinson's Disease. Timini emphasises that the rise of the chemical imbalance explanation for mental illness isn't a conspiracy theory, any more than capitalism itself. A confluence and co-operation of financial interests enabled it to take hold.
Towards the end of the book, Timini cautiously enters the difficult waters of gender dysphoria and trans identity (particularly among the young) as psychiatric disorders. I think that topic really deserves a longer and more detailed treatment, but respect his attempt. A key point he makes that I've not really seen elsewhere is that increasing reports of gender dysphoria among children and teenagers have coincided with a rise in gender essentialism in the Western world. To me it seems intuitive that more people would become uncomfortable with their gender the stricter and more rigid gender norms become. Unfortunately this could be a sort of vicious cycle, as aggressive transphobia from TERFs is coupled with doubling down on absolute gender essentialism, which further limits the space for variation within genders, which makes gender dysphoria more likely, which makes TERFs even louder in their hostility, etc. Personally, I'm content to be a cis woman as long as nobody expects me to wear makeup, remove my body hair, date men, or have children. (Ideally I would also be paid as much as a man for doing the same work, but at least two of my former employers didn't do so.) I don't have a strong internal sense of gender and suspect this could be the case for plenty of people. Timini notes that when trans identity is treated as a psychiatric problem,
That seems counterproductive to genuine acceptance of diversity. Towards the end of the book, Timini covers mental illness frameworks and colonialism, again relatively quickly. He refers to a great book on the topic Crazy Like Us: The Globalization of the Western Mind and makes this excellent point:
[Continued in comments below]
Despite three decades of intense neuroimaging research, we still lack a neurobiological account for any psychiatric condition. Advances in scientific knowledge have helped cardiologists, oncologists, and other medical specialists improve success rates for a variety of clinically important outcomes, confirming that current treatments are more effective than the ones that were available twenty or thirty years ago. Similar data is hard to find for psychiatric disorders. As a result, functional neuroimaging or other physical tests play no part in clinical decision-making.
Research from several countries has found that, despite continuous growth in the availability of mental health services, only about 15-25 percent of those referred significantly improve or recover in the long term. This dismal picture is found in both child and adult mental health services. [...]
The likelihood of positive outcomes for those with mental disorders is further hampered by the stigma associated with the idea that mental distress is the product of a medically malfunctioning brain. Nearly all studies that have looked at public attitudes toward mental illness have found that the medical model for mental illness ('mental illness is an illness like any other illness') is associated with increased negative attitudes, greater fear of patients, and a greater likelihood of wanting to avoid interacting with them. In contrast, the idea that mental distress, in all the variety of ways it may be expressed, is the outcome of adverse experiences is associated with empathy and a desire to help.
These opening chapters reminded me of The Maps We Carry: Psychedelics, Trauma and Our New Path to Mental Health, a thoughtful and nuanced memoir of mental illness. In that, Rose Cartwright discusses her amazement upon realising that nearly everything she had believed about mental illness, both her own and more broadly, was speculative rather than scientific. Her book arrives at similar conclusions to Timimi's, from the direction of someone experiencing mental illness rather than treating it.
While these initial chapters were forthrightly expressed, they did not contain any points that were genuinely new to me. Towards the middle of the book, Timini expanded his arguments into more controversial territory, that of autism, ADHD, and neurodiversity. This was the most thought-provoking section for me and developed some thoughts I'd been struggling to articulate for myself. Timini makes the point that the word neurodiversity presupposes a neurological difference between neurodivergent and neurotypical people. No such physical brain difference has been found by medical researchers. Both autism and ADHD are diagnosed using questionnaires and observation by clinicians, in the same way as other mental disorders. However the nature of these diagnoses, which has led to the neurodiversity movement, is that they are framed as a permanent difference rather than a disorder that can come and go. In fact, like other mental illness diagnoses, they still do not have a physical basis and are therefore social constructs. Timini considers the implications:
I have met, corresponded with and debated via email, meetings, conferences, and in person with some neurodiversity activists. I admire what they have done and set out to do, which is to move autism from the sphere of disorder into one of human difference. I think many people have been helped by this, particularly those who saw themselves in a negative light and were burdened by self-criticisms. However, taking something that is defined as a medical condition, often characterised as resulting in a lack of empathy, brings dangers when expanded rather than challenged as a notion. The sense of not being good enough is so ubiquitous in this hyper-individualised culture that an individualised explanation (having a neurodiversity that causes you to be 'not good enough') may reinforce rather than challenge or change cultural and economic systems encouraging that.
In the past ten years, an increasing number of friends who I attended university with have either sought out diagnosis for ADHD and/or autism, or started referring to themselves as neurodivergent. Most recently, several have started describing our whole friends group as neurodivergent, tacitly including me. I've always felt a bit uncomfortable with having this label applied to me, without feeling able to talk about it. My discomfort centres upon not understanding the definition of neurodiversity or the limits of what is considered neurotypical. Even NeuroTribes: The Legacy of Autism and the Future of Neurodiversity did not really define for me what autism is. Reading Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity helped me to understand this confusion: there is no single clear definition of ADHD or autism, let alone neurodiversity. The diagnostic criteria for the former two are vague and culturally contingent. Indeed, a friend who has been through the diagnostic process for ADHD complained bitterly about the questionnaire used. Yet that is all there is - ADHD doesn't have some underlying neuroscientific truth that the questionnaire is trying to approximate. I know that neurodiversity means a lot to some of my friends, that they feel better able to understand themselves and live their lives as a neurodivergent person. As far as I can tell, the main elements to this are, a) finding a word to describe distress that they feel, b) feeling part of a community of people who experience similar difficulties and can share advice, c) in the case of ADHD, accessing medication that helps to manage symptoms. It feels like attacking something that my friends really care about to acknowledge that Timini's critique made sense to me. These are good questions:
I understand that there are many who have found the act of naming helpful. Parents may be enabled to have new sympathy for their child and adults may feel something about their life now makes sense. But at what price? How long do these initial feelings of relief last? What goes missing from that person's narrative when a label that cannot explain is used to explain? I worry about the potential for a subtle kind of violence that can be inflicted on someone thus labelled, which may limit their own, their families' and a whole host of people's beliefs about what they can and can't do, what they need protection from and don't. I'm concerned that having the label of autism provides a cruel kind of hope. Parents may feel that something is now understood, so experts will know what to do to help. As the days, months, and years accrue with matters not improving, what does that do to parents' feelings about their 'disordered' child? These are the types of dilemmas I regularly see in my consulting room. [...]
Autism has become the new catch-all for young patients who don't follow the increasingly narrow boundaries of expected behaviours, and to such an extent that we overlook histories that would obviously have an impact on their presentations. It keeps coming up as 'maybe they have autism' by referrers, parents, teachers, in meetings and clinical reviews, as if that's going to provide an explanation for behaviours that concern, frustrate, or infuriate.
I think the phrase 'a cruel kind of hope' applies across mental illness diagnosis. Being diagnosed with an illness by a doctor comes with expectations that some kind of treatment is available to help with the symptoms, maybe even cure it. That is much less likely to be the case for mental illness, where diagnosis, as Timini says, can often lead to worse outcomes by speciously placing borders on the patient's experience of distress. He also links the rising profile of neurodiversity with changes in the workplace:
Companies have traded job security, stability, and a unionised workforce for employee well-being services, mindfulness classes, and mental health days. Anxiety, stress, depression are things that happen to the worker that our enlightened approach to mental health can now treat, so you can return to the insecure jobs we offer without the employer having to change working practises. This new world of pseudo-emotionally aware language of mental health with the requirement of having strong people skills in the workforce means there is now a greater political and personal demand for everyone to having the sort of enhanced social and emotional flexibility they didn't previously need.
