If the basic logic of the DSM is flawed, it should be abandoned. Instead, psychiatrists should move towards a system that looks at an individual’s mental experiences in context, alongside their unique developmental vulnerabilities and strengths, as the main source for analysing and responding to their distress. Diagnosis would no longer name a disorder but map what kinds of support, relationships and learning processes are most likely to help a person regain agency, coherence and a sense of future.
A good therapist, psychologist and psychiatrist treat the person anyway, the DSM is just a guide.
For example: If a person with Emotional Dysregulation gets a Borderline Personality Disorder diagnosis based on 5 or 7 criteria on the list the therapy is going to focus on their key issues. And let’s say they aren’t a cutter, the therapist isn’t going to say hey let’s discuss anti self harm strategies, if that person doesn’t self harm.
Also its not fake science it is statistics, which is a real science and is in the title of the manual.