Discussion with Stijn Vanheule on issues with the scientific status of classificatory psychiatric diagnosis and its reductionist impact on discussions about mental health problems in the general public. During this session we also address how psychoanalytic case-by-case construction provides a relevant alternative to this. From a Lacanian perspective, diagnosis is not concerned with disorders and makes no ontological claims. Instead, it should be conceptualized in terms of how the Real, the Imaginary, and the Symbolic function. This discussion was facilitated by Dr Leon Brenner and joined in with Derek Hook.