In relation to autism this leads to an interesting paradox. One of the core features of the diagnosis implies a lack of empathy. However, improving the 'emotional intelligence' of the workforce is for the purpose of using empathy to successfully exploit and manipulate your customers and workforce into doing what you wish for your own personal (and company) gain. It seems strange that people who find it difficult to understand emotional nuances but who can be compassionate are pathologised, yet those who can use an understanding of others' emotional state to manipulate them for selfish ends are rewarded.
Earlier this year my workplace held a neurodiversity training session. The trainer quoted an unsourced statistic that made my jaw drop: more than 70% of generation alpha identify as neurodivergent. I have two responses to this. Firstly, as a survey statistician I find it extremely hard to believe that this measure came from a robust random probability survey and is therefore truly representative of that age group. It is notoriously difficult to get under-21s to respond to surveys. Secondly, assuming it was true, how could more than half of a population cohort be considered 'divergent' from the norm. Surely this could only mean that what is normal is changing by generation, which is perfectly reasonable if you accept that the mental norm is socially constructed. Returning to the training, at no point was I as a line manager told what additional support or accommodations were available to neurodivergent people I might manage. (In my experience, you have to create your own accommodations in the workplace whenever you can, rather than trusting your employer to do so.)
The chapters on parenting were less personally relevant but no less radical in tone. Timini then examines what he calls the 'mental health industrial complex', which sells medication, therapy, wellbeing advice, workplace neurodiversity training, etc, etc. This section reminded me of how diagnostic categories of mental illness were formed as a consequence of drugs being developed to treat specific symptoms. Such a pharmaceutical-led approach leads to confusion about what these medicines actually do:
Just as alcohol can cause some social disinhibition whether you are socially anxious or not, antidepressants can produce a low level of emotional blunting (a kind of 'I don't care' feeling) in whoever takes them regardless of diagnosis. Calling drugs antipsychotics or antidepressants is a marketing not a scientific/theraputic term. Antipsychotics should be called 'neuroleptics' (inhibiting the nervous system) and antidepressants by their subcategory action. [...]
But in everyday life we refer to them as antidepressants, or antipsychotics, or mood stabilisers, or anxiolytics, or anti-ADHD medication. This is a sure sign that marketing not science is dictating the concepts used in practice and in the language that has since leaked out into culture. Psychiatric brands are ripe for exploitation and profit extraction, and the chemical imbalance story is ideal for medicalisation of mood, distress, difference, and the sort of widespread insecurities so many feel these days.
Incidentally, there is at least one illness with symptoms directly caused by a lack of dopamine in the brain, but it isn't depression. It is Parkinson's Disease. Timini emphasises that the rise of the chemical imbalance explanation for mental illness isn't a conspiracy theory, any more than capitalism itself. A confluence and co-operation of financial interests enabled it to take hold.
Towards the end of the book, Timini cautiously enters the difficult waters of gender dysphoria and trans identity (particularly among the young) as psychiatric disorders. I think that topic really deserves a longer and more detailed treatment, but respect his attempt. A key point he makes that I've not really seen elsewhere is that increasing reports of gender dysphoria among children and teenagers have coincided with a rise in gender essentialism in the Western world. To me it seems intuitive that more people would become uncomfortable with their gender the stricter and more rigid gender norms become. Unfortunately this could be a sort of vicious cycle, as aggressive transphobia from TERFs is coupled with doubling down on absolute gender essentialism, which further limits the space for variation within genders, which makes gender dysphoria more likely, which makes TERFs even louder in their hostility, etc. Personally, I'm content to be a cis woman as long as nobody expects me to wear makeup, remove my body hair, date men, or have children. (Ideally I would also be paid as much as a man for doing the same work, but at least two of my former employers didn't do so.) I don't have a strong internal sense of gender and suspect this could be the case for plenty of people. Timini notes that when trans identity is treated as a psychiatric problem,
The child's gender identity is conceptualised as existing a priori, as though it is an essential quality of the child that is beyond the reach of social or environmental influences. Family dynamics, traumatic experiences, social issues, cultural exposure to how masculinity and femininity are constructed and regulated, all become irrelevant in this framework. This gets transformed into an ideological stance that can hinder more fluid and open understandings, and may obstruct the potential for other, less medically invasive, avenues to psychological change.
That seems counterproductive to genuine acceptance of diversity. Towards the end of the book, Timini covers mental illness frameworks and colonialism, again relatively quickly. He refers to a great book on the topic Crazy Like Us: The Globalization of the Western Mind and makes this excellent point:
...No society really knows how to distinguish between mental suffering that's a sign of illness from experiences that are not. Sorrow and grief are often linked with inner depth and dignity, not pathology. Given these alternative perspectives of experiencing the world, some anthropologists have argued that the high rate of depression in the US is itself a product of a culture that prioritises the pursuit of happiness and consumption as a basic aim of human existence.
[Continued in comments below]
February 26, 2026
"Why are there so many more people receiving mental disorder diagnoses? Why are diagnoses like attention deficit hyperactivity disorder (ADHD) and autism becoming so prevalent? Is increasing recognition leading to better outcomes and better mental health in our societies?"
I first heard about the author from his recent appearance on Michael Shermer's Skeptic podcast, which I found intriguing, so I decided to take a deeper dive and hear his full and polished case. I was not disappointed.
It was a super interesting book. The thesis is thought-provoking. Broadly speaking, it is a shot across the bow at the entire paradigm of modern psychiatry. Timimi says that while mental health spending, programs, and treatments have all been vastly expanding over the last few decades, no actual headway (on the aggregate) has been made towards improving "mental health" metrics. In fact, despite increased funding and wider access to programs, trends are going in the opposite direction. What's going on here?
Author Sami Timimi is a British psychiatrist, psychotherapist, and author. He works as a consultant in child and adolescent psychiatry. He writes from a critical psychiatry perspective on topics relating to mental health and childhood and has published extensively in medical, educational, and sociological journals.
Sami Timimi :
He drops the quote above near the start of the book, continuing:
As you might imagine, the book presents a somewhat contrarian take that diverges from the current orthodoxy. It deals with a controversial matter: the entire modern medicalizing, diagnosing and treating of mental illnesses and pathologies. So, the book is going to ruffle some feathers. A cursory glance at some of the other reviews here confirms as much.
Timimi gives the reader a bit about his background here:
The crux of his argument is that mental health issues/diseases/syndromes/etc are not diagnosed in the same manner as the rest of medicine. He introduces the concept of the "empirical anchor." For example, the empirical anchor in diagnosing a broken leg is the X-Ray. It is an objective instrument that provides a concrete, measurable, and stable basis for diagnosis and technical analysis that grounds subjective interpretation or theoretical models. Mental health pathologies lack this anchor, and are instead diagnosed based on symptomatic presentation and subjectivity.
What results is a cycle of pathologising, labelling, and then medicating. He says:
As mentioned briefly above, despite decades of increased funding, awareness, and ease of access to treatment, things are not getting any better. In fact, rates of mental illness are increasing.
He also talks about the failure of psychotherapies (like CBT) to produce tangible results:
In these blurbs, he talks more about the problem of pathologizing mental states without empirical anchors:
Another problem is "concept creep." As anyone who has seen the DSMs knows, they have been getting steadily and progressively larger with each iteration. The original DSM (published in 1952) was a brief, spiral-bound pamphlet of only 132 pages, while the most recent DSM-5 (including its Text Revision) is a substantially larger volume with well over 900 pages. He writes:
Some more of what he covers here includes:
• Autism
• ADHD
• What is ‘mental’?
