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Awais Aftab

Awais Aftab

@awais-aftab · 17 positions · On ppll ↗

Psychiatrist and clinical assistant professor at Case Western Reserve University. Writes Psychiatry at the Margins on the philosophical and scientific debates inside psychiatry and the psy-sciences.

Awais Aftab did not write this page.

We collected these quotes from things they published elsewhere, and every quote links to where it was said. They have no account here and have not endorsed this site. Quotes are word for word; the short line under each one is our own restatement, not their wording. Their own site. Is this you? Claim it or ask us to remove it. Or tell us what is wrong here.

The ideas Awais Aftab's claims keep coming back to. The labels are ours; every quote is Awais Aftab's own words.

Holds now (4)

See how these views changed over time, 2025–2026
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2025 1 views
4First seen · 3 claims A diagnosis acts on the person, and the DSM has not earned its authority
2026 +3 new
4Still held · 4 claims A diagnosis acts on the person, and the DSM has not earned its authority
3New · 3 claims Help the patient who wants it; sides in an argument are not the patient
1New · 4 claims No approach to mental health care is more than highly imperfect
2New · 3 claims When options are scarce, the easiest one gets overused

Each column is a stretch of time in which the same views came up; a new column starts when one appears or goes quiet. Quiet means nothing on it in our sources for that stretch, which is not the same as a change of mind; Dropped means they said they no longer hold it; tap the card for which claim and when. Revised means the view carries on but one of its claims was dropped. Each row is one view, in the same place all the way along. The number is how many claims in that stretch; we hold 3 in 2025, 14 in 2026.

1No approach to mental health care is more than highly imperfect

Our label. 4 claims in Awais Aftab's own words.

Mental-health treatments remain highly imperfect tools that are increasingly relied on in situations where their use isn't truly necessary.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… We have highly imperfect tools at our disposal, and more and more we rely on these tools in situations where their use is less-than-necessary. Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com · 19 Sept 2026All korrents from this piece
    Their wordsWe have highly imperfect tools at our disposal, and more and more we rely on these tools in situations where their use is less-than-necessary.

    ↗Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com

    19 Sept 2026

No approach to mental healthcare exceeds being highly imperfect, and anyone claiming otherwise is dishonest or mistaken.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… Anyone selling you anything better than 'highly imperfect' in the realm of mental healthcare is a fool or a grifter. Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com · 19 Sept 2026All korrents from this piece
    Their wordsAnyone selling you anything better than 'highly imperfect' in the realm of mental healthcare is a fool or a grifter.

    ↗Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com

    19 Sept 2026

Treating optional, contributory medical authority as mandatory and overriding erodes people's capacity to cope with suffering through non-medical means.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… When we start treating weak norms of consultation as strong norms, when we assign preemptive authority in areas where only contributory authority is justified, when we destroy traditional cultural means of support to shunt people into medical treatment, we erode people's capacity to meet suffering with the resources they already have or could have had outside medicine. Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com · 19 Sept 2026All korrents from this piece
    Their wordsWhen we start treating weak norms of consultation as strong norms, when we assign preemptive authority in areas where only contributory authority is justified, when we destroy traditional cultural means of support to shunt people into medical treatment, we erode people's capacity to meet suffering with the resources they already have or could have had outside medicine.

    ↗Maybe Don’t Ask Your Doctor if Zoloft Is Right for Youpsychiatrymargins.com

    19 Sept 2026

Psychiatry's confidence in its theories of mind and brain exceeds the evidence supporting them.

Mental modelWhat counts as evidence

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… Psychiatry has unearned confidence in both its theories of mind and its theories of brain. The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com · 12 Sept 2026All korrents from this piece
    Their wordsPsychiatry has unearned confidence in both its theories of mind and its theories of brain.

    ↗The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com

    12 Sept 2026

2When options are scarce, the easiest one gets overused

Our label. 3 claims in Awais Aftab's own words.

When supply of most treatments in a care system is constrained, overuse concentrates on the few treatments that remain easily available, rather than reflecting excess care overall.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… The problem with medical and psychiatric care is not necessarily that we do too much but that we do too much of some things because we have constrained the supply of all the other things. I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com · 26 Sept 2026All korrents from this piece
    Their wordsThe problem with medical and psychiatric care is not necessarily that we do too much but that we do too much of some things because we have constrained the supply of all the other things.

    ↗I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com

    26 Sept 2026

In healthcare systems, it is easier to obtain a prescription than to get attentive, thorough clinical care from a physician.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… It is relatively easy to ask for and be prescribed medications, but quite difficult to see a physician who actually cares and listens and thoughtfully attends to diagnostic work-up and treatment risks and patient concerns. I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com · 26 Sept 2026All korrents from this piece
    Their wordsIt is relatively easy to ask for and be prescribed medications, but quite difficult to see a physician who actually cares and listens and thoughtfully attends to diagnostic work-up and treatment risks and patient concerns.

    ↗I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com

    26 Sept 2026

When patients have access to a full range of treatment options, medication becomes one deliberate choice among many rather than a default fallen into out of desperation.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… When a patient has ready access to a full range of options, then medication becomes one tool among many, chosen deliberately, not defaulted to out of desperation. I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com · 26 Sept 2026All korrents from this piece
    Their wordsWhen a patient has ready access to a full range of options, then medication becomes one tool among many, chosen deliberately, not defaulted to out of desperation.

    ↗I Believe in a Radical Abundance of Relational Carepsychiatrymargins.com

    26 Sept 2026

3Help the patient who wants it; sides in an argument are not the patient

Our label. 3 claims in Awais Aftab's own words.

