DSM

I came across an interesting article the other day. It Is Time to Rename the DSM, by Bruce A. Thyer, PhD, Florida State University, Ethical Human Psychology and Psychiatry, Vol 8, No. 1, Spring 2006 Dr. Thyer points out that although the DSM claims to be atheoretical, its contention that the various “mental illnesses” reside within the individual, as opposed, for instance, to being understandable reactions to adverse life events, is in itself a theoretical stance. Dr. Thyer also points out that in the manual’s description of conduct disorder there is a little known (and in my experience even less used) caveat to the effect that this so-called diagnosis should not be assigned if the misbehavior is “…simply a reaction to the immediate social context.” This is laudable, of course, on the part of the APA, but Dr. Thyer goes on to pose the obvious question: Why is this exclusion not applied to all the conditions listed? He then answers his own question: Because “…if this practice was followed, the very concept of mental disorders threatens to evaporate, in favor of viewing these as environmentally driven phenomena.” ...

Daniel Carlat’s blog carries an interesting item. It seems that a lady named Suzy Chapman started a site called dsm5watch, in which she expressed criticism of the DSM. Well, the APA didn’t like this and sent her a cease and desist letter, claiming that the string “DSM-5” is trademarked, and that she was infringing their rights. She complied, changing the name of her site to dxrevisionwatch. What I find interesting here is that the APA claim to be interested in public comment. I guess as long as it doesn’t get too critical. ...

Every society in every generation makes errors. Some of the errors are minor. Some are major. One of the great errors of the 20th century was this: we accepted the spurious notion that a wide range of life’s problems were in fact illnesses. This spurious notion was initiated with good intentions – to provide shelter and humanitarian care for a relatively small number of individuals whose plight was truly dreadful. But then the concept of mental illness took off, fuelled largely by the efforts of psychiatrists to legitimize their status as “real” doctors. ...

The central theme of this blog is that almost all the so-called mental illnesses listed in the APA’s Diagnostic and Statistical Manual are nothing more than the ordinary everyday challenges of human existence. The psychiatric profession has “elevated” these problems to the status of disorders and illnesses to justify and legitimize their involvement in these areas, and in particular to justify the use of drugs to alter people’s moods and actions. Psychiatry – once a respectable helping profession – has degenerated into something little better than drug pushing. The real winners, of course, are the pharmaceutical companies, who use the psychiatrists and other mental health professionals to promote the widespread drugging of the population. The DSM’s so-called sexual disorders represent a particularly blatant example of psychiatric invention. ...

The central theme of this blog is that there are no mental illnesses. The concept of mental illness is a spurious invention of psychiatrists and other mental health professionals for the purpose of medicalizing normal human problems and selling drugs. The central tenet of the mental health system is that unusual, bizarre, and disturbing behaviors are caused by mental disorders (or illnesses). But their definition of a mental disorder is: a serious behavioral problem. So problem behavior is caused by problem behavior. This is the facile logic behind the widespread peddling of drugs in which psychiatry and the mental health system engage. ...

The central theme of this blog is that mental illness is a spurious and invalid concept, which is promoted and developed by the American Psychiatric Association to legitimize the use of mood-altering drugs. It is certainly true that people display various problems in their daily lives and particularly in their interpersonal relationships. The American Psychiatric Association claims that all such problems are caused by mental illness and their list of these so-called illnesses is so long that virtually anybody can be embraced within their coils. ...

CONDUCT DISORDER The essential feature of Conduct Disorder, according to the APA, is a “repetitive and persistent pattern” of rule breaking or activity which violates other people’s basic rights. The manual identifies four broad categories of behavior under this heading: aggression; destruction of property; theft or deceitfulness; and serious violation of rules. DSM goes on to state that individuals with this disorder display little concern for the feelings or welfare of others, are frequently callous and indifferent to other people’s pain and loss, and show little in the way of feelings of guilt or remorse. Poor frustration tolerance, irritability, temper tantrums, and recklessness are cited as frequently associated features. ...

The notion of a professional group such as the APA sitting in their councils and committees inventing illnesses for themselves to treat seems so preposterous that a measure of disbelief on the part of the reader is understandable. In its historical context, however, the development is not so surprising. The original 1952 DSM was very simple and unpretentious, and whilst part of the APA’s motivation in drafting the document was undoubtedly to draw some credibility and respectability to their profession, there is at the same time nothing to suggest any great drive at that time towards aggrandizement or service expansion. However, having agreed in 1952 that neurosis was a form of mental disorder, it was inevitable that subsequent revisions of the manual would attempt to define this feature further and look for subdivisions of the general category. This, of course, is exactly what has happened, and the current version of DSM lists literally dozens of disorders of this sort, although the general term neurosis is no longer used. (For an interesting discussion of this matter, see Karen Franklin’s post at In The News.) ...