• Where is the self?
• Psychiatric diagnoses are facts of culture not nature
• There is no such thing as a psychiatric diagnosis
• The failure to improve outcomes
• Concept expansion
• The creation of ADHD
• The disparate rates of diagnosis between men and women
• Is ADHD an evidence-based construct?
• Ritalin and methamphetamines; the error of the "low dopamine" diagnosis in ADHD
• The creation of autism
• The mental health industrial complex; The myth of the chemical imbalance
• Neurodiversity, gender and new human typologies
• Living in a compare-and-compete culture
• Colonial psychiatry
• Rehabilitating emotions
So, where does all this leave us? How do we look at issues of "mental health"? Well, the framework of pathologizing, labelling and medicalizing human experience is a large part of the problem, Timimi argues, saying:
********************
Searching for Normal was a fascinating look into the topic. I found quite a lot of the writing here compelling. I would definitely recommend this one to anyone interested.
5 stars.
I first heard about the author from his recent appearance on Michael Shermer's Skeptic podcast, which I found intriguing, so I decided to take a deeper dive and hear his full and polished case. I was not disappointed.
It was a super interesting book. The thesis is thought-provoking. Broadly speaking, it is a shot across the bow at the entire paradigm of modern psychiatry. Timimi says that while mental health spending, programs, and treatments have all been vastly expanding over the last few decades, no actual headway (on the aggregate) has been made towards improving "mental health" metrics. In fact, despite increased funding and wider access to programs, trends are going in the opposite direction. What's going on here?
Author Sami Timimi is a British psychiatrist, psychotherapist, and author. He works as a consultant in child and adolescent psychiatry. He writes from a critical psychiatry perspective on topics relating to mental health and childhood and has published extensively in medical, educational, and sociological journals.
Sami Timimi :
He drops the quote above near the start of the book, continuing:
"What the public is being told about the nature of mental health is misleading and may be harming our collective sense of well-being. Mental health ideology may be the biggest and most powerful cause of mental health problems today.
I will explain why I believe this to be the case and what we could, at an individual and collective level, do about it."
As you might imagine, the book presents a somewhat contrarian take that diverges from the current orthodoxy. It deals with a controversial matter: the entire modern medicalizing, diagnosing and treating of mental illnesses and pathologies. So, the book is going to ruffle some feathers. A cursory glance at some of the other reviews here confirms as much.
Timimi gives the reader a bit about his background here:
"I qualified as a doctor in 1988 and have been a consultant in child and adolescent psychiatry since 1997. I’ve worked in inpatient and outpatient settings, with urgent, crisis, eating problems and paediatric liaison services.
I’ve been teaching, writing and lecturing for most of that time. I’ve published in many leading journals as well as chapters in numerous academic books. I’ve authored six books and collaborated with academics and service users from a variety of backgrounds in research, editing or coauthoring books, devising projects, writing documents and building new services. In this book I aim to bring those years of clinical and academic experience to a general audience to share what I have learned."
The crux of his argument is that mental health issues/diseases/syndromes/etc are not diagnosed in the same manner as the rest of medicine. He introduces the concept of the "empirical anchor." For example, the empirical anchor in diagnosing a broken leg is the X-Ray. It is an objective instrument that provides a concrete, measurable, and stable basis for diagnosis and technical analysis that grounds subjective interpretation or theoretical models. Mental health pathologies lack this anchor, and are instead diagnosed based on symptomatic presentation and subjectivity.
What results is a cycle of pathologising, labelling, and then medicating. He says:
"...Little did I know, when I first stepped into the world of child psychiatry three decades ago, how far and deep the tentacles of diagnostic mental health ideology would reach. That the diagnostic ideology – so demoralising in adult psychiatry – would start to strangle my adopted profession, bringing along with it a culture of pathologising, labelling and medicating. There has never been a generation of young people so colonised at such a young age by mental health propaganda.
Neither did I realise that child psychiatry itself would become an exporter to the world of adult psychiatry, causing the ballooning of concepts originally developed for the young, such as ADHD and autism. We have now long surpassed in mythology the phrenologists of the Victorian era and the quackery of astrological chart readings. People really believe that the developments in psychiatric diagnosis and treatment are the result of science. I hope this book will help disabuse some of you of that notion."
As mentioned briefly above, despite decades of increased funding, awareness, and ease of access to treatment, things are not getting any better. In fact, rates of mental illness are increasing.
"In 2021, New York Times reporter Benedict Carey, after covering psychiatry for twenty years, concluded that psychiatry had done ‘little to improve the lives of the millions of people living with persistent mental distress. Almost every measure of our collective mental health – rates ofsuicide, anxiety, depression, addiction deaths, psychiatric prescription use – went in the wrong direction, even as access to services expanded greatly.’17
In 2023, Time reported that ‘about one in eight US adults now takes an antidepressant’; however, ‘mental health is getting worse by multiple metrics. Suicide rates have risen by about 30 per cent since 2000 … As oflate 2022, just 31 per cent of US adults considered their mental health “excellent”, down from 43 per cent two decades earlier. Trends are going in the wrong direction, even as more people seek care. That’s not true for cancer, it’s not true for heart disease, it’s not true for diabetes, or almost any other area of medicine.’18
A 2023 study based on Danish population records found that about 80 percent of the population will receive psychiatric drug treatment, with the likelihood of being treated in a mental health hospital being 29 per cent. Furthermore, after receiving treatment, they were more likely to experience new socio-economic difficulties, become unemployed or receive a disability benefit, earn lower income, live alone or be unmarried.19"
He also talks about the failure of psychotherapies (like CBT) to produce tangible results:
"...The field has been troubled not so much with a replicability crisis, but rather the repeated finding of a lack of progress. Nothing in therapy seems to be getting better. Controlled trials that test efficacy of therapies started using the sort of methodologies we regularly use in research in the 1970s. Studies carried out since then with different therapeutic modalities have not shown improved rates of recovery from treatment. Some comparisons even suggest outcomes from therapy in controlled trials have got slightly worse over time.9"
In these blurbs, he talks more about the problem of pathologizing mental states without empirical anchors:
"If you hear one in four of the population are possessed by or will be possessed by a mental disorder, be wary. It’s an appalling mistake to make with appalling consequences for patients and professionals alike. One in four who have what sort of ‘thing’? Where is this ‘thing’ located and how do I find it? How can I truly develop an accurate way of ‘measuring’ it if I can’t locate it as an empirically knowable ‘thing’?..."
"...Despite three decades of intense neuroimaging research, we still lack a neurobiological account for any psychiatric condition. Advances in scientific knowledge have helped cardiologists, oncologists and other medical specialists improve success rates for a variety of clinically important outcomes, confirming that current treatments are more effective than the ones that were available twenty or thirty years ago. Similar data is hard to find for psychiatric disorders. As a result, functional neuroimaging or other physical tests play no role in clinical decision-making.21
Research from several countries has found that, despite continuous growth in the availability of mental health services, only about 15–25 per cent of those referred significantly improve or recover in the long term.22
This dismal picture is found in both child and adult mental health services. Non-attendance rates and numbers dropping out of treatment are also substantial. In most Western countries there has been a steep rise in the number of youths and adults categorised as disabled mentally ill (in other words those who require disability benefits because of a mental health condition).23"
Another problem is "concept creep." As anyone who has seen the DSMs knows, they have been getting steadily and progressively larger with each iteration. The original DSM (published in 1952) was a brief, spiral-bound pamphlet of only 132 pages, while the most recent DSM-5 (including its Text Revision) is a substantially larger volume with well over 900 pages. He writes:
"...Because mental health ideology is carved out of subjectivity, it is vulnerable to what I call the elastic band effect – that diagnoses are elastic and can expand (or contract) in response to social forces..."
