NIMH’s Insel Doubles Back on
Backing Away from DSM-5

Kermit Cole
11
354

Two weeks ago NIMH director Thomas Insel issued a statement in which he said that the DSM “weakness is its lack of validity” and that “Patients with mental disorders deserve better.” On May 6 Chairman of the DSM05 Task Force David Kupfer wrote “We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.” Today Insel and APA president-elect Jeffrey Lieberman released a joint statement, saying that the DSM “represents the best information currently available for clinical diagnosis of mental disorders. Patients, families, and insurers can be confident that effective treatments are available and that the DSM is the key resource for delivering the best available care.”

Article →

Previous articleMan Jumps, News at…?
Next articleDxSummit Officially Launches
Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

11 COMMENTS

  1. The problem is that Insel said what he said, and Kupfer said what he said. Both statements are going to be there to haunt them in the future. It will not be possible anymore to dismiss as “anti psychiatry nonsense” those who say “the weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure” or “We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting”.

    I can only speculate that probably Insel was threatened to agree to this travesty if he wanted to continue to keep his job. Problem? It is impossible to retract what Insel said, that was agreed to by Kupfer in what seemed like a panicked reaction. So this joint statement is an attempt at squaring a circle that doesn’t really cut it.

    • I totally agree that this is insulting, bogus damage control and an insult to those seeing through it.

      The truth is that the DSM has been known to be bogus, unreliable, invalid junk science, pseudoscience created by psychiatry when it sold out to BIG PHARMA in the 1980’s to give them a bogus medical aura when Freudian analysis waned and the so called profession was dying with lots of competition from other therapists. Bob Whitaker and Dr. Peter Breggin explain how this horrific eugenics agenda came about and it certainly had nothing to do with improving the mental health of their many victims.

      Plus, it is also obvious that psychiatry exists for the nasty political purpose of social control to serve as part of the increasingly fascist BIG BROTHER military state to keep any dissidents or those challenging anyone in power in line with the threat of loss of all human, civil, democratic rights with forced poisoning and jailing in the guise of mental health.

      So, it was nice to have the truth validated by Insel briefly, but I sure don’t need him or anyone else to convince me that the DSM is the most vile, self serving fraud to perpetrate the worst human rights abuses and medical crimes against humanity along with the toxic drugs, ECT and other tortures the fraudulent DSM of VOTED IN stigmas unleashed on normal humans by medicalizing typical life stressors, crises, losses and other challenges.

      Further, this statement says it all. The mental death profession operates by their own consensus and such consensus by a group of the worst ethically challenged people with huge conflicts of interest holds no credibility for me.

    • It seems obvious that Insel took part in this weasel-worded exercise in psychiatric ad copy because to avoid completely alienating the APA power structure. Those emperors wanting to protect their non-existent clothes aside, this is really a hilarious bit of writing. Insel doesn’t really take back any of the main points in his piece; and by signing on to this one, his APA buddy is tacitly agreeing with much of Insel’s first piece.

      The funniest sentence in this “non-retraction retraction”:

      “DSM-5 … reflects the scientific progress seen since the manual’s last edition was published in 1994.”

      Since virtually nobody thinks DSM 5 is really better than DSM 4, they must be saying there hasn’t BEEN any “scientific progress” since 1994.

  2. BTW, those willing to send a note to Insel, below is the link with his email address and my own note.

    Dear Dr Insel,

    First of all, I apologize for this anonymous email . I found your address here,

    http://hr.od.nih.gov/workingatnih/executive/lookbook/ic/nimh.htm

    One of the unfortunate realities of the lack of validity of DSM is that there are many of us who have been harmed by it and we are forced into hiding because our lives could be doubly victimize if we were to publicly admit to our contact with psychiatry. My story, in case you are interested is here,

    https://www.madinamerica.com/2013/01/ny-times-invites-readers-to-a-dialogue-on-forced-treatment/#comment-19770

    Your April 29th statement that “the weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure” gave us, in the survivor community, tremendous hope in confronting the system that has ruined so many of our lives based on a lie. The panicked response by Kupfer basically agreeing with that was priceless.

    I learned with sadness that you have decided to back pedal , probably pushed by a lot of pressure from all sides. Only God knows exactly what happened and I hope that some time you’ll write a book to set the record straight.

    Nonetheless, what has happened during the last two week has been exhilarating in so many ways that many of us feel that there is no way back to the regime in which shrinks abused people for “lack of insight” into something that has not be proved to be real in the biological sense.

    My only hope is that at some point in the future you’ll have the courage to put the well being of those of us who have been abused by psychiatry ahead of your own self interest. What you did was very courageous and I believe that your legacy will be better assured if you stick by it instead of succumbing to whatever pressures made you back pedal.

    Respectfully.

  3. “Patients, families, and insurers can be confident that effective treatments are available and that the DSM is the key resource for delivering the best available care…Yet, what may be realistically feasible today for practitioners is no longer sufficient for researchers. Looking forward, laying the groundwork for a future diagnostic system that more directly reflects modern brain science will require openness to rethinking traditional categories.” -the Joint Statement.

    I think this illustrates a crucial change in DSM narrative from years past. I have been hearing for years that the DSM was mostly useful as a research document, but should not (and is not) taken seriously as a clinical one. I feel like the most serious praise the DSM endeavor had was least in having some reliability in research, even if that research was never really well applied to practice. Their statement is a reversal, saying the DSM is not a good research document (even though new domains in research have not been well developed yet), but patients, families, and clinicians should still trust and use the DSM to inform practice (which “good” clinicians and APA leaders have very frequently said they don’t do).

    I agree with cannotsay, their initial statements/reactions still stand and this new joint release is a poor attempt at double-backing.

  4. I guess it’s all part of Insel’s strategy. The damage has been done, that is all what was important to him (to gain power). Now he can pretend to be the nice guy again (to the APA). It’s FUD (fear, uncertainty and doubt).

  5. If I was on the House Committee on Energy and Commerce, I’d be looking through Insel’s investment portfolio over the next few months.

    I wonder what his price was?

    Or did the same people who gave us Chief Justice Roberts impenetrably, incomprehensible, stand it on its head Obamacare decision perhaps help Mr Insel see that light at the end of the tunnel?