A collection of articles on the DSM in the news today and recently. We’re watching a house come down!! It looks like the publication of DSMV is — not at all by design — turning into a watershed event.
From Dr. Cacciatore: ”According to the ethical standards of our discipline, social workers have a duty to act on the behalf of those we serve. In particular, we have a responsibility to influence peripheral forces that would further harm vulnerable populations…. We must also speak up for the many other people—especially children—who will be over-diagnosed by DSM-5 and may receive harmful and unnecessary medications that can cause huge weight gains. Social workers should protect people from being medicated when they don’t need it and from the stigma of being labeled with illnesses they don’t really have.”
Jeffrey Lieberman, incoming president of the APA, responds to criticism of the DSM and psychiatry, saying “it’s important to understand the difference between thoughtful, legitimate debate, and the inevitable outcry from a small group of critics – made louder by social media and support from dubious sources — who have relentlessly sought to undermine the credibility of psychiatric medicine and question the validity of mental illness.” (borrowed from MIA) — read the article here (make sure to take a look at the comments which are far more in touch with what is going on than the article.)
Sadly the new president of the APA not only seems to lack any understanding about why people are critical of psychiatry, he further maligns and discredits and lies about the many 1000s of us who’ve been gravely harmed…clearly this is not a move in the right direction for the American Psychiatric Association. It’s rather darkly humorous to see just how out of touch with reality the man is.
So now there is a brilliant response to Lieberman’s babbling by Judy Stone. A must read:
Frankly, I’m appalled by Lieberman’s post, especially as it was invited. Although masquerading as a reasoned critique, it is anything but that. Rather, the piece is self-promotional and condescending.
Rather than respond to critics of the APA’s new Diagnostic and Statistical Manual of Mental Disorders, aka DSM-5, the Bible of psychiatry with sound arguments,Lieberman stoops to disparaging characterizations of critics as “real people who don’t want to improve mental healthcare,” and that he, as Professor and president-elect of the APA, is in a far better position to understand and solely make decisions….
Update: (go to this first post about Hearing Voices Network to first read the story of Jacqui Dillon, Hearing Voices Chair. Our lived experience matters. Right now those of us harmed by the DSM are denied and we were harmed by previous DSMs not this one!!)
“The Hearing Voices Network in England has issued a position statement on DSM 5 and the wide issue of psychiatric diagnoses following last week’s debate on the need for a new paradigm in mental health services, reported largely as a ‘turf war’ between psychiatry and psychology. Concerned that this debate can all too easily sound ‘academic’ and miss the voices of the very people these systems impact upon – those diagnosed with mental health problems – HVN are taking the debate back to the people.
“We believe that people with lived experience of diagnosis must be at the heart of any discussions about alternatives to the current system.”
DSM: Letting Go of the Big Lie — DxSummit.Org
When I was trained as a psychologist, I was told by our chief clinical instructor never, ever to lie to a patient. Lying was an ethical breach, I was warned. One should be tactful, to be sure. But like George Washington, we must never tell a lie. Another instructor, however, told the class that we all lie to our patients. Of course we lie, he said. Lying is part of life, part of the warp and woof of human interaction. Yet another professor, apparently of a similar stripe, informed us that he found it most expedient for billing purposes to assign every one of his patients the same diagnosis (Generalized Anxiety Disorder) because its definition is so broad almost anyone with problems in living fits it, and after all, psychiatric diagnosis is largely a fabrication anyway. For him, lying was what you had to do to make a living.
When I entered the field as a fully trained psychologist, the lies I encountered did not end but metastasized….
Why the Fuss Over the D.S.M.-5? New York Times
“So why the fuss over D.S.M.-5? Because of the unwarranted clout that its diagnoses carry with the rest of society: They are the passports to insurance coverage, the keys to special educational and behavioral services in school and the tickets to disability benefits.
This is a problem because the D.S.M. is an imperfect guide to predicting what treatments will benefit patients most — a reality tied to the fact that psychiatric diagnoses are based on clinical appearances that tend to cluster, not on the mechanism behind the illness, as is the case with, say, bacterial pneumonia.”
“Western psychiatry is in crisis. The direction taken by the new Diagnostic and Statistical Manual of Mental Disorders (DSM 5), due to be published later this week, has received ample criticism. Moreover, in disagreement with the American Psychiatric Association, the United States National Institute of Mental Health (NIMH), the world’s largest research institute, has announced they will no longer fund projects based exclusively on DSM categories. Unfortunately, while Mental Health Europe considers the NIMH decision to be the right one, by focusing almost entirely on neuroscience and on so-called disorders of the brain, the NIMH is missing out on the critical importance of user experiences to psychiatric research and to the practice of psychiatry”
“Over the course of my life, I have been given no fewer than five different diagnoses for mental illnesses, under the diagnostic system laid out in psychiatry’s “bible,” the DSM. But it was a sixth diagnosis— one that ironically will no longer appear in the edition being rolled out this week, DSM-5— that probably most accurately describes what is genuinely different about me. I’m sharing this because my experience is a case study for explaining why the latest revision to the manual is raising such ire.”
“Thousands of psychiatrists will descend on San Francisco this weekend for a meeting that will mark the release of the latest edition of the profession’s diagnostic guide, the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short. This hugely influential book has been 14 years in the making, and it’s been dogged by controversies every step of the way.”
It’s been nearly 20 years since the American Psychiatric Association’s survey of mental disorders—better known as the Diagnostic and Statistical Manual, or DSM for short—last saw a major revision. With the long-awaited fifth edition to be released later this month, psychoanalyst Gary Greenberg’s The Book of Woe: The DSM and the Unmaking of Psychiatry is both timely chronicle and scathing critique. He argues that the field of psychiatry is overdiagnosing and overprescribing and must narrow its mission in order to survive. Documentary filmmaker Mitch McCabe joined Greenberg in conversation at Politics & Prose.
Humanizing Mental Health: Existentialism and the DSM-5 — Dx Summit.org
With global and economic upheaval pushing people (and institutions) to the edge, perhaps the time is ripe for a new era of humanistic psychology to infuse every field that’s interested with awareness of existential humanistic values of self-responsibility, unconditional regard, and empathic engagement, woven, with intentionality, into internal institutional templates and approaches to corporate culture. It could make a world of difference in work-life meaning, contributing to workplace happiness and productiveness.
Allen Frances continues to beat the drum of dissent against the DSM5 too, but I can’t really take the man very seriously since he seems to think the DSM IV which he oversaw, is a fine text. I find his rhetoric against the DSM 5 rather hard to swallow for that reason. The DSM has been fatally flawed from the beginning and all that Frances warns about with the DSM5 has already been happening for a long time with the DSM he himself fathered. In any case if you want to follow his blog it’s here. I find his credibility lacking. At the very least his stance seems disingenuous. Anyway, there is also a Mother Jones article in which he is interviewed with the entertaining title: Psychiatry’s New Diagnostic Manual: “Don’t Buy It. Don’t Use It. Don’t Teach It.”
And another one with Allen Frances with a good title: Millions of people who went to sleep last night thinking they were normal woke up this morning with a new mental disorder. Lets remember all the other many millions of us who already had inappropriate diagnosis too.
This is a start to this post. I’m going to continue adding to it today and for the next week or so…enjoy and check back often.
And for other posts on the DSM over the course of the last few years see the DSM category page.