"...Sociologist Nick Haslam18 coined the term ‘concept creep’ to refer to the gradual expansion of what he called ‘harm-related’ concepts. He argued that many psychological concepts had undergone a process of inflation whereby they identify an increasingly wide range of phenomena. That broadening, he said, occurs in two directions. Concepts creep horizontally by coming to refer to qualitatively new phenomena, and vertically by coming to refer to less extreme states.
The concept creep happening in mental health is part of this tendency for ideas about harm, suffering and maltreatment to expand their meanings over time. A few decades ago, bullying referred only to peer aggression carried out by children. It was intentional behaviour repeated multiple times and done in the context of a power imbalance. Over time, bullying expanded horizontally to include adults in workplaces who carry out exclusionary rather than intimidating behaviour (such as shunning) and intimidation carried out online rather than only in person (referred to as ‘cyberbullying’).
Bullying also expanded vertically to include acts that were unintentional, unrepeated and directed at people of equal or even higher power than the perpetrator."
Some more of what he covers here includes:
• Autism
• ADHD
• What is ‘mental’?
• Where is the self?
• Psychiatric diagnoses are facts of culture not nature
• There is no such thing as a psychiatric diagnosis
• The failure to improve outcomes
• Concept expansion
• The creation of ADHD
• The disparate rates of diagnosis between men and women
• Is ADHD an evidence-based construct?
• Ritalin and methamphetamines; the error of the "low dopamine" diagnosis in ADHD
• The creation of autism
• The mental health industrial complex; The myth of the chemical imbalance
• Neurodiversity, gender and new human typologies
• Living in a compare-and-compete culture
• Colonial psychiatry
• Rehabilitating emotions
So, where does all this leave us? How do we look at issues of "mental health"? Well, the framework of pathologizing, labelling and medicalizing human experience is a large part of the problem, Timimi argues, saying:
"What if a major driver of mental health problems is the belief that we have a problem? What if the ‘solution’ is sometimes as easy as getting rid of the idea that we have a problem needing a solution?
What if it’s simply a matter of rehabilitating a respect and appreciation for the ordinariness and necessity of the full range of emotional experiences we can have? We have personal histories and social contexts; these shape us by interacting with our biology. We are then exposed to narratives that structure the meanings we give our experiences. It is the narratives structuring our meanings that can have profound effects on how we subsequently feel."
********************
Searching for Normal was a fascinating look into the topic. I found quite a lot of the writing here compelling. I would definitely recommend this one to anyone interested.
5 stars.
August 20, 2025
The description of this book really perked my interest as someone who has been harmed by psychiatric systems, medication, labelling etc. But I’ve been shocked by this book and I in fact could not continue to force myself to read it to the end because of how much I disagree and how much upset this book raised inside me.
I read a fair chunk of this book though, one awful point was calling Autism a brand. Neurodiverse people were also likened to an anti religious cult.
I know from other people that at no point in this book is the people benefiting from a diagnosis of autism or adhd explored.
I was also deeply bothered by a part where the author mentions not taking responsibility for behaviour and it being like ‘oh that’s just my adhd’.
Correct me if I’m wrong but if I had say arthritis and said ‘oh gosh my knees sore today it must be the arthritis’ that would, using this authors logic, also be wrong?
I could say more but I’ll stop. This book let me down.
I read a fair chunk of this book though, one awful point was calling Autism a brand. Neurodiverse people were also likened to an anti religious cult.
I know from other people that at no point in this book is the people benefiting from a diagnosis of autism or adhd explored.
I was also deeply bothered by a part where the author mentions not taking responsibility for behaviour and it being like ‘oh that’s just my adhd’.
Correct me if I’m wrong but if I had say arthritis and said ‘oh gosh my knees sore today it must be the arthritis’ that would, using this authors logic, also be wrong?
I could say more but I’ll stop. This book let me down.
This entire review has been hidden because of spoilers.
August 17, 2025
This was super interesting and thought provoking: a psychiatrist’s take on the increased diagnoses of adhd and autism in terns and how this illustrates the mental health industrial complex that we now all live in and how mental health and its jargon has now been co opted by capitalism to keep us focused on ourselves and the labels we have rather than work to overcome our collective struggles.
It explores how behaviours, especially in youth, are increasingly pathologized as ADHD or autism, often reflecting cultural and political biases rather than objective medical needs. In diagnoses of these disorders the cultural context and individual’s coping strategie, i.e. resilience, is downplayed. He raises the issue of what is mental health/unhealth vs. what is resilience and coping/getting through it. All this is is cultural perception, patience and the ability to rest.
“A tautology is a circular thinking trap, a statement that repeats an idea effectively saying the same thing twice.
A description cannot explain itself. Low mood and depression are synonymous; you cannot use one to explain the other.”
“Because mental health ideology is carved out of subjectivity, it is vulnerable to what I call the elastic band effect - that diagnoses are elastic and can expand (or contract) in response to social forces.”
“Trauma itself can become a new source of mental health expansionism. It is com-modifiable and easier to marketise than a more nebulous and nuanced articulation of distress. It fits in perfectly with the cultural trend to notice our vulnerability more than our resilience.”
“Anything that has the scent of mental health and the idea of helping vulnerable and suffering people is an attractive balm for the guilt of the wealthy. I am not suggesting here that such concepts and interventions are not helpful for many people; I am suggesting that they may act to distract from socio-economic injustice.
Even something as apparently politically neutral as treating
'trauma' may provide protection from class injustice by providing a vehicle for do-gooding philanthropy.”
“Autism has become the new catch-all for young patients who don't follow the increasingly narrow boundaries of expected behaviours, and to such an extent that we overlook histories that would obviously have an impact on their presentations.”
“After years of trying to find the correct evidence-based model, eventually came to the realisation that (except for some aspects of psychoanalytic and systemic models) most psychotherapeutic models were just systematised versions of Western 'folk psychology': variants with a few rules and turns of language to create an aura of deverness, professionalism and science.”
“The first headline from the common factors literature is that the extra-therapeutic aspects - in other words, factors that have little or nothing to do with what directly happens within a therapy session - have a much bigger influence on outcomes than those within treatment. This is the whole range of things that the person walks into the consulting room with. From their personal history to their social, financial, employment, relationship circumstances and beliefs about therapy/treatment.”
“Some of the most effective interventions seem to have been when I am not trying to solve emotional pain, but helping people stay with, accept and, therefore, see aspects of their life beyond the pain they experience. Industrialised therapy seems to me at risk of mechanising emotions by trying to reason and appeal to the patient's rational side. When this doesn't work there is a risk that the patient will, often unintentionally, be blamed for being too stupid/uncooperative/bloody-minded/ill.”
Systemic philosphy: “It suggested that the systems of knowledge we use are relative and arise from those who have the power in any society to influence the common social narratives. It understood that our consciousness and even common sense' are products of our social and personal circum-stances, from our family to wider community histories and practices.
This means we have finite ways of making sense of our experiences, through using the stories our families and broader culture provide as meaning-making vehicles.”
“According to research, believing that one's depression is caused by a chemical imbalance tends to make people more pessimistic about recovery, leads them to believe they have less ability to deal with their moods, and to believe that medication is a more credible solution than therapy? Those who believe this disease theory of depression also have poorer recovery rates than those who don’t.”
