Protocols for Personhood: Expanding the Scope of Diagnostic Frameworks

Title (same as in your application form)

Protocols for Personhood: Expanding the Scope of Diagnostic Frameworks

Team member names

Sam Diamond
Bazil Azmil

Short summary of your improvement idea

This proposal aims to broaden the scope of psychiatric diagnosis beyond its current medical context by creating a supplementary meta-protocol to support self-understanding.

We recognize the increasing reliance on diagnostic protocols for self-understanding and propose the creation of a new, transdisciplinary mode of diagnosis that incorporates insights from non-medical protocols such as personality tests and crowdsourced feedback from online diagnostic communities. By exploring and combining these diverse approaches, we seek to create a more expansive framework for self-understanding and subject formation beyond the binaries of well/unwell and healthy/sick.

The last decades have seen an acceleration in the adoption of diagnostic protocols. Examples include medically approved psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM); regulated online medical resources such as WebMD and Healthline; technology companies that supply self-diagnosis and symptom-checking services such as Ada; personality maps such as the Myers–Briggs Type Indicator (MBTI) and the Enneagram of Personality; and community-sourced diagnosis through channels such as Reddit, TikTok, and Quora. There has been an accompanying expansion of the diagnostic field, both within and beyond the established medical terrain. Whereas previously there was a limited number of conditions one might be diagnosed with, such as depression or anxiety, there is now an expansive list of diagnostic categories, personality disorders, and personhood types: one might be suffering from limerence or be labelled with Pathological Demand Avoidance (PDA), for example, while frameworks such as attachment theory come with their own myriad categories of relational styles.

While they encompass many seemingly disparate areas, from accredited mental and physical health diagnoses to corporate organization models to online community association, these protocols all reflect a will toward self-understanding, with the meta outcome of creating new categories of people. As people increasingly look to protocols for orientation and self-realization, the corollary effect is protocol-formed people, a phenomenon the late Canadian philosopher Ian Hacking has described as “making up people.” What if the diagnosis protocol for these categories could be changed to encompass positive or neutral states? What if the recent increase in demand for diagnosis has opened a path for creating new types of people?

We plan to trace the recent history of the phenomenon of diagnostic category expansion before offering a comparison of diagnostic protocols, considering methodological differences and outcomes as tools for subject creation. We will then consider how to create a mode of protocolized diagnosis that fuses the strengths of these protocols and recognizes their status as engines of person-creation rather than cameras that capture a priori categories of personhood, to be thought of as a meta mode of diagnosis that combines existing categories and protocols to create a more comprehensive, less pathologizing model for self-understanding. We will use as inspiration the transdiagnostic approach of The Unified Protocol (UP), which “targets shared underlying mechanisms of all emotional disorders, thereby offering a single treatment that can be used across the most common clinical presentations.”

Answers to the following questions. Please structure the body in explicit Q&A form.

What is the existing target protocol you are hoping to improve or enhance? Eg: hand-washing, traffic system, connector standards, carbon trading.

Wide-scope pathology diagnosis.

What is the core idea or insight about potential improvement you want to pursue?

We aim to expand psychiatric diagnosis into a broader rubric for self-understanding and subject formation, leveraging insights from non-medical diagnostic protocols.

The current form of psychiatric diagnosis, while medically indispensable, can potentially be expanded to become a wider rubric for self-understanding and a looser and more positive mode of subject formation.

A new framework for self-diagnosis could implement learnings from diagnostic protocols from non-medical/psychiatric areas, such as personality categorization tests and social media communities. This protocol would not seek to replace or compete with existing psychiatric protocols but offer a more expansive rubric for self-understanding and subject creation. Furthermore, it would treat these categories as unfixed and malleable, with the aim of facilitating self-learning and self-understanding rather than restrictive pathologization.

What is your discovery methodology for investigating the current state of the target protocol? Eg: field observation, expert interviews, historical data analysis, failure event analysis

  • Review existing literature on the history of diagnostic protocols, focusing on the evolution of the DSM and the more recent creation of the UP.
  • Compare a wide range of diagnostic protocols qualitatively, mapping their differences and outcomes, informed by empirical research studies.
  • Conduct expert interviews with psychiatrists, psychotherapists, psychoanalysts, and members of online diagnostic communities.

In what form will you prototype your improvement idea? Eg: Code, reference design implementation, draft proposal shared with experts for feedback, A/B test of ideas with a test audience, prototype hardware, etc.

We will create a draft proposal for this diagnosis protocol contextualized by a research essay, which will be shared with field experts for feedback. We will also test the protocol on subjects to collect empirical results and compile case studies.

How will you field-test your improvement idea? Eg: run a restricted pilot at an event, simulation, workshop, etc.

We will gather feedback from experts and stakeholders in the field, including psychotherapists, psychoanalysts, psychiatrists, and psychologists, as well as online forum contributors and moderators and professionals from companies like WebMD, to refine our proposal and ensure its practical applicability.

Who will be able to judge the quality of your output? Ideally name a few suitable judges.

Suitable judges include working professionals and academics from psychiatry, psychology, social sciences, as well as members of online communities.

  • Jessica Ocean, Psych Crisis
  • Saskia Wolfaardt, practising clinical psychologist
  • David H. Barlow, Kristen K. Ellard, and Christopher P. Fairholme, authors of The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders
  • Toby Shorin, Care Culture

How will you publish and evangelize your improvement idea? Eg: Submit proposal to a standards body, publish open-source code, produce and release a software development kit etc.

A draft workbook of the protocol will be designed and published, to be distributed free of charge and submitted for extensive feedback from professionals. An accompanying web version of the draft protocol will also be published. Supplementary case studies will be supplied. It will be emphasized that this protocol is not to be used as a replacement for medical treatment.

What is the success vision for your idea?

The protocol’s adoption as a tool for self-understanding, with the related goal of expanding the scope and structure of diagnostic protocol creation.


I’d be interested to see how protocols for diagnostics in “self-directed” medicine could establish greater community (and clarity) in the practice. It’s an interesting area for intervention.