Uncertainty about a disease's underlying mechanism does not excuse withholding treatment from patients who want it.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… But not knowing is not a license to do nothing - to tell patients, well, come back in a decade and maybe we can help. The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com · 12 Sept 2026All korrents from this piece
    Their wordsBut not knowing is not a license to do nothing - to tell patients, well, come back in a decade and maybe we can help.

    ↗The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com

    12 Sept 2026

In providing care, there are no ideological sides — only the patient and what actually helps them.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… When it comes to providing care that helps patients, there are no sides. There is only the patient; the illness or disorder disrupting the patient's life and the lives of loved ones; and, in the case of mental illness and infectious disease, the question of whether that illness adversely affects the broader community. The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com · 12 Sept 2026All korrents from this piece
    Their wordsWhen it comes to providing care that helps patients, there are no sides. There is only the patient; the illness or disorder disrupting the patient's life and the lives of loved ones; and, in the case of mental illness and infectious disease, the question of whether that illness adversely affects the broader community.

    ↗The Lawsuit That Came to Symbolize the Fall of Psychoanalytic Psychiatry: Eric Caplan on Osheroff v. Chestnut Lodgepsychiatrymargins.com

    12 Sept 2026

A prescriber cannot outsource containment to the therapy hour: the emotional and relational dynamics are part of prescribing, not an intrusion on it.

Mental modelThe therapeutic alliance

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… The emotional and relational dynamics are not an intrusion upon the work of prescribing. They are a part of the work itself. The Fantasy of Being "Just" a Psychiatric Prescriberpsychiatrymargins.com · 5 Jul 2026
    Their wordsThe emotional and relational dynamics are not an intrusion upon the work of prescribing. They are a part of the work itself.

    ↗The Fantasy of Being "Just" a Psychiatric Prescriberpsychiatrymargins.com

    5 Jul 2026

4A diagnosis acts on the person, and the DSM has not earned its authority

Our label. 7 claims in Awais Aftab's own words.

The Rumpelstiltskin effect claims only that the act of being diagnosed can itself help, not that a diagnosis is a net good for the patient.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… The Rumpelstiltskin effect is not a claim that receiving a diagnosis is a net benefit or a net positive. It is a claim that the mere act of receiving a diagnosis can be beneficial. The Principle of Rumpelstiltskin: Psychiatrists and Witchdoctorspsychiatrymargins.com · 25 Jul 2026
    Their wordsThe Rumpelstiltskin effect is not a claim that receiving a diagnosis is a net benefit or a net positive. It is a claim that the mere act of receiving a diagnosis can be beneficial.

    ↗The Principle of Rumpelstiltskin: Psychiatrists and Witchdoctorspsychiatrymargins.com

    25 Jul 2026

Clinical diagnosis can have a therapeutic effect independent of any other intervention.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… Their experiences highlight a striking, neglected and unchristened medical phenomenon: The therapeutic effect of a clinical diagnosis, independent of any other intervention, where clinical diagnosis refers to situating the person's experiences into a clinical category by a clinician or the patient. The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org · 22 Aug 2025All korrents from this piece
    Their wordsTheir experiences highlight a striking, neglected and unchristened medical phenomenon: The therapeutic effect of a clinical diagnosis, independent of any other intervention, where clinical diagnosis refers to situating the person's experiences into a clinical category by a clinician or the patient.

    ↗The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org

    22 Aug 2025

Diagnoses that have therapeutic effects are medical interventions and should be treated and researched as such.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… If a clinical diagnosis can have a therapeutic effect, then, at least in some instances, diagnoses are medical interventions in themselves and ought to be treated and researched as such, with an eye to both positive effects and potential iatrogenic harms. The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org · 22 Aug 2025All korrents from this piece
    Their wordsIf a clinical diagnosis can have a therapeutic effect, then, at least in some instances, diagnoses are medical interventions in themselves and ought to be treated and researched as such, with an eye to both positive effects and potential iatrogenic harms.

    ↗The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org

    22 Aug 2025

Self-diagnosis is an attempt to secure the therapeutic effect of a medical intervention patients cannot officially access.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… Likewise, self-diagnosis should be understood as an attempt to secure the therapeutic effect of a medical intervention to which patients do not have official access. The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org · 22 Aug 2025All korrents from this piece
    Their wordsLikewise, self-diagnosis should be understood as an attempt to secure the therapeutic effect of a medical intervention to which patients do not have official access.

    ↗The Rumpelstiltskin effect: therapeutic repercussions of clinical diagnosis (with 1 co-authors)doi.org

    22 Aug 2025

The DSM does not deserve the respect and authority currently given to it.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… I do not believe that DSM deserves the respect and authority we bestow on it. Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com · 4 Sept 2026All korrents from this piece
    Their wordsI do not believe that DSM deserves the respect and authority we bestow on it.

    ↗Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com

    4 Sept 2026

The DSM's revision process has no consistent standard for when practical or political consequences should be allowed to override the available evidence.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… There is no consistency, no respect for evidence, no clear bar for when downstream implications matter and when they don't. Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com · 4 Sept 2026All korrents from this piece
    Their wordsThere is no consistency, no respect for evidence, no clear bar for when downstream implications matter and when they don't.

    ↗Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com

    4 Sept 2026

Restructuring the DSM's chapter organization to add categories like a postpartum chapter is blocked only by self-imposed rules and conventions, not by any deeper constraint.

  1. Awais Aftab Psychiatrist and clinical assistant professor at Case… The only thing stopping the DSM is a bunch of self-imposed rules and conventions. Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com · 4 Sept 2026All korrents from this piece
    Their wordsThe only thing stopping the DSM is a bunch of self-imposed rules and conventions.

    ↗Postpartum Psychosis and Diagnostic Sclerosispsychiatrymargins.com

    4 Sept 2026