“As the concept of depression sank into the minds of psychiatrists and psychotherapists, the nature of consultations no longer invited a person to talk about the social and historical context of their strug-gles. Distress was no longer part of a shared struggle, but one that pointed to something medically wrong within the person, which required treatment with drugs or therapy. Consultations now had a primarily educative function, teaching distressed patients the meaning of depression and convincing them to accept the 'correct' treatment. Rates of depression rose, and, thanks to MHIC, a rich and meaningful psychosocial history was buried.”
“There are many other consequences of collapsing and disappearing local idioms. It depoliticises social and economic sources of distress and suicide, as well as taking away the deeper cultural significance and meanings attached to mental suffer-ing, which in many traditions is a source of growth, a path to accepting the limits of human capacity, and a mechanism for strengthening social bonds.
This globalisation-led 'depression as a concept' helped its transformation from being an extremely rare diagnosis in much of the world to one that is thought to be one of the most common.”
Further it looks af how pharma companies, media, and psychiatric institutions are critiqued for transforming ordinary human distress into medical conditions to be diagnosed and treated.
My one critique point is that the point he makes about transition in teenagers and their sometimes wanting to go beyond gender norms is seen immediately as a reason to label them trans, rather than let them explore, which I think is true in some cases, but the way he frames it makes it seem like this is incredibly common, which I do not believe to be true. This whole section felt a little surface level/ dismissive of the trans experience but he has several comments throughout that reiternatr that he supports trans people and their rights, so this feels a bit more like he just wanted another example for his premise rather than that he wanted to be dismisive.
It explores how behaviours, especially in youth, are increasingly pathologized as ADHD or autism, often reflecting cultural and political biases rather than objective medical needs. In diagnoses of these disorders the cultural context and individual’s coping strategie, i.e. resilience, is downplayed. He raises the issue of what is mental health/unhealth vs. what is resilience and coping/getting through it. All this is is cultural perception, patience and the ability to rest.
“A tautology is a circular thinking trap, a statement that repeats an idea effectively saying the same thing twice.
A description cannot explain itself. Low mood and depression are synonymous; you cannot use one to explain the other.”
“Because mental health ideology is carved out of subjectivity, it is vulnerable to what I call the elastic band effect - that diagnoses are elastic and can expand (or contract) in response to social forces.”
“Trauma itself can become a new source of mental health expansionism. It is com-modifiable and easier to marketise than a more nebulous and nuanced articulation of distress. It fits in perfectly with the cultural trend to notice our vulnerability more than our resilience.”
“Anything that has the scent of mental health and the idea of helping vulnerable and suffering people is an attractive balm for the guilt of the wealthy. I am not suggesting here that such concepts and interventions are not helpful for many people; I am suggesting that they may act to distract from socio-economic injustice.
Even something as apparently politically neutral as treating
'trauma' may provide protection from class injustice by providing a vehicle for do-gooding philanthropy.”
“Autism has become the new catch-all for young patients who don't follow the increasingly narrow boundaries of expected behaviours, and to such an extent that we overlook histories that would obviously have an impact on their presentations.”
“After years of trying to find the correct evidence-based model, eventually came to the realisation that (except for some aspects of psychoanalytic and systemic models) most psychotherapeutic models were just systematised versions of Western 'folk psychology': variants with a few rules and turns of language to create an aura of deverness, professionalism and science.”
“The first headline from the common factors literature is that the extra-therapeutic aspects - in other words, factors that have little or nothing to do with what directly happens within a therapy session - have a much bigger influence on outcomes than those within treatment. This is the whole range of things that the person walks into the consulting room with. From their personal history to their social, financial, employment, relationship circumstances and beliefs about therapy/treatment.”
“Some of the most effective interventions seem to have been when I am not trying to solve emotional pain, but helping people stay with, accept and, therefore, see aspects of their life beyond the pain they experience. Industrialised therapy seems to me at risk of mechanising emotions by trying to reason and appeal to the patient's rational side. When this doesn't work there is a risk that the patient will, often unintentionally, be blamed for being too stupid/uncooperative/bloody-minded/ill.”
Systemic philosphy: “It suggested that the systems of knowledge we use are relative and arise from those who have the power in any society to influence the common social narratives. It understood that our consciousness and even common sense' are products of our social and personal circum-stances, from our family to wider community histories and practices.
This means we have finite ways of making sense of our experiences, through using the stories our families and broader culture provide as meaning-making vehicles.”
“According to research, believing that one's depression is caused by a chemical imbalance tends to make people more pessimistic about recovery, leads them to believe they have less ability to deal with their moods, and to believe that medication is a more credible solution than therapy? Those who believe this disease theory of depression also have poorer recovery rates than those who don’t.”
“As the concept of depression sank into the minds of psychiatrists and psychotherapists, the nature of consultations no longer invited a person to talk about the social and historical context of their strug-gles. Distress was no longer part of a shared struggle, but one that pointed to something medically wrong within the person, which required treatment with drugs or therapy. Consultations now had a primarily educative function, teaching distressed patients the meaning of depression and convincing them to accept the 'correct' treatment. Rates of depression rose, and, thanks to MHIC, a rich and meaningful psychosocial history was buried.”
“There are many other consequences of collapsing and disappearing local idioms. It depoliticises social and economic sources of distress and suicide, as well as taking away the deeper cultural significance and meanings attached to mental suffer-ing, which in many traditions is a source of growth, a path to accepting the limits of human capacity, and a mechanism for strengthening social bonds.
This globalisation-led 'depression as a concept' helped its transformation from being an extremely rare diagnosis in much of the world to one that is thought to be one of the most common.”
Further it looks af how pharma companies, media, and psychiatric institutions are critiqued for transforming ordinary human distress into medical conditions to be diagnosed and treated.
My one critique point is that the point he makes about transition in teenagers and their sometimes wanting to go beyond gender norms is seen immediately as a reason to label them trans, rather than let them explore, which I think is true in some cases, but the way he frames it makes it seem like this is incredibly common, which I do not believe to be true. This whole section felt a little surface level/ dismissive of the trans experience but he has several comments throughout that reiternatr that he supports trans people and their rights, so this feels a bit more like he just wanted another example for his premise rather than that he wanted to be dismisive.
March 28, 2025
This is such an excellent book - with so many examples drawn from the author’s many years of practice and experience which bring his sage advice to life. The present approach which the various professions, institutions and the wider culture have adopted is clearly exacerbating mental health problems widely, and not helping families - the crucible of mentally healthy humans - through difficult issues which can be paralysing, and impact people adversely their whole life. I’ve found it brilliant in improving how I approach dealing with my children, and will continue to turn to Dr Timimi as they continue to grow in a world which is more and more difficult for children to thrive in. It is by far the very best I have come across, reading very many books about it. On the one hand had he offers no easy solution, and indeed I will moist certainly resist the solutions proffered by well-meaning professionals (diagnosis and medication) in future. When Dr Tamimi lays out the actual scientific evidence for it, I cannot consider that giving ADHD child amphetamines is an effective solution to behavioural and concentration problems. I consider it completely unethical too, although Dr Timimi is too polite to put it quite this strongly. But on the other hand he shows us the way, tough though it is, to vastly improve the context for children and teenagers whose personalities and abilities deviate from more ‘normal’, easier to handle specimens of humanity to thrive and live the best lives they can - relatively immunised against the vicissitudes of a UK (indeed more widely Western) society undergoing various crises - not least crises of mental health and adopting healthily to new, ubiquitous technologies etc.
