How harm was justified at the time

It is comfortable to read the field’s historical failures as the errors of unenlightened people. They were not. Aversion therapy for homosexuality was delivered by clinicians who believed they were relieving suffering, within a diagnostic framework endorsed by their profession, with the consent of patients who had been told their identity was a disorder.

The recurring structure

1. 1A theory identifies something as pathological.
2. 2The theory is endorsed by the profession, which confers authority.
3. 3Treatment follows logically from the theory.
4. 4Patients who object are understood as resistant, or as symptomatic.
5. 5Dissenting clinicians are marginal and are treated as unscientific.
6. 6The correction, when it comes, comes substantially from outside the profession — from patients, from activists, from courts.

Current candidates

Reasonable people disagree about what will look wrong in fifty years. Candidates currently argued in the literature include: coercive detention and treatment; the diagnosis and medication of children; applied behaviour analysis for autistic people, criticised by many autistic adults who received it; the routine pathologising of grief; the treatment of distress caused by poverty as an individual disorder; and the digital collection of mental health data with minimal consent.