June 22, 2025
Very interesting read. Completely agree that for SOME people a diagnosis/label can reinforce problems and make improvements less likely but also would’ve been good to touch on the perspectives of those who share what a positive impact a diagnosis has on their sense of self/identity and helped them process and remove self blame for previous experiences
Also in a dream world people wouldn’t need a ‘label’ to receive the support they need and deserve ie in schools but unfortunately we don’t live in a dream world
Also in a dream world people wouldn’t need a ‘label’ to receive the support they need and deserve ie in schools but unfortunately we don’t live in a dream world
March 11, 2026
Una joya inesperada, reflexiva y ética en sus fines, aunque lamentablemente generará pasiones encontradas que no hacen justicia al esmero y cantidad de matices que pueblan este ensayo, ni a las enseñanzas que oferta.
Por supuesto entiendo que hay puntos de debate, pero creo que muchos no entienden que el autor, por poner un ejemplo, no niega la depresión, entendida como síntomas, sufrimiento o fenómeno, ni tampoco su gravedad: lo que niega es su biologizacion, su capitalización, el modo de abordarla...esto es, Sami Timimi critica la negación de su dimensión humana en sentido existencial, psicodinamico y vital.
Tampoco creo que el autor niegue la importancia de ciertas luchas identitarias, pero quizás aquí esté el problema de este opúsculo: abarca mucho más de lo que parece y lo expresa de un modo tan sencillo que los lectores poco duchos en estas temáticas pueden confundirse con lo que aquí está en juego y tomarlo como un librito facilito de divulgación. No lo subestimen.
El libro es sencillo conceptual y discursivamente, cuenta con una bibliografía selecta, pero bien pensada, de Foucault a Marx, Fukuyama o Freud, Sasz o Goffman, si bien su valor supera con mucho las fuentes citadas.
Sorprende, porque con cautela, viene a converger (en lo fundamental para quien sepa leer en profundidad) con autores desconocidos para él como puedan ser el catedrático en farmacología Joan Ramón Laporte, los psiquiatras Marino Pérez Alvarez o José María Alvarez, por no citar a una legión de filosofos, psicoanalistas y psiquiatras, patrios y foráneos, como el "Todos estamos locos" de Eric Laurent o, tirando hacia mucho más atrás, la excesiva, pero pionera "Nemesis medica" de Iván Illich.
Es además motivo de regocijo que haya sido la editorial Debate la que lo haya publicado, teniendo en cuenta que hace no mucho publicó un libro que, en cierta medida podría considerarse "contrario" a éste en tesis clave (y, si leen mi crítica, muy inferior en humanidad, profundidad y ética: me refiero a "Las palabras de la bestia hermosa" de Guillermo Lahera).
En fin, que no puedo sino recomendar su lectura, advirtiendo de que si el lector no está familiarizado con bibliografía previa de esta temática, deberá completar estas reflexiones con más fuentes si desea entenderlas y sopesarlas sin ideologias alienantes o partidismos maniqueos: no, Sami Timimi ni es woke, ni facha, ni transfobo ni racista, ni misogino....
El autor, en definitiva pule con belleza minimalista y sintética el constructivismo social en su mejor versión (sin relativismos trasnochados, pero firme en su critica al cientifismo), sabe valorar las psicoterapias (aunque se le nota especialmente crítico con el cognitivismo y el conductismo, con buenas razones para ello) y desea aportar con una voz critica para parar tanta ceguera, mafia económica y desresponsabilizacion.
Por supuesto entiendo que hay puntos de debate, pero creo que muchos no entienden que el autor, por poner un ejemplo, no niega la depresión, entendida como síntomas, sufrimiento o fenómeno, ni tampoco su gravedad: lo que niega es su biologizacion, su capitalización, el modo de abordarla...esto es, Sami Timimi critica la negación de su dimensión humana en sentido existencial, psicodinamico y vital.
Tampoco creo que el autor niegue la importancia de ciertas luchas identitarias, pero quizás aquí esté el problema de este opúsculo: abarca mucho más de lo que parece y lo expresa de un modo tan sencillo que los lectores poco duchos en estas temáticas pueden confundirse con lo que aquí está en juego y tomarlo como un librito facilito de divulgación. No lo subestimen.
El libro es sencillo conceptual y discursivamente, cuenta con una bibliografía selecta, pero bien pensada, de Foucault a Marx, Fukuyama o Freud, Sasz o Goffman, si bien su valor supera con mucho las fuentes citadas.
Sorprende, porque con cautela, viene a converger (en lo fundamental para quien sepa leer en profundidad) con autores desconocidos para él como puedan ser el catedrático en farmacología Joan Ramón Laporte, los psiquiatras Marino Pérez Alvarez o José María Alvarez, por no citar a una legión de filosofos, psicoanalistas y psiquiatras, patrios y foráneos, como el "Todos estamos locos" de Eric Laurent o, tirando hacia mucho más atrás, la excesiva, pero pionera "Nemesis medica" de Iván Illich.
Es además motivo de regocijo que haya sido la editorial Debate la que lo haya publicado, teniendo en cuenta que hace no mucho publicó un libro que, en cierta medida podría considerarse "contrario" a éste en tesis clave (y, si leen mi crítica, muy inferior en humanidad, profundidad y ética: me refiero a "Las palabras de la bestia hermosa" de Guillermo Lahera).
En fin, que no puedo sino recomendar su lectura, advirtiendo de que si el lector no está familiarizado con bibliografía previa de esta temática, deberá completar estas reflexiones con más fuentes si desea entenderlas y sopesarlas sin ideologias alienantes o partidismos maniqueos: no, Sami Timimi ni es woke, ni facha, ni transfobo ni racista, ni misogino....
El autor, en definitiva pule con belleza minimalista y sintética el constructivismo social en su mejor versión (sin relativismos trasnochados, pero firme en su critica al cientifismo), sabe valorar las psicoterapias (aunque se le nota especialmente crítico con el cognitivismo y el conductismo, con buenas razones para ello) y desea aportar con una voz critica para parar tanta ceguera, mafia económica y desresponsabilizacion.
January 3, 2026
i really wanted to like this book, i thought it would explore more the relationship between mental health and inequality.
the author at some point makes the point that there's an increase in the diagnoses of mental health conditions, and mentions that it's medication that's making things worse, that we should consider a different approach, so far, we are good.
the douche then guides you to a point where he starts mentioning that there's an increase in ppl identifying with different genders, and he's like, no way, this is due to inequality and we should not prescribe medication. the guy just can't accept that trans ppl have existed through history, and that there's just more ppl coming forward and being open about it because our society became more inclusive, at least for a while, not even god knows where we are heading now.
anyways, the douche starts using correct pronouns for trans ppl and suddenly drops them, and makes you wonder if, after editing and reviewing it before publishing, was this left out intentionally? because it doesn't happen only once.
he talks about sustainability and inclusivity as bandwagons, critizises DEI saying it won't "change the systemic injustices in housing, jobs, (...)" and keeps going.
there were many points while reading when i started being skeptical about this author, it has been a really strained lecture for me, and i can't bring myself to finish reading this.
i believe this is an extremely divisive book.
the author at some point makes the point that there's an increase in the diagnoses of mental health conditions, and mentions that it's medication that's making things worse, that we should consider a different approach, so far, we are good.
the douche then guides you to a point where he starts mentioning that there's an increase in ppl identifying with different genders, and he's like, no way, this is due to inequality and we should not prescribe medication. the guy just can't accept that trans ppl have existed through history, and that there's just more ppl coming forward and being open about it because our society became more inclusive, at least for a while, not even god knows where we are heading now.
anyways, the douche starts using correct pronouns for trans ppl and suddenly drops them, and makes you wonder if, after editing and reviewing it before publishing, was this left out intentionally? because it doesn't happen only once.
he talks about sustainability and inclusivity as bandwagons, critizises DEI saying it won't "change the systemic injustices in housing, jobs, (...)" and keeps going.
there were many points while reading when i started being skeptical about this author, it has been a really strained lecture for me, and i can't bring myself to finish reading this.
i believe this is an extremely divisive book.
January 15, 2026
Lots of thought provoking content. I didn’t agree with everything but it’s always good to challenge one’s beliefs.
November 3, 2025
A fascinating look into mental health of children and adolescents. It's informed my teaching practice well.
March 30, 2026
مع جميع قراءاتي البسيطه لعلم النفس اضع هذا الكتاب على قمتها لان هذا ما اجده فعلا خلال عملي بهذا المجال وهو حقيقي ..
June 2, 2025
In his most comprehensive book to date, Timimi has delivered another blistering critique of the contemporary yet predominant “medical model of mental health.” Though sure to challenge some people’s ingrained beliefs, it needs to be known. As Vasily Grossman put it, “It is the writer's duty to tell the terrible truth, and it is a reader's civic duty to learn this truth.”
March 21, 2026
Timimi is a child and adolescent psychiatrist and a psychotherapist in the UK and he's from Iraq. Him being an outsider is a good thing in some aspects and not so good in other aspects. For example he is able to contemplate mental health outside the bubble of the medical model that psychiatrists of the West are taught in. This model is not conducive to the betterment of our mental health as a collective and as individuals. On the other hand, Timimi can't help but enlighten us of his anti-capitalist, anti-white racist collectivist ideologies that he starts rambling about more and more toward the last 25% of the book.
The best idea he presents is that psychiatric diagnoses are similar to brands that are marketed to consumers, the patients, taking into account their need to validate themselves as having a valid, medical reason for their problems along with convincing them that they need a professional to prescribe them a drug for it or else things will get much worse. This branding can also be targeted to parents and teachers so that the parents wouldn't feel bad about their child having behavior problems, which might reflect badly on parents. Rather, their children have a "neurodevelopmental disorder" that requires yet another intervention of professionals while takin away any responsibility from the parents or a restrictive, toxic school environment. This also ties in with autism and “masking” in a really funny way in that autism is branded especially towards women since masking removes the necessity of actual observable symptoms resulting in a psychiatric diagnoses based mostly on feelings. This is accompanied by massive increases of tags in social media like autism in women or ADHD in women which are many times more popular than the equivalent terms for men.
Timimi brings to light many relatively new studies about the fraudulence and subjectivity of many of these diagnoses which don't really reach the bubble of the medical model of mental health. Examples would be the RIAT analysis of some psychiatric medications (https://www.bmj.com/content/346/bmj.f...), which uses previously unpublished confidential company documents about trials of medications that they got a hold of through court cases and the Freedom of Information Act.
https://www.researchgate.net/publicat... – this one is about the antidepressant fluoxetine, which was originally touted to be safe and effective for youngsters but the re-analysis shows it to be unsafe and ineffective.
https://pmc.ncbi.nlm.nih.gov/articles... – this a similar study about antidepressants paroxetine and imipramine
Some other examples of other topics:
https://www.nature.com/articles/s4138... – a systematic review of the science behind the serotonin theory of depression, showing “no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity. ”
https://depts.washington.edu/psychres... - this the 36-month follow-up of a big prominent study about stimulants used for ADHD treatment, showing the advantages of using the drugs had disappeared by 36 months. The original study in question included a 14-month follow-up, meaning the change would appear somewhere between 14 months and 36 months.
https://pubmed.ncbi.nlm.nih.gov/41342... - this is a meta-analysis (Cochrane systematic review) of the science behind using methylphenidate for ADHD in children and adolescents showing the low quality of evidence for positive effects on using these drugs while having side-effects like sleep problems and a decreased appetite.
https://link.springer.com/article/10.... – this one is a review of the science behind autism spectrum disorder, showing the disorder doesn't have a neurobiological basis and that it doesn't even have validity to exist as a diagnosis.
https://www.thelancet.com/journals/la...
https://www.thelancet.com/journals/la...
These last two are about a massive ADHD study (https://pmc.ncbi.nlm.nih.gov/articles...) showing smaller structures in some areas of the brain of ADHD patients. However, the last two studies show that there is no basis to claim that ADHD has a neurobiological basis and that when you normalize the data to IQ, the apparent brain changes disappear.
The best idea he presents is that psychiatric diagnoses are similar to brands that are marketed to consumers, the patients, taking into account their need to validate themselves as having a valid, medical reason for their problems along with convincing them that they need a professional to prescribe them a drug for it or else things will get much worse. This branding can also be targeted to parents and teachers so that the parents wouldn't feel bad about their child having behavior problems, which might reflect badly on parents. Rather, their children have a "neurodevelopmental disorder" that requires yet another intervention of professionals while takin away any responsibility from the parents or a restrictive, toxic school environment. This also ties in with autism and “masking” in a really funny way in that autism is branded especially towards women since masking removes the necessity of actual observable symptoms resulting in a psychiatric diagnoses based mostly on feelings. This is accompanied by massive increases of tags in social media like autism in women or ADHD in women which are many times more popular than the equivalent terms for men.
Timimi brings to light many relatively new studies about the fraudulence and subjectivity of many of these diagnoses which don't really reach the bubble of the medical model of mental health. Examples would be the RIAT analysis of some psychiatric medications (https://www.bmj.com/content/346/bmj.f...), which uses previously unpublished confidential company documents about trials of medications that they got a hold of through court cases and the Freedom of Information Act.
https://www.researchgate.net/publicat... – this one is about the antidepressant fluoxetine, which was originally touted to be safe and effective for youngsters but the re-analysis shows it to be unsafe and ineffective.
https://pmc.ncbi.nlm.nih.gov/articles... – this a similar study about antidepressants paroxetine and imipramine
Some other examples of other topics:
https://www.nature.com/articles/s4138... – a systematic review of the science behind the serotonin theory of depression, showing “no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity. ”
https://depts.washington.edu/psychres... - this the 36-month follow-up of a big prominent study about stimulants used for ADHD treatment, showing the advantages of using the drugs had disappeared by 36 months. The original study in question included a 14-month follow-up, meaning the change would appear somewhere between 14 months and 36 months.
https://pubmed.ncbi.nlm.nih.gov/41342... - this is a meta-analysis (Cochrane systematic review) of the science behind using methylphenidate for ADHD in children and adolescents showing the low quality of evidence for positive effects on using these drugs while having side-effects like sleep problems and a decreased appetite.
https://link.springer.com/article/10.... – this one is a review of the science behind autism spectrum disorder, showing the disorder doesn't have a neurobiological basis and that it doesn't even have validity to exist as a diagnosis.
https://www.thelancet.com/journals/la...
https://www.thelancet.com/journals/la...
These last two are about a massive ADHD study (https://pmc.ncbi.nlm.nih.gov/articles...) showing smaller structures in some areas of the brain of ADHD patients. However, the last two studies show that there is no basis to claim that ADHD has a neurobiological basis and that when you normalize the data to IQ, the apparent brain changes disappear.
October 24, 2025
Timimi writes well and touches upon some interesting points from a Marxist (i.e. class-based) perspective, e.g. the commodification of mental health, the problem of subjectivity in psychological care and a broad individualised approach to mental health within Western cultures that allows governments and organisations to avoid actually important structural changes.
However, his argument that mental and developmental disorders can't be real because we can't currently perform physical tests to identify them is... bold, and ultimately not convincing. He is essentially claiming that these disorders are made up by the 'mental health industrial complex' to push drugs and other therapies in the name of profit. While I'm sure there are bad-faith actors within the industry (like every industry), I was dubious about such conspiratorial thinking, and I have the sense Timimi was cherry picking and/or misrepresenting the evidence to make such claims work.
Random examples include:
- Using Peter Gøtzsche (a "fierce crusader" against medical practices based on insufficient evidence) to reinforce the idea of pharmaceutical companies being 'crime syndicates', but failing to mention that Gøtzsche co-authored a paper with a known antivaxxer against the Covid-19 vaccine.
- Claiming (without reference) that "More young Australians are taking antidepressants, and more young Australians are killing themselves and self-harming, often by intentionally overdosing on the very substances that are supposed to help them." First of all: where's the evidence for that statement? How do you know they're overdosing on antidepressants specifically? Second of all: um, no. The suicide rate fluctuates but has been consistently going down since the 70s, and there has been a downward trend since 2019 specifically.
- Using a study that implies gender-affirming healthcare doesn't work (https://pubmed.ncbi.nlm.nih.gov/36832...) that is "scientifically and methodologically flawed" (https://pmc.ncbi.nlm.nih.gov/articles...)
I don't have the theoretical background to know for sure if Timimi was misrepresenting things, but I found the above points in a 15-min skim and Google. Essentially, Timimi lost all my trust at that point and I stopped reading.
However, his argument that mental and developmental disorders can't be real because we can't currently perform physical tests to identify them is... bold, and ultimately not convincing. He is essentially claiming that these disorders are made up by the 'mental health industrial complex' to push drugs and other therapies in the name of profit. While I'm sure there are bad-faith actors within the industry (like every industry), I was dubious about such conspiratorial thinking, and I have the sense Timimi was cherry picking and/or misrepresenting the evidence to make such claims work.
Random examples include:
- Using Peter Gøtzsche (a "fierce crusader" against medical practices based on insufficient evidence) to reinforce the idea of pharmaceutical companies being 'crime syndicates', but failing to mention that Gøtzsche co-authored a paper with a known antivaxxer against the Covid-19 vaccine.
- Claiming (without reference) that "More young Australians are taking antidepressants, and more young Australians are killing themselves and self-harming, often by intentionally overdosing on the very substances that are supposed to help them." First of all: where's the evidence for that statement? How do you know they're overdosing on antidepressants specifically? Second of all: um, no. The suicide rate fluctuates but has been consistently going down since the 70s, and there has been a downward trend since 2019 specifically.
- Using a study that implies gender-affirming healthcare doesn't work (https://pubmed.ncbi.nlm.nih.gov/36832...) that is "scientifically and methodologically flawed" (https://pmc.ncbi.nlm.nih.gov/articles...)
I don't have the theoretical background to know for sure if Timimi was misrepresenting things, but I found the above points in a 15-min skim and Google. Essentially, Timimi lost all my trust at that point and I stopped reading.
April 1, 2026
Timimi presents sensible and solid information that includes case studies, research, and personal anecdotes. It's a refreshing read - aside from his extensive discussion of perspectives outside his expertise, including history, sociology, and literature. Unfortunately, he is so convinced of the Truth and Preeminence of Marxism that his insight and commonsense regarding psychiatry and psychotherapy is compromised.
I had to take a few breaks, grit my teeth and carry on through the tedious politically-informed sections in order to finish what I would otherwise have recommended as a "good read".
For me, this is a first class example of how certain academic fields have taken it upon themselves to weave ideological beliefs into their fields so that indoctrinated students proceed to unwittingly promote political dogma throughout their careers.
I had to take a few breaks, grit my teeth and carry on through the tedious politically-informed sections in order to finish what I would otherwise have recommended as a "good read".
For me, this is a first class example of how certain academic fields have taken it upon themselves to weave ideological beliefs into their fields so that indoctrinated students proceed to unwittingly promote political dogma throughout their careers.
July 8, 2025
valuable and interesting exploration of how capitalism and for-profit medicine influence people's individual health journeys and even understanding of themselves and their intersecting identities. major marks off though for a misguided section on transgender identity which focuses heavily on the tiny population of people who have de-transitioned, at the expense of the many whose lives have been saved by gender affirming care. I think there's absolutely something to be said for understanding gender as a culture-bound phenomenon, and Dr Timimi does not come across as a bigot here but does seem to fall for some anti-trans talking points common to UK culture. I hope he revisits this portion of the book with deeper understanding.
January 11, 2026
A book railing against the current mental health paradigm, written by a psychiatrist, who operate from the DSM, a book literally bought and paid for by drug companies.
I had zero respect for the guy throughout the book. I've sat with far too many families impacted by the devastation of neurodivergence. A child beating his head against the wall is not a social construct. For anyone who has worked with families and situations affected by this, you understand the absurdity of his arguments.
So why the two stars? He did have some valid points regarding overdiagnosis of behaviour that may be a natural part of the cycle of life's ups and downs. But it's a hell of a slippery slope as to where this line is actually drawn.
I had zero respect for the guy throughout the book. I've sat with far too many families impacted by the devastation of neurodivergence. A child beating his head against the wall is not a social construct. For anyone who has worked with families and situations affected by this, you understand the absurdity of his arguments.
So why the two stars? He did have some valid points regarding overdiagnosis of behaviour that may be a natural part of the cycle of life's ups and downs. But it's a hell of a slippery slope as to where this line is actually drawn.
March 24, 2026
This is the strongest and most comprehensive assessment I have read thus far of our current mental health system and the societal constructs that have built it. I’ve read a few books on this topic over the last couple of years owing to my fascination with the rapid increase in what my father (a behavioural paediatrician for 40 years) used to call “label-itis.” In a society that seems determined to celebrate diversity and inclusivity and acceptance, we are more married to our labels and diagnoses than ever before. I loved reading Timimi’s take on this culture of over-pathologizing. Thorough without being radical.
September 28, 2025
The book is a good summary about what is going wrong and how we could probably change it. One major problem is that the industry is making a lot of money by using psychiatric diagnosis. This of course implies a capitalistic motivation. And because capitalism is a social construct, the models of diagnosis are also a social construct. We must be aware that we even fail to build a definition of 'what is normal' respective mental health, because we always drift away into subjectivity.
June 24, 2025
An interesting read, I liked the way this book was put together with real-life examples and conversations. For me it felt a little longer than it needed to be though.
Thank you to Vintage for sending me a copy.
Thank you to Vintage for sending me a copy.
November 11, 2025
I thought this was an extremely well written and fascinating book. I can totally see why it would be polarising but I really think that those people who absolutely hate it are just misunderstanding what he is trying to say.
December 8, 2025
This was really good and would defo recommend everyone to read. The author is just a bit irritating at times, but that’s expected from a male psychiatrist. Still very good ideas and interesting theories that I do agree with
February 9, 2026
This was a very interesting book. The introduction of the case studies was pleasant and brought different perspectives. Having multiple people in my life on the neurodiversity spectrum helps me understand multiple aspects of their reality. I found the book ran long and overexplained certain points, even though I enjoyed the material, which was based on science and well-researched studies. A great part of the book felt like one long research paper.
January 30, 2026
The best book I have read on this topic
Wonderfully clear explanation about how and why psychiatric diagnoses have been created. The absence of underpining science, how they reflect and serve the social and economic context we live in and why they are not just wrong but harmful. A great read for the general readers and those working in health alike.
Wonderfully clear explanation about how and why psychiatric diagnoses have been created. The absence of underpining science, how they reflect and serve the social and economic context we live in and why they are not just wrong but harmful. A great read for the general readers and those working in health alike.
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